DISEASES OF THE EXTERNAL EAR 1.2 (AB)

Question 1

What are exostoses?

Answer 1

“Benign bony outgrowths in the periosteum.”

Question 2

What is the typical structure of exostoses?

Answer 2

“They demonstrate concentric lamellar bony organization.”

Question 3

What are common symptoms of exostoses?

Answer 3

“Often asymptomatic but may cause conductive hearing loss if obstructive.”

Question 4

What complications can arise from untreated exostoses?

Answer 4

“Infection and otalgia.”

Question 5

What is the treatment for symptomatic exostoses?

Answer 5

“Excision using a diamond burr.”

Question 6

What severe complication can arise from exostoses?

Answer 6

“Potential perforation of the tympanic membrane.”

Question 7

What is squamous cell carcinoma (SCC)?

Answer 7

“A malignant tumor that can arise from the epithelium and adnexa.”

Question 8

What percentage of external auditory canal tumors are SCC?

Answer 8

“20%.”

Question 9

What is the second most common skin cancer?

Answer 9

“Squamous cell carcinoma.”

Question 10

What percentage of malignant tumors of the auricle and EAC are SCC?

Answer 10

“80%.”

Question 11

Does SCC commonly metastasize?

Answer 11

“No. metastasis is uncommon.”

Question 12

What is the treatment for small SCC tumors?

Answer 12

“Local wide excision.”

Question 13

What is the treatment for large SCC tumors?

Answer 13

“Whole auricle is sacrificed.”

Question 14

What is the treatment for SCC with lymph node involvement?

Answer 14

“Radical en bloc resection.”

Question 15

What is a major etiological factor for SCC?

Answer 15

“Excessive UV exposure.e.g.sunbathing.”

Question 16

What is basal cell carcinoma (BCC)?

Answer 16

“A malignancy caused by the proliferation of basal cells in the epithelium.”

Question 17

How does BCC compare to SCC in terms of aggression?

Answer 17

“BCC is locally aggressive and more invasive than SCC.”

Question 18

Does BCC metastasize?

Answer 18

“No. but it is locally aggressive and can invade cartilage and bone.”

Question 19

What is the primary risk factor for BCC?

Answer 19

“Overexposure to sunlight. particularly in outdoor workers.”

Question 20

How fast can a small BCC nodule grow?

Answer 20

“It can double in size within a week and become a large necrotic mass in a year.”

Question 21

What is the treatment for BCC?

Answer 21

“Wide surgical excision similar to SCC.”

Question 22

What is a malignant melanoma?

Answer 22

“An extremely rare malignancy developing from a pigmented nevus.”

Question 23

What are signs of malignant melanoma?

Answer 23

“Sudden elevation. ulceration and bleeding of a darkly pigmented nevus.”

Question 24

What is the treatment for malignant melanoma?

Answer 24

“Wide excision.”

Question 25

What is adenoid cystic carcinoma?

Answer 25

"A malignancy arising from ceruminous glands. also called cylindroma."

Question 26

What are the clinical features of adenoid cystic carcinoma?

Answer 26

"Yellowish smooth masses with numerous dilated vessels."

Question 27

What is the primary treatment for adenoid cystic carcinoma?

Answer 27

"Surgical excision."

Question 28

What is an adenoma?

Answer 28

"A rare tumor originating from sebaceous glands in the fibrocartilaginous EAC."

Question 29

What are the symptoms of an adenoma?

Answer 29

"Small. soft. painful swelling at the meatal entrance."

Question 30

When does an adenoma become symptomatic?

Answer 30

"When it grows large enough to cause obstruction."

Question 31

What is the treatment for adenoma?

Answer 31

"Complete excision with electrocautery of the tumor bed."

Question 32

What is aural atresia?

Answer 32

"A congenital absence or severe narrowing of the external auditory canal (EAC)."

Question 33

How common is aural atresia?

Answer 33

"Occurs in 1 in 10 000 live births."

Question 34

What embryonic structures are involved in aural atresia?

Answer 34

"1st and 2nd branchial arches and 1st branchial cleft."

Question 35

How often is aural atresia bilateral?

Answer 35

"One-third of cases are bilateral."

Question 36

What complication can EAC stenosis lead to?

Answer 36

"Canal cholesteatoma."

Question 37

What are Group I external ear anomalies?

Answer 37

"Minor malformations with a mostly normal auricle and occasional EAC hypoplasia."

Question 38

What are Group II external ear anomalies?

Answer 38

"Moderate malformations like microtia and EAC hypoplasia or aplasia."

Question 39

What are Group III external ear anomalies?

Answer 39

"Severe malformations. including absent auricle and ossicles."

Question 40

What are first branchial cleft anomalies?

Answer 40

"Congenital anomalies due to failure of normal obliteration of the first branchial cleft."

Question 41

What types of abnormalities can first branchial cleft anomalies present as?

Answer 41

"Cysts. sinuses or fistulas."

Question 42

What is Type I first branchial cleft anomaly?

Answer 42

"A duplication of the membranous EAC from ectoderm of the 1st branchial cleft."

Question 43

What is Type II first branchial cleft anomaly?

Answer 43

"Contains ectoderm and mesoderm elements from the 1st and 2nd branchial arches."

Question 44

Where are Type II first branchial cleft anomalies typically located?

Answer 44

"Anterolateral neck. anterior to the SCM. often coursing over the mandible and through the parotid."

Question 45

What is the common presentation of first branchial cleft anomalies?

Answer 45

"Asymptomatic until infection occurs."

Question 46

What is the treatment for recurrent first branchial cleft anomalies?

Answer 46

"Complete surgical excision with facial nerve preservation."