A Family Doctor's Tale - EAR CANAL POLYPS

DOC I HAVE EAR CANAL POLYPS

Ear canal polyps or aural polyps are benign swellings that grow from the skin or glands of the external ear canal or from the lining of the ear drum.

Ear canal polyps occurs as a result of chronic irritation of the skin of the ear canal or eardrum usually from infections of the external ear canal.

The symptoms and signs of ear canal polyps are:
Symptoms:
1.pain in the ear


2.Itchiness


3.ear discharge


4.loss of hearing

Signs:
1.Presence of polyps in the ear canal


2.Infection in the ear canal

Diagnosis or ear canal polyps:
1.Otoscopy usually show the presence of pedunculated soft fleshy swellings in the ear canal

2.Infection may be present in ear canal with pus and debris

3.MRI or CAT SCAN may be done to exclude the presence of cholesteatoma (also a chronic infected ear cyst in the middle ear or inner ear) which can damage the bone in the inner ear and spread to the brain causing infection.

4.Ear canal polyp biopsy to exclude malignancy

The complications of ear canal polyps are:
1.Rarely Ear canal polyps may become malignant

2.In diabetes or immune deficient patients severe infections called malignant otitis externs  may spread to the mastoid and spread to the brain causing brain abscess, facial paralysis, deafness, meningitis, and osteomyelitis of the base of the
skull

Treatment of ear canal polyps is by:
1.Topical steroid cream and antibiotic ear drops

2.For chronic or repeat infections, steroid creams and white table vinegar (5% acetic acid) usually help to dissolve the polyps

3.Antifungal drops and creams are used for fungal infection.

4.Surgery of ear tubes may be necessay for ear canal Polyps developing from ear tubes if eardrop treatment is not effective.

5.Cholesteatoma-generated polyps may require drops and oral antibiotics

Some side effects of the medications used are:
1.allergic reaction


2.severe itching,


3.blistering,

4.redness,


5.thickening of the ear canal skin.

These medicines must be stopped if any of these symptoms develop.

Surgical removal of ear canal polyps may have pain and bleeding as side effects.

Prognosis of Ear canal polyp is:
In most cases, the infection and the ear canal polyp should resolve with treatment

Recurrence of the ear infection is common.
Reappearance of symptoms of ear discharge, hearing loss, bleeding, and itching may indicate the underlying infection has recurred.

In these cases, maintenance steroid drops, vinegar irrigations, or antifungal agents may be needed.