Swelling in the ear

Introduction Patients with middle ear cancer have a feeling of bloating in the ear in the early stage and obvious pain in the late stage. Middle ear cancer is a malignant cancer that occurs in the middle ear. It accounts for 1.5% of ear tumors and 0.06% of systemic tumors. In most patients, the posterior wall of the middle ear or the external auditory canal has granulation or polypoid tissue growth, which blocks the ear canal and is prone to bleeding.

Cause

First, patients with viral infections have a history of upper respiratory tract infection within one month before onset. It is reported that the incidence of sudden onset of upper respiratory tract infection is 8% to 30%. It has been confirmed by serological and viral isolation methods that the virus that causes abrupt mutations includes mumps virus, measles virus, influenza and parainfluenza virus, adenovirus type III, etc., which can cause viral endolymphatic labyrinth, herpes zoster. The virus can cause viral neuronitis and ganglion inflammation. The path of infection of the virus into the inner ear is: 1 through the blood circulation into the inner ear. 2 The subarachnoid space enters the inner ear through the cochlear aqueduct. 3 diffuse into the inner ear through the middle ear mucosa. After infection, the virus proliferates a lot, adheres to red blood cells, makes the blood flow stagnate and is in a hypercoagulable state, and the virus can cause endometrial edema, so it is easy to cause blood vessel embolism, resulting in inner ear blood flow disorder and cell necrosis.

Second, inner ear vascular disease in patients with diabetes, hypertension, arteriosclerosis and cardiovascular disease, the inner ear vascular matrix is more prone to spasm and thrombosis. This can explain why patients are induced by factors such as fatigue and anxiety. In recent years, some people have observed blood lipids, cholesterol and blood flow maps in patients with sudden onset, and have not found any important factors related to the onset. Wright (1975) reported a case of sudden onset of cardiopulmonary bypass surgery. Zhong Naichuan (1980) reported two cases of erythrocytosis-induced axillary sputum in the northwestern plateau, an example of a sudden convulsion caused by embolization of the inner ear.

Third, the inner ear window membrane rupture, sneezing, vomiting, sexual intercourse and diving, etc., can cause venous pressure and cerebrospinal fluid pressure suddenly increased, in addition to causing rupture of the snail window, vestibular window membrane, can also cause vestibular membrane, laminar and The endolymphatic sac rupture, and the potential congenital inner ear malformation is more likely to occur, which can cause lymphatic ion disorder and cell poisoning. There is too much lymphatic fluid in Meniere's disease, which can also cause rupture of the volute window and sudden axon.

an examination

Related inspection

Ear, nose, throat swab bacterial culture Otolaryngology CT examination

Bloody ear leaks, deafness, and swelling in the ear are often early symptoms. Then there is deep ear pain, radiating to the ankle and occiput. In most patients, the posterior wall of the middle ear or the external auditory canal has granulation or polypoid tissue growth, which blocks the ear canal and is prone to bleeding. Carcinomas originate from the drumsticks or mastoids. In the early stage, facial paralysis and dizziness can occur. In the late stage, difficulty in opening the mouth and symptoms of V, VI, IX, X, XI, and XII are found. Cervical lymph node metastasis can occur on the affected side or both sides, as well as in the visceral or skeletal. X-ray film or CT examination of the skull base and the humerus can indicate the extent of cancerous erosion, which can be confirmed by pathological examination, and the treatment can be selected according to its type. In addition, taking the secretions of the external auditory canal for exfoliation is also helpful for diagnosis.

Differential diagnosis

Differential diagnosis of swelling in the ear:

1. The mass at the ear hole: Some people will have two hard masses in the area of the ear hole, and the longer they grow. Medically, this mass is called "keloid" and is the most special type of scar.

2, mastoid edema after the ear: mastoid edema after the ear is the clinical symptoms of acute suppurative mastoiditis. There is a continuous mucosal phase between the middle ear mastoids, and there is an inflammatory reaction in the mastoid mucosa after the middle ear purulent infection. The initial stage is catarrhal, the mastoid area may have mild tenderness, the perforation of the tympanic membrane is pus, the mastoid The inflammatory response disappears. If the drainage is not smooth, or type III pneumococcal infection, the toxicity is very strong, destroying the bone, so that the mastoid small mucosa edema, hemorrhage, necrosis, it becomes acute suppurative mastoiditis, actually the follow-up of acute otitis media It should be called acute suppurative otitis media.

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