Features of the structure of the external ear and their influence on the course and methods of correction of inflammatory and scar adhesive processes

Abstract

Structural features of the extarnal ear form a number of factors that affect the course of inflammatory and scar processes. A strong difference in the structure of the external ear requires an individual approach, taking into account their structure. To maintain normal functioning, the external ear has specialized defense mechanisms, such as the presence of ceruminous glands, a weak acidic environment with bactericidal properties, a special epidermal migration mechanism aimed at self-cleaning the lumen of the auditory canal. But in addition to protective factors, the structure of the external ear has features that contribute to the development of a long-term inflammatory process. The data of studies describing the features of the narrowing of the of the cavity external auditory canal, both due to age-related changes in the auricle and due to the bending of the walls of its bone section. The shape of the external auditory canal affects not only the visualization of ear structures, but also the course of the inflammatory process. In the case of the development of scar and adhesive changes in the external auditory canal, this leads to a significant hearing loss. The main principles of the methods developed by the authors for the elimination of scar changes in the external auditory canal, depending on the localization in its departments, are described. In addition to the direct elimination of cicatricial changes, it is mandatory to eliminate the places of maximum narrowing of the external auditory canal with the expansion of its cavity, the formation of a skin lining, taking into account the complexity of epithelialization and the need to restore protective mechanisms. An important role in maintaining the effectiveness of treatment is played by the correct choice of tamponade and stenting for a long time. To correct the inflammatory process and prevent excessive formation of connective tissue, injections of ultra-long-acting glucocorticosteroids are used, carried out directly at the site of scar formation. Such an integrated approach to the correction of scars in the external auditory canal, taking into account the peculiarities of its structure, allows achieving high treatment results (up to 80 %), preventing the recurrence of the adhesive process and prolonged inflammation.