BOIL IN THE EAR

WHERE DOES IT OCCUR?

BOILS always occurs in the cartilaginous part of the external auditory meatus,because only the cartilaginous part contains hair follicles.

WHAT ARE THE CAUSES OF BOIL?

Following are the causes of boil in the ear :

1)Scratching or cleaning of the ear causes laceration of skin and hair follicle becomes infected.

2)Repeated infection from one boil to another.

3)Patient with low resistance.

4)Diabetic patients.

WHAT IS THE CAUSATIVE ORGANISM?

Infection is caused by Stayllococcus aureus and albus and reaches the hair follicles.

WHAT ARE THE SYMPTOMS?

1)Pain, at first it is mild, severe, finally becomes excruciating.

2)Temperature.

3)Blood stained scanty discharge if boil ruptures.

4)Painful mastication.

5)Ear is painful on touching.

6)There may or may not be deafness. If there is deafness that is slight because of blockage of meatus.

WHAT ARE THE SIGNS?

1)Painful manipulation of pinna.

2)The oedematous and narrow meatus.

3)Localised and red raised visible area.

4)Post -auricular swelling because of cellulitis. The swelling is pitting on pressure because of accumulation of lymph.

5)The displacement of Pinna outwards or forwards in severe cases.

6)Tympanic membrane , nose and throat are normal.

7)Temperature.

8)Hardly any deafness.

WHAT IS THE TREATMENT?

1)MEDICAL TREATMENT:

A)GENERAL TREATMENT:

a) Relieve pain by analgesics (Aspirin or morphine).

b) Control the infection by giving Antibiotics (Penicillin or Terramycin).

B)LOCAL TREATMENT:

a) Application of heat (foamentation) by dry heat or from infra red lamp.

b) Apply local medication to decrease inflammation by 10% Icthyl glycerine in the form of drops or Wicks. The advantage of putting Wicks is that :

i) It remains in constant touch with meatus.

ii) It prevents approximation of inflammatory and healthy portion.

iii) Wicks acts as dilators.In about 2-3 days inflammation subsides.

c) Gentle Cleaning of ear.

2)SURGICAL TREATMENT:

This should be done when boil is pointing or real abscess has formed.Incision for abscess should be along the axis of meatus and not vertical because of the danger of stenosis of meatus. Never incise unripe boil, otherwise inflammation will spread to other tissues.

3) GENERAL TREATMENT:

i) Improve general health of the Patient.

ii) No scratching.

iii) If patient is Diabetic, treat accordingly.

WHAT ARE THE COMPLICATIONS OF BOIL?

i) Multiple boil formation.

ii) The inflammation reaches the cartilage leading to Perichrondritis and Chrondritis.

iii) Post-aural abscess.

iv) Regional Lymphadenitis due to the involvement of Lymph glands.

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