Aural Polyps: Definition, Causes, Symptoms, and Treatment

Otic Polyp: Polypoid Lesion Which is A Growth In The External Ear Canal

Aural polyps are usually reddish, smooth mucosa-covered, painless lesions that originate from the middle ear and protrude into the external ear canal. There is usually a condition that causes chronic irritation in the middle ear, such as chronic otitis media or cholesteatoma. As seen in the photo above, in a patient with chronic suppurative otitis media with cholesteatoma, inflammatory discharge from the external ear canal can also be seen along with the polyp. Patients may have symptoms such as long-standing hearing loss and inflammatory discharge from the ear.

What is an Aural Polyp?

An ear polyp is a fleshy lesion that appears in the external ear canal, middle ear or eardrum. It is usually associated with chronic ear infections, cholesteatoma or other inflammatory disorders of the ear that can cause long-term mucosal irritation in the middle ear. Rarely, it can also occur due to middle ear tumors. Aural polyps can gradually grow and block the external ear canal and cause hearing problems to increase. They usually cause patients to see a doctor because they are worried when they are visible.

Causes of Aural Polyps

Otic polyps occur due to conditions that cause long-term irritation and inflammation in the middle ear. If these causes continue, their size and the amount of symptoms they cause increase. Aural polyps are usually caused by the following:

Chronic Ear Infections: Recurrent or untreated middle ear infections can cause persistent inflammation and cause aural polyp formation. If the polyp completely blocks the external ear canal, the middle ear infection can flare up and the polyp can grow.

Trauma: Injuries to the ear canal or eardrum caused by physical trauma or surgical procedures can cause aural polyps.

Foreign Bodies: The presence of objects in the ear canal and middle ear can cause irritation and inflammation, leading to the development of aural polyps.

Underlying Conditions: Cholesteatomas or tumors can cause chronic inflammatory processes in the middle ear to accelerate, leading to the development of aural polyps.

Symptoms of Aural Polyps

As aural polyps grow, the symptoms they cause may increase. These symptoms include:

- Persistent feeling of ear congestion

- Hearing loss or a feeling of fullness in the ear.

- Persistent ear discharge (especially in patients with cholesteatoma, the usually foul-smelling ear discharge, which resembles sewage, may get on patients' pillows while they sleep).

- Structural changes, deterioration or irritation in the ear canal.

- Occasional bleeding from the outer ear due to bleeding from the polyp

Diagnosis of Aural Polyps

Aural polyps can be easily diagnosed by otolaryngologists. What is needed to diagnose ear polyps:

Ear examination: An otoscope or microscope can be used to examine the ear canal and eardrum, allowing for easy diagnosis.

Hearing Tests: Audiometric tests can be performed to determine the effect of the polyp on hearing. When aural polyps completely fill the external auditory canal, conductive hearing loss can be clearly seen.

Imaging Methods: Thin-section temporal bone tomography or MRI may be requested to investigate underlying cholesteatoma, chronic suppurative otitis media, or possible tumoral masses that may cause aural polyps.

Ear Discharge Culture Antibiogram Test: Although this test can be helpful in treatment, it is not very valuable in terms of diagnosis. Laboratory analysis of ear discharge can identify infections or other problems.

Here is a photo of me and my surgical team. I would like to thank all of them for their support. Our patient had chronic suppurative otitis media with cholesteatoma and aural polyp for a long time. We performed a modified radical mastoidectomy and aural polypectomy on the patient under general anesthesia. I wish him a disease-free and healthy life. There is a risk of facial nerve injury during these surgeries and the quality of the microscope, other surgical materials, the surgeon's mastery of anatomy and experience are very important.

Treatment Options for Aural Polyps

In the treatment of aural polyps, various treatments can be planned for both the polyp and the underlying condition. Aural polyp treatment includes the following:

Drug Therapy

Antibiotics: Oral or topical antibiotics can be used to treat infections.

Steroids: Can be used as local drops to reduce inflammation and shrink the polyp.

Surgical Treatment

Aural Polypectomy: Removal of the polyp with a minor surgical procedure. Unless the underlying condition is corrected, polyp development may occur again. It may not be sufficient for treatment alone.

Most patients with aural polyps have underlying chronic otitis media, cholesteatoma. In these patients, mastoidectomy operations can be performed to clean the diseased middle ear and areas within the mastoid bone. In the adjacent photo, the initial mastoidectomy cavity is seen after the incision made behind the auricle at the beginning of the modified radical mastoidectomy operation (the image may be disturbing for some patients, it opens in a larger size when you click). After this stage, the bone drilling process is continued with the help of a drill and the cavity is expanded.

Treatment of Underlying Conditions: Surgical treatments can be performed for cholesteatoma, chronic otitis media or, although rare, tumoral masses. The patient I shared with you above underwent modified radical mastoidectomy + polpectomy procedures. In this patient, cholesteatoma and inflammatory soft tissues in the middle ear and mastoid cells were cleaned during the operation.

Supportive Care

Regular cleaning of the ear canal by a professional. If necessary, it may be useful to shrink the polyp using acid boric powder.

Avoiding irritating substances such as water or foreign objects entering the ear.

Recommendations for Preventing the Development of Aural Polyps

It may be useful for patients who have previously been treated for aural polyps or who have newly developed aural polyps to consult their ear specialist and pay attention to the following recommendations:

- Rapid treatment of ear infections under the supervision of an ENT doctor

- If there are symptoms of chronic otitis, it is essential to be followed by an ENT specialist

- If there is a perforation in the eardrum, water or other liquid contact with the ear should be prevented

- Avoiding inserting objects into the ear canal

- Protecting the ears from excessive moisture

- Treating allergies and sinus disorders well, as they can facilitate the development of ear infections

When Should You Seek Medical Help from an ENT Doctor?

If you experience persistent ear pain, discharge or hearing loss, you should consult an ENT specialist. In the presence of foul-smelling ear discharge and inflammatory ear discharge, the opinion of the ENT specialist is very important. Early intervention can prevent complications and improve outcomes.

Ear polyps, although usually noncancerous, can cause significant discomfort and hearing problems in the long term if left untreated. Early treatment planning is important.

Similar links >> Link where you can read articles on chronic otitis media and similar subjects >> https://www.ent-istanbul.com/search?q=chronic+otitis+media

Source links >> A Clinicopathological Study of Aural Polyps: A Retrospective Analysis in a Tertiary Care Hospital - PMC / Aural polyps: MedlinePlus Medical Encyclopedia

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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