A unique case is presented of a penetrating injury of the parotid gland and complete transection of the cartilaginous portion of the external auditory canal by a tree branch. A subsequent superficial parotidectomy along with end-to-end anastomosis of the external auditory canal and appropriate antimicrobial therapy was successful. A review of the literature did not reveal any previous similar cases.

Until now, little was known about the mode of parotid involvement in external auditory canal (EAC) carcinoma. The incidence of parotid node metastasis and direct parotid invasion was examined in patients with EAC carcinoma. The study comprised 11 patients with squamous cell carcinomas (SCC) and 10 patients with adenoid cystic carcinomas (ACC). A retrospective review of the surgical specimens was undertaken with specific reference to parotid node metastasis and parotid invasion. Parotid node metastasis was noted only in two cases of advanced staged SCC, whereas none of the ACC patients showed parotid node metastasis. Direct parotid invasion occurred only in advanced staged SCC,however, it did occur in early stage ACC. Our data indicated that elective parotidectomy for control of occult parotid node metastasis is necessary only in advanced SCC carcinoma, whereas parotid management to secure adequate safety margins is mandatory for advanced SCC and all cases of ACC.

Keratosis obturans is a rare condition characterized by the accumulation of desquamated keratin material in the bony portion of the external auditory canal. Classically, it is reported to present with severe otalgia, conductive deafness and global widening of the canal. A case of keratosis obturans is described in which the principal symptom was a metallic taste and the main finding was extensive erosion of the hypotympanum with exposure of the facial nerve and the annulus of the tympanic membrane. This presenting symptom and resorption pattern are atypical of keratosis obturans and have not been documented previously.

Most otolaryngologists treat patients with chondrodermatitis nodularis (CDN) by wedge excision. Although the results of this technique are generally good, it can leave the patient with an asymmetric, deformed ear.

In the dermatological literature, a relatively straightforward technique has been described for the treatment of CDN by smoothing only the underlying cartilage. This is based on the assumption that CDN is caused by pressure necrosis of protuberant cartilage, and thus is primarily not a skin disease. Reports on this technique claim excellent cosmetic results with only a small chance of recurrence.

In the present study we analyse the application of this technique to 34 patients with 37 CDN lesions. All patients were symptom-free with a minimum follow-up of three months according to their medical reports.

Seventeen patients with 19 lesions were interviewed later by telephone. In a mean follow-up of 30.7 months, 34 of these patients remained symptom-free and only one required revision surgery. The authors recommend this safe and simple technique to other physicians who treat patients with CDN.

Prominent ears are the most frequent congenital deformity in the head and neck area. Otoplasty has undergone important developments and numerous techniques have been employed to address the anatomical defects, namely the lack of antihelix and the overdevelopment of the concha. We present a cartilage-sparing technique involving scapha – conchal sutures insertion to recreate the antihelix, conchal setback and cartilage weakening. No cartilage is excised. Prior to creating the antihelix, the medial surface of the cartilage is superficially scored. Occasionally a tangential excision of the posterior prominence of the cartilage prior to the placement of set back sutures is employed for an excessively large conchal bowl. A series of 86 consecutive patients underwent otoplasty with this technique. According to our experience the described technique gives good and predictable long-term results with a natural-appearing ear. Significant complications are rare. In case of loss of correction, revisional surgery is straightforward on the intact pinna cartilage.

The ability of superglue (a cyanoacrylate adhesive) to bond strongly and quickly to skin presents considerable problems when it is inserted into the ear. A case of a patient who inadvertently self-administered Bostik superglue into her left external auditory meatus is reported. The superglue was removed successfully, in the form of a cast, with warm three per cent hydrogen peroxide without damaging the meatus or the typanic membrane. The use of hydrogen peroxide to remove superglue from the ear has not been described previously.

The available data on the effect of human wet cerumen on bacterial growth are not conclusive. Nevertheless it is widely accepted that cerumen has a bactericidal effect.

In this study the activity of human wet cerumen on bacterial growth was assessed by applying cerumen suspensions to bacterial cultures. Bacterial counts were performed before and after application of cerumen suspensions. A total of 383 assays was carried out with 73 pools of cerumen that were tested against cultures of Staphylococcus aureus, Staphylococcus epidermidis, Corynebacterium spp., Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa and Serratia marcescens.

An increase in growth occurred much more frequently than a decrease in growth in almost every microrganism tested, with the mean increase percentage being much higher than the mean decrease percentage, except in the case of S. aureus.

The largest average growth increase was obtained with E. coli. The largest average decrease in bacterial growth was recorded with S. marcescens.

Our study does not support the conception of a decrease in bacterial growth produced by humen wet cerumen. In vitro, the most observable effect was in fact an increase in microbial growth.