What should I pay attention to when taking an ear sample for auricular abnormalities?

Referral should be recommended if severe inflammation, redness, swelling, or excessive foreign body are found at the time of earmold removal. Wait until the condition improves.

If the ear canal is damaged or the eardrum is perforated, the patient should be explained in time to avoid unnecessary medical disputes.

Otoscopy should be done to see if there is a cavity after surgery. If so, the cavity should be filled with a large or multiple cotton barrier to prevent the ear from being removed after coagulation. If this happens, you should seek help from an ear specialist.

If a patient is found to have a lump or cavity in the wall of the ear canal, after taking the ear impression, the ear impression should be marked on the ear impression and explained in the order to prevent the engineer from mistakenly thinking that the air bubble will polish it off or fill it, causing uncomfortable or swelling pain for the hearing impaired.

The size of the barrier should be determined according to the size of the patient's ear canal. If it is too large, the user is prone to discomfort when stuffed in, and it is not easy to stuff in; It is too small to completely fill the wall of the external auditory canal, and it is easy to be damaged by the earprint material through the obstruction. If necessary, a cotton ball can be soaked in medical paraffin oil before being placed in the external auditory canal to increase comfort.

When mixing the ear material, the action should be fast (should be completed within 15 seconds), the mixing should be uniform, and the ear print material will solidify quickly in summer due to the high temperature.

Observe whether the pinna of the ear is too active with the chewing motion. If so, the patient should be asked to bite the tongue depressor or finger while preparing the earprint material.

1.Pay attention to the removal technique gently and do not break: during the removal of the impression, it must be operated in order, and the technique must be gentle, so as to avoid the increase of negative pressure and damage to the patient's periosteum or break the ear canal.

After the earmold, it is difficult to remove the part of the ear canal that remains in the ear canal, so you need to get the help of a higher level of care professional or consult an otolaryngologist to solve it.

2.Check the external auditory canal again after taking out the impression: after taking out the impression, the external auditory canal should be re-checked for whether there is a cotton barrier or ear print material remaining, whether it has caused damage to the patient, etc., if the above abnormalities are found, it needs to be dealt with in time.

For those who have no ears or have severe deformities of the auricle, the impression sampling of patients with hidden ears is no different from that of ordinary people, but it must be noted in the impression sampling sheet that it is forbidden to take ear samples when there is acute inflammation of the auricular surface, auricular laceration and purulent perichondritis, and if the auricular pseudocyst is in the auricular cavity, auricular chamber, triangular fossa and other parts, try to avoid wearing the eardrum, if it must be worn, it should be noted in the impression sampling sheet, and the auricular malignant tumor should not be taken in principle.

What should I pay attention to when removing impotence? The doctor will tell you.

If it is found that the external auditory canal is incomplete, the tympanic membrane is perforated or missing and there is a surgical cavity, special care should be taken to place the cotton barrier correctly, the cotton barrier has the effect of protecting the tympanic membrane, and preventing the impression material from being injected too deeply, the position of the cotton barrier should reach or exceed the second bend 1mm, depending on the specific type of hearing aid worn, the size of the cotton barrier should be determined according to the cross-sectional area of the patient's external ear canal, and the cotton barrier should be able to contact the wall around the external auditory canal, otherwise the impression material is easy to cross the cotton barrier and hurt the tympanic membrane or cause difficulty in removal, The barrier should not be too large, as it can be placed too shallow or cause pain.

Whether the cotton barrier can be filled, whether the wall of the external auditory canal has collapsed, whether it is placed in the correct position, whether it is too deep, or whether it does not reach 1-2 mm in the 2nd bend of the external auditory canal.

Inquire about the medical history in detail, find out whether the patient has an ear infection in the last 3 months, whether he has undergone surgery, whether he has suffered from sudden deafness, etc., carefully examine the external auditory canal, completely remove cerumen and foreign bodies in the ear canal, observe the structure of the external auditory canal with an electric otoscope, and make a cotton barrier that matches the ear canal if the ear canal is narrow, such as the enlargement of the external auditory canal and the tympanic chamber or the enlargement of the external auditory canal and the tympanic chamber, tympanic sinus and mastoid cavity are integrated, which is often manifested as a small cavity of the ear canal, first use a cotton ball to fill the enlarged tympanic chamber, tympanic sinus and mastoid cavity, Reshape the ear canal to prevent incarceration and fracture after the impression is formed, which makes it difficult to remove the ear impression, and ensure that the part of the ear canal that is taken out is aligned with the tympanic membrane.

It is necessary to pay attention to whether the ear canal is small on the outside and large on the inside, so it is not easy to take ear samples, and the ear occluder should also be used large, otherwise it cannot be blocked.

1 All people have two sets of auditory conduction pathways to produce hearing, which are air conduction and bone conduction. Air conduction is through the external auditory canal and tympanic membrane to vibrate the ossicles and reach the inner ear to produce hearing; Bone conduction is the direct vibration of sound waves from the skull to produce hearing through the inner ear. In microtia, bone conduction is normal, so hearing on the affected side is normal.

The crux of the problem is air conduction, because the external auditory canal is atresia and the middle ear is deformed, the air conduction pathway is blocked, and the patient's hearing threshold on the affected side is between 40 and 60 dB (normal 0-20 dB). Fortunately, most patients with microtia are unilateral ear deformities, the unaffected ear is normal, and the affected ear itself also has part of the hearing, so in addition to having a certain impact on auditory positioning, it has basically no impact on daily life, work and study. There is a dry scab in the external auditory canal, and the patient is reluctant to wear it. Even if the hearing problem is corrected by surgical ear canal treatment, the hearing of the affected ear can only be partially improved, but it is far from the hearing of the unaffected ear, so even if the hearing is still dependent on the unaffected ear after the ear canal is beaten, it seems that the ear canal is of little significance.

In fact, most of the patients with unilateral microtia also wear bone bridge or Baha bone conduction hearing aids to improve their hearing, and it is recommended that patients with unilateral microtia are implanted with bone pont bone conduction hearing aids to improve their hearing after auricular reconstruction surgery, so that the effect is better. This is currently the best way to improve hearing for patients with unilateral microtia.

During embryonic development, the outer and middle ears originate from the same tissue mass, mainly the first and second branchial arches. However, the inner ear has another unique tissue origin. As a result, microtia patients also have deformities in the middle ear and normal inner ear, so microtia patients also have partial hearing on the affected side (bone conduction hearing).

However, it is important to note that if the patient has atresia of the external auditory canal and middle ear deformity, the hearing threshold on the affected side is as high as 40 to 60 dB (normal 0 to 20 dB).

Fortunately, most patients with microtia have a normal ear on the unaffected side, and the affected ear itself also has some hearing, so the affected ear has basically no effect on the patient's daily life and learning, except for a slight impact on auditory positioning.

Surgery to correct hearing problems involves avoiding the facial nerve and making a hole in the bone, and tissue grafting to form the eardrum, but the deformed, fused ossicles may not be repaired. There are also many problems with skin grafting in the bone tunnel, and there is often a chronic discharge after surgery, followed by infection and an unpleasant odor, and the opening of the bone hole (external auditory canal) is often narrowed. In the absence of complications, the patient's hearing has improved in the near term, but the long-term effect is unlikely to be sustainable.

After microtia correction, patients should avoid water in the ear canal and cannot swim. In view of the above-mentioned surgical limitations and wound healing issues, most doctors in the world believe that there are postoperative risks and complications in middle ear surgery, so it is only used for patients with bilateral microtia.

About Hearing Questions Hearing is the primary concern of parents when they counsel. They either think that the affected side has no hearing at all, or they think that they can recover hearing after the hole, or even think that as long as the ** is cut open, there will be an ear canal inside, etc. In fact, they all made conceptual mistakes, which have to be explained in terms of embryonic development.

The ear is made up of three parts: the outer ear, the middle ear, and the inner ear. The outer ear consists of the pinna and the external auditory canal; The inner ear is composed of a snail-like cochlea, which acts like an electronic system, transmitting information through the auditory nerve to the brain to form hearing. The middle ear is an air-containing cavity in between, with three ossicles, the malleus, the incus and the stapes, forming a movable chain of ossicles.

During embryonic development, the outer and middle ears originate from the same tissue mass, mainly the first.

1. Second branchial arch tissue; However, the inner ear has another unique tissue origin. Therefore, microtia patients also have deformities in the middle ear at the same time, but the inner ear is normal, so microtia patients also have partial hearing on the affected side (bone conduction hearing). The crux of the problem is air conduction, because the external auditory canal atresia and middle ear deformity have a hearing threshold of 40 to 60 dB (normal 0 to 20 dB).

Fortunately, most microtia patients have a normal ear on the unaffected side, and the affected ear itself also has some hearing, so except for a slight impact on auditory positioning, there is basically no impact on daily life and learning.

Does microtia have a big impact on hearing? According to experts, generally speaking, about 40% of the hearing on the affected side of unilateral microtia deformity, coupled with normal hearing on the unaffected side, except for a little worse in judging the direction, it does not have much impact on language pronunciation and daily life, so whether to undergo external auditory canal surgery to enhance hearing in such patients has always been controversial, and the main reason for opposition is that there are many surgical complications, the degree of hearing improvement is very small and often not long-lasting. In recent years, with the advancement of technology, otologists are more inclined to surgery.

There are also differences between otologists and plastic surgeons on the sequence of surgery, the lack of elasticity of ear reconstruction will affect the surgical operation of otologists, but after external auditory canal surgery, the mastoid area is often scarred, which affects the plastic surgeon to make full use of the place ** for auricular reconstruction, but as long as the position of the reconstructed ear is left well, experienced otologists can also perform hearing reconstruction surgery after auricular reconstruction surgery.

As long as there is no abnormality in the inner auditory canal, microtia can restore hearing after correction, experts remind us that we should choose a formal and authoritative plastic surgery institution for correction when correcting microtia, so that the postoperative effect will be more obvious.

Generally speaking, about 40% of the hearing on the affected side of unilateral microtia is abnormal, and the hearing on the unaffected side is normal, except for a slight difference in the direction of judgment, it does not have much impact on language pronunciation and daily life. In recent years, with the advancement of technology, otologists are more inclined to surgery. There are also differences between otologists and plastic surgeons on the sequence of surgery, the lack of elasticity of ear reconstruction will affect the surgical operation of otologists, but after external auditory canal surgery, the mastoid area is often scarred, which affects the plastic surgeon to make full use of the place ** for auricular reconstruction, but as long as the position of the reconstructed ear is left well, experienced otologists can also perform hearing reconstruction surgery after auricular reconstruction surgery.

As long as there is no abnormality in the inner auditory canal, microtia can restore hearing after correction, experts remind us that we should choose a formal and authoritative plastic surgery institution for correction when correcting microtia, so that the postoperative effect will be more obvious.

<1> Everyday noise:

It is best not to exceed 85 decibels of daily noise (comparable to traffic noise on busy roads).

Precautionary measures: When drying your hair with a hair dryer, it is best to use the lowest setting while wearing earplugs; When using a juicer, blender, or coffee grinder, use a clean rag or towel to reduce noise; Wear earplugs when using a lawn mower; Keep the volume low when listening, up to 1 hour a day.

2> Ambient Noise:

Director Wu Jianming said: ** meetings, fireworks, sports events and other activities will produce huge noise, and many people are unprepared for this, which can easily lead to auditory nerve damage.

Precautionary measures: Elderly and children should have earplugs on hand when participating in activities that may cause loud noise.

3> Pick your ears:

The accumulation of earwax (earwax) can easily block the ear canal, leading to temporary hearing damage, and frequent ear picking may also damage the ear canal and affect hearing.

Precautionary measures: Do not constantly pick your ears with ear pickers, hairpins or matchsticks, etc., as the ears usually have a "self-cleaning function" and the earwax will fall off naturally.

4> allergies:

Nasal congestion caused by colds or allergies can cause the ear canal, which regulates the pressure, to become swollen and blocked, causing temporary hearing loss.

Precautionary measures: Go to the hospital, the doctor will prescribe appropriate medication according to the condition to control allergies and prevent edema in the middle ear area.

5> Ignoring symptoms such as tinnitus:

Some patients ignore the symptoms of hearing loss for a long time and do not seek medical attention promptly**.

Precautionary measures: Seek medical attention as soon as you notice the cause of frequent tinnitus. Tinnitus can be the first sign of a serious illness and should not be taken lightly.

If it does not affect the inner ear, you can have auricular reconstruction, but if it has affected your hearing, you need to choose a hearing aid to help you.

As long as there is no abnormality in the inner auditory canal, it is possible to restore hearing after microtia correction.

It is recommended that you go to a regular medical institution for consultation, and the doctor will give you a reasonable plan based on your deformity.