Background and Objective: To design and fabricate a suction port adapter to use various sizes of suction cannulas with a wireless otoendoscope enabling ear cleaning under endoscopic guidance demonstrated using an ear examination simulator. Methods: Design: Instrument Innovation. Setting: Tertiary Private Training Hospital. Patient: Ear Examination Simulator. Results: The fabricated suction port adapters were able to hold the wireless otoendoscope and suction cannulas together, allowing simultaneous inspection of the ear canal and suctioning of ear canal debris using the Ear Examination Simulator. Conclusion Our prototype 3D-printed suction port adapters for a wireless otoendoscope may improve ear cleaning by enhancing the accuracy of suctioning debris and decreasing duration since they hold the suction cannulas in place under endoscopic guidance. They may aid ENT physicians in easier visualization and simultaneous ear cleaning of patients and improve ear cleaning techniques and times, especially among less experienced physicians, but actual clinical trials are needed to confirm this.
Printing, Three-Dimensional ; Cerumen ; Otoscopy

BACKGROUND: Axillary osmidrosis is caused by excessive secretion of apocrine sweat, which causes foul odor and extreme social embarrassment. Axillary osmidrosis can be treated by a number of methods, but surgery is the treatment of choice. OBJECTIVE: The purpose of this study was to evaluate clinical results of surgical treatment for axillary osmidrosis by the bipedicle flap method and CO2 laser. METHODS: December 1995 and December 2002, 53 patients with axillary osmidrosis were treated by the bipedicle flap method and with CO2 laser. Post-operative complications and convalescent time in the patients (106 axillae) were then of evaluated. Among them, 37 patients were followed up for a minimum 6 months, and the patients were asked to complete a questionnaire on their family history, aggravation factors, association with wet ear wax or palmoplantar hyperhidrosis, degree of satisfaction, decreased sweating, decreased axillary hair, tension on motion, and scarring. RESULTS: Follow-up ranged from 6 to 84 months (mean: 41months). Thirty one (83.8%) out of 37 patients were satisfied or partially satisfied with the results. Six (16.2%) out of 37 patients were dissatisfied. Post-operative complications were seen in 27 (25.5%) out of 106 axillae. The average convalescent time was 18 days. CONCLUSION: Based on the long-term evaluation, this bipedicle flap method and CO2 laser treatment were found to be effective for axillary osmidrosis.
Axilla ; Cerumen ; Cicatrix ; Follow-Up Studies ; Hair ; Humans ; Hyperhidrosis ; Lasers, Gas* ; Odors ; Questionnaires ; Sweat ; Sweating

BACKGROUND AND OBJECTIVES: Impacted cerumen is a common condition in adults. It is commonly believed that wearing hearing aids may increase the cerumen impaction, although no empirical evidence exist. The current study was aimed at studying if the use of hearing aids increase the likelihood of impaction of cerumen. SUBJECTS AND METHODS: The study used retrospective design. The study sample included 164 consecutive patients who were referred to cerumen clinic from Royal Glamorgan Hospital, Wales. Audiologist classified the cerumen impaction into four categories (i.e., no cerumen; non-occluding cerumen; occluding cerumen; and fully non-occluding cerumen and debris). Chi-square analysis was performed to study the association between hearing aid use and cerumen impaction. RESULTS: The current study results showed no association between hearing aid use and cerumen impaction. Also, there was no association between right/left ear and cerumen impaction. CONCLUSIONS: These results interesting and contrary to our assumption that hearing aid use increases the likelihood of cerumen impaction. More well-controlled studies with prospective designs are needed to confirm if these results are accurate.
Adult ; Cerumen* ; Ear ; Hearing Aids* ; Hearing Loss ; Hearing* ; Humans ; Prospective Studies ; Retrospective Studies ; Wales

BACKGROUND: Pityrosporum yeast is a resident microflora of the normal skin and abundant in seborrheic dermatitis. In pathologic conditions, pityrosporum yeast is converted into hyphal form. Previous studies showed that this hyphal form could be found on clinically normal skin too. OBJECTIVES: We compared the incidence of Pityrosporum infection of the external ear canal in normal controls with that in patients with seborrheic dermatitis. METHODS: Seborrheic dermatitis, 258 subjects and normal person, 362 subjects were studied. Ear wax specimens were stained with 20% Parker ink-KOH(P-KOH) solution. The number of pityrosporal hyphae were graded according to hyphal index(1+ to 3+). RESULTS: The incidence of Pityrosporum infection of the external ear canal is 28.7% in patients with seborrheic dermatitis and 24.6% in normal controls, Amounts of pityrosporal hyphae are similar between two groups too. According to age group, incidence of PV of the external ear canal in patients with seborrheic dermatitis is statistically significantly higher than in normal controls. Female with seborrheic dermatitis have more Pityrosporum infection of the external ear canal than normal female controls. Pityrosporum infection of the external ear canal in patients with seborrheic dermatitis is prevalent in summer and spring in contrast to normal controls who have high incidence in spring. Among patients with Pityrosporum infection of the external ear canal, asymtomatic cases amount up to 70%. CONCLUSION: The results of this study showed that the incidence of Pityrosporum infection of the external ear canal in patients with seborrheic dermatitis and normal person is similar, but according to the age, sex and season, there were some differences between two groups.
Cerumen ; Dermatitis, Seborrheic* ; Ear Canal* ; Ear, External* ; Female ; Humans ; Hyphae ; Incidence* ; Malassezia ; Seasons ; Skin ; Yeasts

BACKGROUND: Although the wet earwax has been known to be related with the incidence of tinea versicolor, very little has been revealed on how they are correlated with each other. The incidence of Malassezia furfur, the etiological organism of tinea versicolor, and its population densities as yearst and mycelial form in the different types of earwax, the dry and the wet, have not been studied. METHODS: The type of earwax in 65 patients with tinea versicolor were classified into 2 types, dry and wet, by its appearence and the subjective complaints of the patients. The dry and wet cerumens were obtained from 142 and 49 individulas without tinea versicolor respectively. The cerumens were stained with 10% Parker ink-KOH solution. The incidence and its population densities of yeast and mycelial M. furfur in the wet cerumens were compared with those in the dry cerumens according to a new grading method using bacterial index(BI) of lepra bacilli. RESULTS: 1. Dry and wet earwax were observed in 58.5%(38 cases) and 41.5%(27 cases) of 65 patients respectively. 2. The incidence of yeast M. furfur in the dry and wet cerumens were 100% and 63.3%(31 of 49 cases) respectively, and that of mycelial M. furfur, 28.2%(40 of 142 cases) and 32.7%(16 of 49 cases) respectively. 3. The population densities(from 3+ to 6+) of yeast M. furfur in the dry and wet cerumens were ob served in 93.0%(132 of 142 cases) and 49.0%(24 of 40 cases), and those(3+) of mycelial M. furfur, 21.1%(30 of 142 cases) and 24.5%(12 of 49 cases) respectively. CONCLUSION: The incidence(41.5%) of wet earwax in tinea versicolor patients is significantly higher than that(0.8%) in The Korean control group. The ratio between the incidence of mycelial M. furfur and that of yeast M. furfur in the wet cerumens is higher than in the dry cerumens, and the ratio of population densities in the wet cerumens is also higher. These observations suggest that the skin surface conditions of the wet earwax group may be more suitable for yeast-mycelial transformation of M. furfur than those of the dry earwax group. The comparison of chemical compositions of the skin surface between dry and wet earwax groups is needed to elucidate the correlation between tinea versicolor and the types of earwax in the future.
Cerumen ; Humans ; Incidence* ; Malassezia* ; Population Density* ; Skin ; Tinea Versicolor* ; Tinea* ; Yeasts

PURPOSE: To examine the effect of unilateral otitis media and unilateral cerumen occlusion of the ear canal on thermometers. METHODS: One hundred eighty six children with unilateral otitis media, fifty children with unilateral cerumen occlusion, and fifty children with neither otitis media nor cerumen were enrolled. Temperature was measured in both ear canals using thermometers. After 15 minutes, second temperature was measured again in both ears. Unilateral otitis media was graded by video otoscope for 7 grades. Differences in temperatures between affected ears and unaffected ears were analyzed. RESULTS: No temperature difference between the normal and cerumen groups was observed. The mean temperature of the otitis media ear canal was 0.13+/-0.20degrees C higher than that of the intact ear canal (36.99+/-0.54degrees C vs 36.86+/-0.52degrees C; P<0.001). There was no statistically significant temperature difference between grades. CONCLUSION: Unilateral otits media can affect estimation of body temperature measured by thermometers.
Body Temperature ; Cerumen ; Child ; Ear ; Ear Canal ; Humans ; Otitis ; Otitis Media ; Otoscopes ; Thermometers

To investigate the difference of dry ear wax and wet ear wax, the lipid composition of wet ear wax was analyzed and compared with that of dry ear wax. In dry ear wax, squalene, steryl esters, wax esters, triglycerides free fatty acids and cholesterol were found. Squalene, triglycerides, free fatty acids and cholesterol formed the main demonstrable fractions in wet ear wax. In addition, three unidentified spots were always present in wet ear wax. Our results indicate that wet ear wax is due to the difference of quantity and composition of ear wax lipids.
Cerumen/metabolism* ; Ear Canal/metabolism ; Ear Diseases/metabolism* ; Human ; Lipids/metabolism*

BACKGROUND AND OBJECTIVES: This study was designed to isolate bacteria and fungi from healthy ear canal in Koreans and compare with known pathogens. SUBJECTS AND METHOD: Specimens were collected from the external ear swab and cerumen of 45 healthy volunteers from February 2003 to May 2003. RESULTS: Forty-five subjects were cultured. In 8 subjects, we failed to obtain enough cerumen. Three canal and 11 cerumen showed no growth. Forty-two canal specimens yielded 72 microorganisms, of which 84.7% were gram positive bacteria. Twenty-six cerumen specimens yielded 43 microorganisms and 76.7% of them were gram positive. Staphylococci was 76.4% of canal bacteria and 74.4% of cerumen bacteria. In both canal and cerumen, the most commonly isolated microorganism was Staphylococcus capitis. Coryneform bacteria were 6.9% of bacteria in canal and were not isolated from cerumen. Two Aspergillus species and one Penicillium species were isolated from canal and cerumen. CONCLUSION: Coagulase-negative staphylococcus (CNS) were found to be the predominant microorganism and, in particular, Staphylococcus capitis was the most commonly isolated microorganism from the normal external auditory canal in Koreans.
Aspergillus ; Bacteria ; Cerumen ; Ear Canal* ; Ear* ; Ear, External ; Fungi ; Gram-Positive Bacteria ; Healthy Volunteers ; Penicillium ; Staphylococcus

OBJECTIVES: The earwax (cerumen) that covers external auditory canal (EAC) skin contains a mixture of ceruminous and sebaceous gland substances, such as lipids, peptides, and proteins. The components secreted from the ceruminous gland that is a modified sweat gland form cerumen and contain several antimicrobial factors. Since substance P (SP) and calcitonin gene-related peptide (CGRP), known as a secretagogue, have been found in sweat glands, our purpose was to determine the expression of SP and CGRP in the glands of EAC skin. METHODS: Sections of normal human EAC skins were immunostained for the presence of SP and CGRP using polyclonal antibodies. Immunoreactivity was detected using an avidin-biotin peroxidase complex method. RESULTS: SP staining was found in ceruminous gland acini and myoepithelial cells. But the SP staining was not found in the sebaceous glands and epidermal region. CGRP was strongly stained in the ceruminous gland and weakly in the sebaceous gland cells. Interestingly, most prominent staining of SP and CGRP was noted in the myoepithelial cells of the ceruminous gland. CONCLUSION: The findings in this study suggest that SP and CGRP are expressed in the glands of the EAC skin and secreted in the process of ceruminous gland secretion.
Antibodies ; Calcitonin Gene-Related Peptide* ; Calcitonin* ; Cerumen ; Ear Canal* ; Humans ; Methods ; Peptides ; Peroxidase ; Sebaceous Glands ; Skin* ; Substance P* ; Sweat Glands

BACKGROUND: Otomycosis is a mycotic disease of the external auditory meatus. Aspergillus is the most common pathogen. Despite the fact that a great number of fungi are considered as the cause of otomycosis, otomycosis due to dermatophytes occurs with great rarity. OBJECTIVE: The purpose of this study was to investigate clinical and mycological features of dermatophytosis in the external auditory meatus. METHODS: We performed a clinical and mycologic analysis of 17 patients who had been clinically and mycologically diagnosed with dermatophytosis of the external auditory meatus. In addition, amplication of TRS-1 and TRS-2 of the ribosomal DNA nontranscribed spacer was performed on strains of Trichophyton (T.) rubrum and T. raubitshcekii which were isolated from skin lesions of the external ear and cerumen in 6 patients. RESULTS: The ratio of male to female patients was 1.4:1. The age of patients were 6 to 72 and mean age of onset is 36.4. Eleven patients had concomitant dermatophytosis of other sites. Tinea unguium was combined in 7 cases, tinea pedis in 4 cases, tinea corporis in 3 cases, tinea manus in 2 cases and tinea cruris in 1 case. The positive rate of KOH examination was 88.2% and the positive rate of fungal culture on PDAC media was 88.2%. The most common organism cultured was T. rubrum (80.0%), followed by T. raubitschekii (13.3%) and T. mentagrophytes (7.7%). Ten patients were treated with topical terbinafine and seven patients with oral itraconazole, so all patients were cleared of fungi from the external auditory meatus and inflammation was resolved. With TRS-1 and TRS-2 amplication, 4 of 5 pairs of T. rubrum and 3 strains of T. raubitshcekii showed the same types regardless of the site in each patient. CONCLUSION: Dermatophytosis occurs rarely in the external auditory meatus but we experienced 17 cases of dermatophytosis at this site. With suspected otomycosis, dermatophytosis of the external auditory meatus and concomitant dermatophytosis must be investigated and treated simultaneously to prevent any recurrence.
Age of Onset ; Arthrodermataceae ; Aspergillus ; Cerumen ; DNA, Ribosomal ; Ear, External ; Female ; Fungi ; Humans ; Inflammation ; Itraconazole ; Male ; Onychomycosis ; Otomycosis ; Recurrence ; Skin ; Tinea Pedis ; Tinea* ; Trichophyton