The external auditory canal (ear canal) is lined with hair-bearing skin and is part of the external ear (see Chapter 1).

Congenital Anomalies

The external ear canal may be poorly developed or even absent. This can be an isolated anomaly, but it is more often part of a significant deformity of the external ear, sometimes involving the middle ear and rarely the inner ear (microtia; see Chapter 5). The child may also be deaf and management can be very difficult as a conventional hearing aid will not fit in the ear canal. If the child has some inner ear (cochlear) hearing function he/she may need a bone anchored hearing aid (BAHA). This is fitted behind the ear on to a titanium screw which is attached to the skull (Figure 7.1).

Inflammation and Infection

The skin of the external ear is sensitive and can be exposed to water, pathogens and trauma from, for example, hair clips and cotton buds which many patients and parents will use to clean the ear canals and to attempt to remove wax. The main clinical features of inflammation of the external ear are pain, itching and discharge.

Skin Disorders 

Eczema, psoriasis and skin allergies may all involve the external ear canals. The treatment is that of the underlying disorder, but applying topical treatment to the inflamed external ear canal can be difficult because of pain and swelling.

Otitis Externa 

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