Atheroma behind the ear

The entire area of the auricle includes many sebaceous glands, they are also present in the area behind the ear, where lipomas, papillomas, fibromas, including atheroma behind the ear, can form.

Subcutaneous fatty tumors can form in the ear and auricle area; almost all of them are characterized by slow growth and benign course.

Statistically, a tumor in the parotid area is diagnosed in only 0.2% of cases of benign neoplasms in the facial area. Much more common are cysts and tumors of the auricle, especially its lobe. This is due to the structure of the ear, which mainly consists of cartilaginous tissue, the fatty layer is only in the lobe, which does not contain cartilage.

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Causes of atheroma behind the ear

It is believed that the main reasons for the appearance of atheroma as a blockage of the sebaceous gland duct are metabolic disorders or hormonal imbalances. Indeed, the accumulation of secretion of the glands of external secretion (glandulae sebacea) can be provoked by excessive production of hormones, but there are also other factors. For example, the causes of atheroma behind the ear can be as follows: •

• Excessive sweating due to a malfunction of the autonomic nervous system, which regulates the excretory systems and can provoke dysfunction of internal organs.
• Seborrhea, including of the scalp.
• Acne - simple, phlegmonous, most often in the upper neck area.
• Incorrect piercing, ear piercing and compensatory redistribution of sebum from damaged and scarred sebaceous glands.
• Diabetes mellitus.
• Endocrine diseases.
• Head injury with damage to the skin in the ear area (scarring).
• A specific oily type of skin.
• Excessive production of testosterone.
• Hypothermia or prolonged exposure to direct sunlight.
• Violation of personal hygiene rules.

In general, the causes of atheroma, including that formed behind the ear, are due to the narrowing of the sebaceous gland duct, a change in the consistency of the sebaceous secretion, which becomes denser, and obturation of the narrowing end. At the site of blockage, a cystic cavity is formed, in which detritus (epithelial cells, cholesterol crystals, keratinized particles, fat) slowly but steadily accumulates, thus, the atheroma increases and becomes visible to the naked eye, that is, it begins to manifest itself in a clinical sense.

Symptoms of atheroma behind the ear

Atheroma, regardless of its location, develops asymptomatically in the first few months, that is, it is not accompanied by pain or other discomfort. Symptoms of atheroma behind the ear are also not specific, the retention neoplasm grows very slowly, the duct of the sebaceous gland remains open for some time and part of the sebaceous secretion is excreted onto the skin, outward. Gradually, the accumulating detritus changes consistency, becomes thicker, viscous, it is this that clogs both the gland itself and then its outlet.

Symptoms of atheroma behind the ear may be as follows:

• The tumor is round in shape and small in size.
• The cyst can be easily felt under the skin as an elastic, fairly dense formation, generally not fused with the skin.
• Atheroma has a capsule and a mushy secretion inside (detritus).
• Sebaceous gland retention cyst is prone to inflammation and suppuration.
• A characteristic distinguishing feature by which atheroma is distinguished from lipoma is a partial adhesion to the skin in the area of the enlarged cyst cavity and the presence of a small, barely noticeable exit in the form of a dark dot (in the case of purulent inflammation - a white, convex dot).
• Due to partial, point adhesion, the skin over the cyst cannot be gathered into a fold during palpation.
• An enlarging atheroma behind the ear may be accompanied by itching and a burning sensation.
• Purulent atheroma manifests itself with typical symptoms of a subcutaneous abscess - reddened skin over the cyst, local increase in temperature, pain.
• A suppurating atheroma is prone to spontaneous opening, when the pus flows out, but the main part of the cyst remains inside and again fills with detritus.
• An inflamed atheroma may be accompanied by a secondary infection, when the symptoms become more pronounced - increased body temperature, headache, fatigue, weakness, nausea.

Despite the fact that the symptoms of atheroma behind the ear are non-specific and appear only in the case of a sharp increase in the subcutaneous cyst, the tumor can be noticed when performing hygiene procedures (washing). Any atypical seal for the ear area, "ball" or "wen" should be shown to a doctor - dermatologist, cosmetologist to determine the nature of the neoplasm and choose a method for its treatment.

Atheroma behind the ear in a child

Atheroma in a child may be a congenital neoplasm, which is most often benign. Also, sebaceous gland cysts are often confused with lipomas, subcutaneous furuncles, dermoid cysts or enlarged lymph nodes.

The appearance of true atheromas in children is associated with increased production of sebum, which is normalized by the age of 5-6 years, then during puberty, repeated hypersecretion of the sebaceous glands is possible, when detritus (cholesterol crystals, fat) accumulates in the ducts. Less often, the cause of the formation of atheroma behind the ear in a child can be elementary poor hygiene. And very rarely, the provoking factor is an attempt to independently "do a hairdo" for a child, that is, an unskilled haircut with damage to the hair follicles.

Atheroma behind the ear, both in a child and an adult, does not manifest itself with pain or other discomfort, except in cases of inflammation and suppuration. Then the cyst looks like an abscess, often very large. The abscess can open up to the outside, but the atheroma capsule remains inside, so the only way to get rid of it can only be surgery.

If the atheroma is small, it is observed until the child reaches 3-4 years of age, then the cyst is subject to enucleation. For children under 7 years of age, all surgical procedures of this kind are performed under general anesthesia, for older patients, cyst removal is performed under local anesthesia. The operation itself lasts no more than 30-40 minutes and is not considered complicated or dangerous. Moreover, such treatment saves the child not so much from a cosmetic defect, but from the risk of atheroma suppuration and possible complications from such a process - internal infection of soft tissues of the head, phlegmon and infection of the ear in general. The most effective new method is radio wave "evaporation" of atheroma, which does not involve tissue dissection, respectively, no scar remains on the skin, this method is considered reliable in terms of eliminating the slightest chance of cyst recurrence, therefore, it also guarantees the effectiveness of the treatment.

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Retroauricular atheroma

A postauricular atheroma, cyst, as well as other subcutaneous neoplasms, is an extremely rare phenomenon in maxillofacial surgery. This area is very poor in fat, so the formation of lipoma, atheroma occurs in no more than 0.2% of all benign neoplasms in the head area.

A sebaceous gland retention cyst behind the ear may resemble a salivary gland adenoma, which is diagnosed much more often. In any case, in addition to the initial examination and palpation, an X-ray and ultrasound of the nearby lymph nodes are also necessary, possibly even an MRI or CT (computer tomography).

If the doctor suspects that the patient is developing a benign atheroma behind the ear, the cyst is excised without waiting for inflammation or suppuration. During the operation, the tissue material is necessarily sent for histology, which confirms or refutes the initial diagnosis.

It is quite difficult to distinguish an atheroma from a lipoma behind the ear by external signs; both neoplasms are painless, have a dense structure and are practically identical in visual symptoms. The only exception may be a barely noticeable point of the sebaceous gland duct, especially if its obturation occurred closer to the skin. More specific is an inflamed atheroma behind the ear, which manifests itself as pain and a local increase in temperature. With a large, suppurating cyst, the general body temperature may increase and symptoms typical of subcutaneous abscesses or phlegmon may appear. A purulent atheroma can spontaneously open inside, in the subcutaneous tissue; this condition is extremely dangerous not only for the health (spillage of pus into the internal auditory canal, into the cartilaginous tissue of the auricle) of the patient, but sometimes even for life, as it threatens systemic intoxication and sepsis.

Removing an atheroma behind the ear has its own difficulties, since there are many large blood vessels and lymph nodes in this area. The cyst is operated on in the so-called "cold period", that is, when the neoplasm has already increased in size, but has not become inflamed and has no signs of secondary infection. The removal procedure does not take much time, new medical technologies, such as laser or radio wave excision of neoplasms, are absolutely painless and allow you to avoid a rough scar on the skin and relapses.

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Atheroma of the earlobe

A sebaceous gland cyst can only form in an area rich in glandulae sebaseae – alveolar glands that secrete sebum or greasy, fatty secretion that protects the skin and gives it elasticity. The ear is almost entirely made of cartilaginous tissue and only its lobe has similar internal glands and a subcutaneous fat layer. Thus, it is in this area that a retention neoplasm or atheroma of the earlobe can develop.

The cyst develops without obvious clinical manifestations, since the gland ducts in the lobe are very narrow, and the gland itself does not actively produce sebum. The most common cause of the formation of an atheroma of the earlobe is considered to be an unsuccessful puncture or injury to this area (laceration, other injuries). The ear is not a hormone-dependent part of the body, so the usual factors that provoke atheroma (metabolism disorders, puberty or menopause) have little effect on its appearance.

Reasons for the formation of atheroma of the earlobe:

• Infection of the piercing hole (poorly treated skin or instruments), inflammation of the sebaceous gland.
• An inflammatory process at the site of the earlobe puncture, a microabscess that compresses the sebaceous gland duct.
• Incomplete healing of the puncture site and an increase in granulation cells, tissue that compresses the sebaceous gland duct.
• A lacerated wound of the earlobe due to a head injury, bruise, or keloid scar compresses the sebaceous glands, disrupting the normal secretion of sebum.
• Hormonal disorders (rare).
• Heredity (genetic predisposition to obstruction of the sebaceous glands).

Symptoms that a subcutaneous cyst may signal may be the following:

1. The appearance of a small lump on the earlobe.
2. The cyst does not hurt at all and does not cause discomfort; the only thing it can cause is an external, cosmetic defect.
3. Atheroma often becomes inflamed, especially in women who wear jewelry on their ears (earrings, clips). Often a secondary infection joins the cyst, bacteria penetrate into a small opening of the sebaceous gland, which is already clogged with detritus, and as a result an abscess develops in the lobe.
4. A subcutaneous cyst in this area is rarely large, most often its maximum is 40-50 millimeters. Larger cysts are abscesses, which almost always open up on their own, with the purulent contents leaking out. Despite the decrease in the size of the atheroma, it remains inside as an empty capsule, capable of accumulating sebaceous secretion again and recurring.

Atheromas are always treated surgically, an earlobe cyst should be removed as early as possible, small neoplasms are excised within 10-15 minutes, the entire operation is performed on an outpatient basis. A small scar after enucleation of an atheroma is practically invisible and cannot be considered a cosmetic defect, unlike a really large, inflamed cyst, which, among other things, is prone to suppuration and carries a potential threat of developing an earlobe abscess.

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Atheroma of the auditory canal

The external auditory canal of the ear consists of cartilage and bone tissue, sulfur and sebaceous glands are located in the skin, therefore, atheroma of the auditory canal is diagnosed in patients quite often. This area is difficult to access for daily hygiene procedures, blockage of the excretory ducts by both sebaceous secretion and secreted cerumen (sulfur). Subcutaneous neoplasms of the auditory canal develop due to the specific localization of the glands. The canal is covered with skin, on which the smallest hairs grow, with which, in turn, numerous sebaceous glands are closely associated. Under the alveolar glands are glandula ceruminosa - ceruminous ducts that produce sulfur. Some of these glands have ducts connected to the excretory ducts of glandulae sebaseae (sebaceous glands), thus, their obturation one way or another periodically occurs as an inevitable condition of the hearing apparatus. However, for the formation of a retention cyst, that is, an atheroma, other factors are also needed, for example the following:

• Infectious diseases of the ear, inflammation.
• Ear injuries.
• Endocrine dysfunctions.
• Metabolic disorder.
• Disorders of the autonomic nervous system.
• Hormonal disorders.
• Violation of personal hygiene rules or injury to the ear canal during independent attempts to remove earwax.

Diagnosis of atheroma of the external auditory canal requires differentiation, since other tumor-like formations, including inflammatory or malignant ones, can be detected in this area. Atheroma should be separated from the following pathologies of the auditory canal:

• Furuncle.
• Acute otitis of the external auditory canal (mainly staphylococcal in nature).
• Fibroma.
• Ceruminous gland tumor - ceruminoma or atenoma.
• Capillary hematoma (angioma).
• Cavernous hemangioma.
• Dermoid cyst (more common in infants).
• Lymphangioma.
• Chondrodermatitis.
• Adenoma of the auditory canal.
• Lipoma.
• Myxoma.
• Myoma.
• Xanthoma.
• Epidermoid cholesteatoma (keratosis obturans).

In addition to collecting anamnesis and initial examination, diagnostics may include the following methods:

• X-ray examination.
• CT scan of the skull.
• Dermatoscopy.
• Ultrasound examination.
• Cytological examination of a smear from the ear.
• Otoscopy (examination of the internal auditory canal using a special device).
• Pharyngoscopy (as indicated).
• Microlaryngoscopy (as indicated).
• Angiography (as indicated).
• If symptoms of hearing loss are present, audiometry is performed.
• A histological examination of the tissue material taken during atheroma surgery is mandatory.

The symptoms of a retention neoplasm of the sebaceous gland in the ear canal are more specific than the manifestations of a common atheroma in another area of the body. Even a small cyst can cause pain, affect audiometric parameters of hearing, and provoke a headache. An inflamed atheroma, prone to suppuration, is especially dangerous. Spontaneous opening of a purulent formation, one way or another, infects the ear canal and carries the risk of infection of deeper structures of the auditory apparatus, so any atypical neoplasm in this area requires immediate medical attention.

Removal of an atheroma of the auditory canal is considered a fairly simple procedure; as a rule, the cyst is localized in a place accessible to a surgical instrument. Enucleation of an atheroma is performed within 20-30 minutes under local anesthesia and often does not require suturing, since cysts in this area are not capable of increasing to gigantic sizes, that is, they do not require a large incision for enucleation.

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Diagnosis of atheroma behind the ear

Benign neoplasms of the ear are much more common than malignant tumors, but despite their quantitative superiority, they have been studied less well. As for cysts and tumor-like formations of the subcutaneous tissue, the only differential method is still histological examination, the material for which is taken during surgical removal of the cyst.

Accurate diagnosis of atheroma behind the ear is important, since retention cysts are not much different in appearance from the following diseases:

• Fibroma.
• Chondroma.
• Papilloma.
• Internal furuncle of the subcutaneous tissue.
• Lymphangioma at the initial stage of development.
• Lipoma.
• Wart.
• Lymphadenitis.
• Dermoid cyst behind the ear.

Recommended methods that should be included in the differential diagnosis of atheroma behind the ear:

• Collection of anamnesis.
• External examination of the area behind the ear.
• Palpation of the neoplasm and regional lymph nodes.
• X-ray of the skull.
• Computed tomography of the skull.
• It is advisable to perform an otoscopy (examination of the internal auditory canal).
• Ultrasound of the lymphatic zone in the area of atheroma.
• Cytology of smears from the internal auditory canal.
• Biopsy with histological examination of the material (usually taken during surgery).

In addition to an otolaryngologist, a dermatologist and possibly a dermato-oncologist should be involved in diagnostic measures.

Before removing an atheroma, the following tests are usually prescribed:

• OAC – complete blood count.
• Biochemical blood test.
• Urine analysis, including sugar.
• Chest fluorography.
• Blood on RW.

Atheroma behind the ear, although considered a benign neoplasm, not prone to malignancy, due to its specific localization and tendency to inflammation, should be determined as accurately and specifically as possible, therefore additional diagnostic methods, no matter how complex they may be, are considered necessary to eliminate the risk of an erroneous diagnosis.

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Treatment of atheroma of the earlobe

The earlobe is a typical place for the formation of a retention cyst, since the ear itself (in the concha) has few sebaceous glands, it consists entirely of cartilaginous tissue. Treatment of atheroma of the earlobe involves the use of several methods, but all of them are surgical. Such operations are completely painless, the procedure is performed under local anesthesia, general anesthesia is indicated for small children under 7 years old.

It should be noted that no method of conservative therapy, especially folk recipes, are able to dissolve the cyst due to its structure. The atheroma capsule is quite dense, the contents are a thick sebaceous secretion with inclusions of cholesterol crystals, therefore, even by reducing the size of the neoplasm or provoking the opening of the suppurating cyst, it will be impossible to get rid of its relapse.

Treatment of earlobe atheroma is carried out using the following surgical methods:

1. Enucleation of atheroma with the help of a scalpel. Under local anesthesia, a small incision is made, the contents of the cyst are squeezed out onto an old napkin, the capsule is excised completely within healthy tissues. The suture on the earlobe after the operation remains minimal and heals within one and a half months.
2. The laser method of cyst removal is considered effective if the tumor is small and has no signs of inflammation.
3. The most effective is the radio wave method, which gives a 100% result in terms of eliminating relapses. In addition, this method does not require tissue trauma and suturing, a miniature incision heals after 5-7 days, and a small scar dissolves within 3-4 months

Whatever method of treating atheroma behind the ear the attending physician chooses, during the procedure the cyst tissue is necessarily sent for histological examination to exclude the potential risk of possible complications.

Treatment of atheroma behind the ear

Wherever the atheroma is located, regardless of its localization, it is removed only by surgery. So-called folk methods or proposals to treat a retention cyst with external medications do not produce results, and sometimes even delay the process, as a result, the atheroma becomes inflamed, suppurates and turns into an abscess, which is much more difficult to remove, and the operation leaves a visible postoperative scar.

Since the treatment of atheroma behind the ear involves cutting tissues near the location of large blood vessels and lymph nodes, the patient undergoes a preliminary detailed examination and health diagnostics. In general, such operations are classified as minor surgery, however, the localization of atheroma requires the doctor's attention. The more thoroughly the procedure is performed, the lower the risk of possible relapses, to which sebaceous gland retention cysts are so prone.

Today, there are three generally accepted methods for neutralizing atheroma:

• The traditional, surgical method, when the cyst is excised with a scalpel. This method is considered quite effective, especially in relation to purulent atheromas. An inflamed cyst requires initial opening and drainage. Then it is treated symptomatically, after all signs of the inflammatory process have gone away, the atheroma is completely excised. After such operations, a scar inevitably remains, which is successfully “hidden” by the auricle itself or hair.
• A more gentle method is laser removal of atheroma, which is effective if the cyst does not exceed 3 centimeters in diameter and has no signs of inflammation. An incision is made in any case, but it is simultaneously coagulated, so such operations are practically bloodless, are carried out quickly, and the suture dissolves within 5-7 days.
• The most popular method in the last 5 years has become the radio wave method of removing subcutaneous cysts and other benign formations in the ear and head area. With the help of a "radio knife" the cyst cavity together with the capsule is "evaporated", while the tissue incision is minimal, accordingly there is no postoperative scar or cosmetic defect.

No other method, neither cauterization nor application of compresses, will give a therapeutic result, so you should not be afraid of surgery, which must be performed as early as possible to avoid the risk of inflammation or suppuration of the atheroma.

Atheroma behind the ear is a benign neoplasm that is almost impossible to prevent, but with the achievements of modern medicine it is quite easy to neutralize. It is only necessary to consult a doctor in time, undergo a comprehensive diagnosis and decide on a completely painless procedure.