Department of Otolaryngology-Head and Neck Surgery, University of Illinois Chicago, Chicago, Illinois.
Otol Neurotol. 2024 Sep 1;45(8):e581-e587. doi: 10.1097/MAO.0000000000004280.
To report a common site of external ear canal erosion in multiple pathologies, located inferiorly at 6 o'clock.
Otology patients who came in 2023 for treatment of external auditory canal erosions.
This clinical capsule is an observational report of the external canal's propensity to erosion at the 6 o'clock location. Patient treatments were canalplasty, mastoidectomy, and medical management.
Documentation of the propensity to erosion at the 6 o'clock location in the external auditory canal. Locations of the niduses of prior series of external auditory canal pathologies are documented.
Eight patients are presented with external auditory canal erosion in 10 ears originating at the 6 o'clock position medial to the bony-cartilaginous junction. No other patient with spontaneous canal erosion presented with their nidus of pathology in another canal location. (A review of 42 case series of 291 patients found that keratosis obturans and bisphosphonate-induced osteonecrosis tended to arise from the same 6 o'clock lateral bony canal location, while 26% of necrotizing otitis externa cases arose there.).
The "6 o'clock spot" in the external canal is a common location of canal erosion for spontaneous wax and keratin collections and may be the precursor to keratosis obturans, bisphosphonate-induced osteonecrosis of the ear canal, and necrotizing otitis externa.
报告多种病变中外耳道侵蚀的常见部位，位于 6 点钟位置下方。
2023 年来就诊治疗外耳道侵蚀的耳科患者。
本临床胶囊是对外耳道在 6 点钟位置易发生侵蚀的观察性报告。患者接受了耳道成形术、乳突切除术和药物治疗。
记录外耳道在 6 点钟位置侵蚀的倾向。记录先前系列外耳道病变的病灶位置。
8 名患者的 10 只耳朵出现外耳道侵蚀，起源于软骨-骨交界处内侧的 6 点钟位置。没有其他自发性耳道侵蚀患者的病变病灶位于另一个耳道位置。（对 42 例病例系列研究的 291 名患者进行回顾，发现角化过度和双膦酸盐诱导的耳骨坏死往往起源于同一 6 点钟外侧骨道位置，而 26%的坏死性外耳炎病例起源于该处）。
外耳道的“6 点钟位置”是自发蜡质和角蛋白堆积导致的耳道侵蚀的常见部位，可能是角化过度、双膦酸盐诱导的耳骨坏死和坏死性外耳炎的前兆。
