John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The anatomy of the ear can be a little confusing, especially since the ear is
responsible not only for hearing, but also for balance.
There are three components to the ear: the outer ear, the middle ear and the
inner ear. All three are involved in hearing but only the inner ear is
responsible for balance.
The outer ear is composed of the pinna, or ear lobe, and the external
auditory canal. Both structures funnel sound waves towards the ear drum or
tympanic membrane allowing it to vibrate. The pinna is also responsible for
protecting the ear drum from damage. Modified sweat glands in the ear canal form ear wax.
The middle ear is an air filled space located in the temporal bone of the
skull. Air pressure is equalized in this space via the Eustachian tube which
drains into the nasopharynx or the back of the throat and nose. There are three
small bones, or ossicles, that are located adjacent to the tympanic membrane.
The malleus, incus, and stapes are attached like a chain to the tympanic membrane
and convert sound waves that vibrate the membrane into mechanical vibrations of
the three bones. The stapes fills the oval window which is the connection to the
inner ear.
Cauliflower ear (boxer's ear, wrestler's ear) is an acquired deformity of the outer ear. It is usually due to blunt trauma to the ear. When the cartilage of the ear is injured by trauma or inflammation, the blood supply from the skin is disrupted. It often forms a large pocket of blood, called a hematoma. As the injury to the ear heals it can shrivel up and fold in on itself and appear pale, giving it a cauliflower-like appearance, hence the term cauliflower ear. Wrestlers, boxers, and martial artists in particular are susceptible to this type of injury.
What causes cauliflower ear?
The ear is vulnerable to blunt trauma. When the ear is struck and a blood clot develops under the skin, or the skin is sheared from the cartilage, the connection of the skin to the cartilage is disrupted, causing cauliflower ear.
The cartilage of the ear has no other blood supply except that supplied by the overlying skin. When the skin is pulled from the cartilage, and/or separated from the cartilage by blood (as with accumulated blood from injury or inflammation) or infection, the cartilage is deprived of important nutrients. Ultimately, the cartilage dies and the risk of infection is increased.
Untreated, the ear cartilage begins to contract on itself forming a shriveled up outer ear, known as the cauliflower ear deformity. Once there is cartilage death and scarring (fibrosis), the resulting deformity is generally permanent. The ear may also appear pale, due to loss of blood supply. In some cases, cosmetic procedures may improve the appearance of the ear.
Cartilage damage may also result from piercing the upper ear in the cartilage. Piercing can lead to a type of ear cartilage infection called auricular perichondritis, which can result in cauliflower ear. An even more rare cause of cauliflower ear is from the inflammation of cartilage in relapsing polychondritis.
A hematoma is a collection of blood that is outside a blood vessel. There are different areas where hematomas occur including the inside the skull, scalp, ear, septum, bones, finger and toenails, and intra-abdominal. Treatment for hematomas depend on the type and location of the hematoma.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Hearing loss (deafness) may be present at birth or it may manifest later in life. Deafness may be genetic or due to damage from noise. Treatment of deafness depends upon its cause.
The evidence is growing and is more convincing than ever! People of all ages
who are generally inactive can improve their health and well-being by becoming
active at a moderate-intensity on a regular basis.
Regular physical activity substantially reduces the risk of dying of coronary
heart disease, the nation's leading cause of death, and decreases the risk for
stroke, colon cancer, diabetes, and high blood pressure. It also helps to
control weight; contributes to healthy bones, muscles, and joints; reduces falls
among older adults; helps to relieve the pain of arthritis; reduces symptoms of
anxiety and depression; and is associated with fewer hospitalizations, physician
visits, and medications. Moreover, physical activity need not be strenuous to be
beneficial; people of all ages benefit from participating in regular,
moderate-intensity physical activity, such as 30 minutes of brisk walking five
or more...