29/06/2026
Aural Polyps
Fleshy, vascular growth from middle ear cleft or EAC mucosa — often signals serious underlying pathology
& Predisposing Factors
1.CSOM — most common; chronic mucosal inflammation → tissue proliferation
2.Cholesteatoma — keratinizing mass irritates mucosa → granulation tissue
3.Foreign body / local trauma — retained objects or mechanical irritation (self-cleaning)
4.Malignancy — rarely, SCC or glomus tumor may mimic a simple polyp
1.Chronic irritation (infection / friction / osteolysis) → local inflammation
Disrupted healing → overproduction of vascularized, edematous granulation tissue
2.Granulation mass → covered by squamous/columnar epithelium → polypoid pedicle
3.Pedicle protrudes through TM perforation into EAC
4.Polyp matrix enzymes → osteoclastic activity → ossicular erosion
Features
Symptoms
1.Foul-smelling, blood-stained otorrhea (bleeds easily — high vascularity)
2.Conductive hearing loss — progressive, ipsilateral
3.Aural fullness — sensation of blockage/pressure
Signs
1.Smooth, pinkish-red, fleshy/globular mass filling EAC
2.May completely obscure tympanic membrane
3.Exquisitely friable — bleeds on gentle probe touch
1.Micro-suction & Probing-Polyp arises from middle ear cleft, not canal wall
-Differentiates from furuncle/exostosis; localizes stalk root
2.HRCT Temporal Bone-Soft tissue in middle ear ± scutum/ossicular erosion-Identifies cholesteatoma vs chronic mucosal disease
4.Pure Tone Audiometry-Moderate-severe CHL with air-bone gap-Mass blocks canal + ossicular chain dampening/erosion
5.Histopathology (Biopsy)-Vascular stroma + chronic inflammatory cells + epithelium-Rules out malignancy, TB, granulomatous disease