Introduction (Definitions/Classification): A collection of blood or tissue under the perichondrium of the external ear separates the cartilage of the ear from the nutrient-rich perichondrial layer. Fibrosis from cartilage necrosis, incomplete evacuation of clotted blood, or infection leads to a deformity resembling a cauliflower; hence the common term “cauliflower ear.” Auricle hematoma is commonly encountered in participants of contact sports such as boxing, rugby, martial arts, and wrestling; usually a consequence of a traumatic blow to the auricle.

Introduction (Definitions/Classification): Bacterial infection of the external auditory canal is the most common form of external otitis. Common pathogens include Pseudomonas aeruginosa and Staphylococcus aureus. Predisposing factors include the following.

History and Physical Examination: Individuals typically have a history of recurrent external otitis, and may present with a history of either tympanic membrane perforation or ear surgery. Common symptoms include discharge, earache, pruritus, and change in hearing acuity. Tinnitus or vertigo may be present in more severe cases. Physical examination typically reveals the following.

Introduction (Definitions/Classification): Mucosal infection or inflammation of the middle ear. Eustachian tube obstruction or dysfunction leads to accumulation of fluid in the middle ear which is a precursor for infection or inflammation. Streptococcus pneumoniae is the most common bacteria implicated in adults. Several viruses may induce otitis media in children. Various pathologic variants include the following.

History and Physical Examination: Individuals typically have a history of seasonal allergies or an upper respiratory infection preceding the following symptoms and signs.

Introduction (Definitions/Classification): A type of dizziness, with a sense of “spinning,” “swaying,” or “tilting” “movement” while stationary. It is not a disease but a symptom of numerous underlying disorders that affect vestibular function (balance and equilibrium). It is two to three times more common in women. Common causes in “otherwise healthy individuals” include the following.

History and Physical Examination: All except BPPV, usually associated with nausea and vomiting.

Introduction (Definitions/Classification): Commonly known as “pink or red eye;” caused by inflammation of the “conjunctiva,” which covers the eyeball and lines the inner portion of eyelids. Etiologic factors include the following.

History and Physical Examination: Chemosis (conjunctival edema), erythema, discharge, morning “eyes stuck,” and “lid crusting” are typical features, yet not useful in distinguishing different types of conjunctivitis. Other differentiating features may include the following.

Introduction (Definitions/Classification): Common eyelid diseases encountered in athletes include the following.

Introduction (Definitions/Classification): Defect of the corneal epithelium. Common causes in athletes include the following.

Introduction (Definitions/Classification): Wing or triangular shaped, proliferation of conjunctival tissue of unclear etiology. Pathogenic factors include genetic predisposition, viral (human papilloma virus), ultraviolet light (UV), and immunologic alterations. Commonly in athletes exposed to sun and wind for prolonged durations.

Introduction (Definitions/Classification): Blood in the anterior chamber of the eyeball induced by trauma.

Introduction (Definitions/Classification): Parting of the retinal pigment epithelium and choroid from the neurosensory retinal layer with resultant ischemia of the retina, progressive degeneration of photoreceptors, and loss of vision. Caused by either

Introduction (Definitions/Classification): Inflammation of the paranasal sinuses and nasal mucosa of less than 4 weeks duration. Thus, more appropriately termed “acute rhinosinusitis.” Classified as:

Introduction (Definitions/Classification): Inflammation of the nasal mucosa marked by paroxysms of sneezing, rhinitis, and itchy eyes.

Introduction (Definitions/Classification): The nose is the most commonly injured area of the face. Logically, nasal trauma is more common during participations in contact sports. Injuries include the following.

Introduction (Definitions/Classification): Contact sports increase risk for orofacial injuries including fracture, tooth avulsion, luxation, with subsequent complications such as abscess formation. Time is of the essence in treating dental injuries.

Introduction (Definitions/Classification): “Recurrent aphthous stomatitis” or “canker sores” is a common finding in the second to fourth decades of life, and can cause significant discomfort. They are not contagious or sexually transmitted. They typically resolve spontaneously within 2 weeks.

Diagnosis: Made by clinical examination.

Treatment: Little evidence exists for medicines used to decrease rate of recurrence.

Introduction (Definitions/Classification): Otherwise known as “strep throat (ST),” inflammation of the pharynx and tonsils caused by primarily group A beta-hemolytic streptococcus (GAS). Less common etiologies include group C and group G streptococci. Duration of illness is 2 to 5 days in untreated patients.

History and Physical Examination: Patients will present with an array of symptoms so it is important to discern if there exists a concern for streptococcal etiology. Have a high suspicion for GAS if two or more of the following are present (think FEAT).

Overlapping signs and symptoms that are suggestive of a viral etiology include the following.

Complications include the following.

Introduction (Definition/Classification): Known as “mono” or “the kissing disease,” IM is a widespread illness spread by saliva. The most common etiology is the EBV. Peak incidence is 10 to 24 years of age. Complications may include involvement of any organ, yet more common problems include the following.

Diagnosis: Established by a combination of clinical and laboratory data.

Introduction (Definitions/Classification): A peritonsillar abscess (PTA or “quinsy”) is the most common infection of the head and neck in adults. An acute pharyngitis causes local inflammation or cellulitis which compresses nearby salivary ducts. Complete obstruction leads to an abscess. The etiology is polymicrobial with a predominance of GAS although Fusobacterium necrophorum is much more widespread than previously thought in adolescents and young adults.

History and Physical Examination: History of recent pharyngitis or tonsillitis is common. Inquire about recurrent infections, previous abscesses, and symptoms concerning for airway compromise.

Presenting signs and symptoms:

Complications include the following.

Diagnosis: Consider imaging for epiglottitis, retropharyngeal abscess, or airway compromise, which assists in diagnosing cellulitis versus an abscess in setting of limited physical examination.

If individual is stable without signs of airway compromise, a 24-hour trial of antibiotics may distinguish cellulitis (improvement) from PTA (no improvement).

Introduction (Definitions/Classification): An acute, typically “self-limited” viral illness caused by either Influenza A or B.