Isolated External Auditory Canal Pruritus: A Somatic Obsession
PDF
Cite
Share
Request
Original Research
VOLUME: ISSUE:
P: -

Isolated External Auditory Canal Pruritus: A Somatic Obsession

1. Mardin Training and Research Hospital, Clinic of Psychiatry, Mardin, Turkey
2. Mardin Training and Research Hospital, Clinic of Otorhinolaryngology, Mardin, Turkey
3. İstanbul Arel University Faculty of Medicine, Department of Otorhinolaryngology, İstanbul, Turkey
No information available.
No information available
Received Date: 28.02.2024
Accepted Date: 17.10.2024
Online Date: 21.10.2024
PDF
Cite
Share
Request

Abstract

Objective: Patients presenting to otorhinolaryngology (OHL) clinics with isolated external auditory canal (EAC) pruritus are common. Although there are many etiological reasons for this complaint, psychological factors have long been ignored. Psychocutaneous diseases must be considered in the differential diagnosis when no symptoms that might cause pruritus are detected in the OHL examinations, including anamnesis and microscopic otoscopy, of patients with isolated EAC pruritus. Recent studies have shown that psychological factors or disorders must not be ignored in patients with isolated EAC pruritus.

Method: A total of 60 patients who applied to the OHL clinic with EAC pruritus and had not received psychiatric treatment before or yet were included in the patient group (PG) in the study, after excluding other causes of EAC pruritus. The control group (CG) comprised 59 healthy participants who did not have previous or current pruritus with EAC and did not receive psychiatric treatment. The socio-demographic data forms that were prepared for the PG and CG participants included in the study were completed. The symptom checklist (SCL-90-R) and the Maudsey Obsessive-Compulsive Inventory (MOCI) to the participants were also administered.

Results: The difference between SCL-90-R test overall scores and subparameters of SCL-90-R test between PG and CG in our study were the difference between obsessive-compulsive symptoms, somatization, interpersonal sensitivity, depression, anxiety, anger-hostility, phobias, paranoid symptoms, psychoticism and additional scale scores was statistically significant (p<0.05). A statistically significant difference was also detected between the MOCI test total scores applied to PG and CG and the MOCI test sub-parameters control, cleanliness, slowness, suspicion, and rumination scores (p<0.05).

Conclusion: The data obtained in this study showed that the complaint of isolated EAC pruritus might have a psychological basis. The statistically significant difference in the parameters measuring the obsession and compulsion scores between the two groups in this study suggested that EAC pruritus might be a somatic obsession. Furthermore, the statistically significant difference between all parameters of the scales in the comparison between the two groups supported the hypothesis that EAC pruritus might have a psychological basis. This result, which was detected in the present study, indicated that psychological factors must not be ignored in EAC-related pruritus. However, more extensive studies are needed on this subject.

Keywords:
External auditory canal pruritus, obsessive compulsive disorder, psychiatric disorders, somatic obsession

References

1
Knuuti J. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC).Russ J Cardiol.2020;25(2):3557.
2
Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Circulation.2021;144(22):e368-e454. Erratum in:Circulation. 2023;148(24):e281.
3
Narula J, Chandrashekhar Y, Ahmadi A, et al. SCCT 2021 expert consensus document on coronary computed tomographic angiography: a report of the society of cardiovascular computed tomography.J Cardiovasc Comput Tomogr. 2021;15(3):192-217.
4
Pack JD, Xu M, Wang G, Baskaran L, Min J, De Man B. Cardiac CT blooming artifacts: clinical significance, root causes and potential solutions.Vis Comput Ind Biomed Art. 2022;5(1):29.
5
Gilard M, Cornily JC, Pennec PY, et al. Assessment of coronary artery stents by 16 slice computed tomography.Heart. 2006;92(1):58-61.
6
Mergen V, Sartoretti T, Baer-Beck M, et al. Ultra-High-Resolution Coronary CT angiography with photon-counting detector CT: feasibility and image characterization.Invest Radiol. 2022;57(12):780-788.
7
Boccalini S, Si-Mohamed SA, Lacombe H, et al. First in-human results of computed tomography angiography for coronary stent assessment with a spectral photon counting computed tomography.Invest Radiol. 2022;57(4):212-221.
8
Geering L, Sartoretti T, Mergen V, et al. First in-vivo coronary stent imaging with clinical ultra high resolution photon-counting CT.J Cardiovasc Comput Tomogr.2023;17(3):233-235.
9
Decker JA, O’Doherty J, Schoepf UJ, et al. Stent imaging on a clinical dual-source photon-counting detector CT system-impact of luminal attenuation and sharp kernels on lumen visibility.Eur Radiol. 2023;33(4):2469-2477.
10
Hagar MT, Soschynski M, Saffar R, et al. Ultra-high-resolution photon-counting detector CT in evaluating coronary stent patency: a comparison to invasive coronary angiography.Eur Radiol.2024;34(7):4273-4283.
11
Stein T, Taron J, Verloh N, et al. Photon-counting computed tomography of coronary and peripheral artery stents: a phantom study.Sci Rep.2023;13(1):14806.
12
McCollough C, Bakalyar DM, Bostani M, et al. Use of water equivalent diameter for calculating patient size and size-specific dose estimates (SSDE) in CT: the report of AAPM Task Group 220.AAPM Rep. 2014;2014:6-23.
13
Leschka S, Kim CH, Baumueller S, et al. Scan Length Adjustment of CT coronary angiography using the calcium scoring scan: effect on radiation dose.AJRAm J Roentgenol. ;194(3):272-277.
14
Hagar MT, Soschynski M, Benndorf M, et al. Enhancing radiation dose efficiency in prospective ECG-triggered coronary CT angiography using calcium-scoring CT.Diagnostics (Basel).2023;13(12):2062.
15
Mannil M, Hickethier T, von Spiczak J, et al. Photon-counting CT: high-resolution imaging of coronary stents.Invest Radiol.2018;53(3):143-149.
16
Symons R, De Bruecker Y, Roosen J, et al. Quarter-millimeter spectral coronary stent imaging with photon-counting CT: Initial experience.J Cardiovasc Comput Tomogr.2018;12(6):509-515.
17
Petritsch B, Petri N, Weng AM, et al. Photon-counting computed tomography for coronary stent imaging: in vitro evaluation of 28 coronary stents.Invest Radiol. ;56(10):653-660.
18
Koons EK, Thorne JE, Huber NR, et al. Quantifying lumen diameter in coronary artery stents with high-resolution photon counting detector CT and convolutional neural network denoising.Med Phys.2023;50(7):4173-4181.
19
Qin L, Zhou S, Dong H, et al. Improvement of coronary stent visualization using ultra-high-resolution photon-counting detector CT.Eur Radiol.
20
Rajiah PS, Dunning CAS, Rajendran K, et al. High-Pitch Multienergy Coronary CT angiography in dual-source photon-counting detector CT scanner at low iodinated contrast dose.Invest Radiol.2023;58(9):681-690.
21
Ochs MM, Andre F, Korosoglou G, et al. Strengths and limitations of coronary angiography with turbo high-pitch third-generation dual-source CT.Clin Radiol.2017;72(9):739-744.
22
Halfmann MC, Bockius S, Emrich T, et al. Ultrahigh-spatial-resolution photon-counting detector CT angiography of coronary artery disease for stenosis assessment.Radiology.2024;310(2):e231956.
23
Mergen V, Eberhard M, Manka R, Euler A, Alkadhi H. First in-human quantitative plaque characterization with ultra-high resolution coronary photon-counting CT angiography.Front Cardiovasc Med. 2022;9:981012.
24
Hagar MT, Soschynski M, Saffar R, et al. Accuracy of ultrahigh-resolution photon-counting CT for detecting coronary artery disease in a high-risk population.Radiology.2;307(5):e223305.
25
Eberhard M, Candreva A, Rajagopal R, et al. Coronary stenosis quantification with ultra-high-resolution photon-counting detector CT angiography.JACC Cardiovasc Imaging. 2024;17:342-344.
26
Elias Michael A, Schoenbeck D, Michael Woeltjen M. Photon counting computed tomography of in-stent-stenosis in a phantom: Optimal virtual monoenergetic imaging in ultra high resolution.Heliyon. 2024;10(6):e27636.