The goal of the study was to assess the presence of an incomplete (iRORA) and complete (cRORA) retinal pigment epithelium (RPE) and outer retinal atrophy in a general population and explore their associations with other parameters. Participants of the population-based Beijing Eye Study with age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV) or those without retinal diseases, underwent optical coherence tomography of the macula. Among 5894 eyes, presence of iRORA and cRORA increased from 0/5117 (0%) and 0/5117 (0%) in the normal group and 0/457 (0%) and 0/457 (0%) in early AMD to 5/277 (1.8%;95%CI:0.3,3.3) and 0/277 (0%) in intermediate AMD, 6/6 (100%) and 6/6 (100%) in geographic atrophy, 0/2 (0%) and 2/2 (100%) in exudative AMD, and 10/30 (33.3%;95%CI:17.8,48.8) and 6/30 (25.0%;95%CI:12.0,38.0) in PCV, respectively. Higher iRORA presence was associated (multivariable analysis) with higher AMD stage (OR:54.7;95%CI:6.68,449;P < 0.001), higher PCV presence (OR:1.523 × 105;95%CI:834,2.785 × 107;P < 0.001), and higher presence of reticular pseudodrusen (OR:19.2;95%CI:1.94,190;P < 0.001). Drusen number (OR:0.97;95%CI:0.91,1.03;P = 0.27) and subfoveal choroidal thickness (OR:1.003;95%CI:0.994,1.013;P = 0.49) were not associated. Higher cRORA presence correlated with higher PCV presence (OR:48.6;95%CI:4.58,517;P = 0.001) and higher presence of reticular pseudodrusen (OR:120;95%CI:13.1,1094;P < 0.001). iRORAs and cRORAs were spatially associated with ellipsoid zone and external limiting membrane defects and intraretinal hyperreflective foci (iHRFs) in the outer and inner retinal layers. The findings suggest that iRORAs and cRORAs presences were relatively low in our population-based study, and were associated with higher presence of reticular pseudodrusen but not with drusen number or subfoveal choroidal thickness. The spatial association with ellipsoid zone defects and external limiting membrane defects and iHRF in the outer retinal layer and beyond fits with the notion of an RPE cell migration playing a role in the development of iRORAs and cRORAs.

Several benign and malignant tumors may be observed on the skin of the external ear at various ages, and some are specifically located in this area. Large lesions may be disfiguring and impair hearing by obstructing the external auditory canal. They may also cause chronic ulcerations and, in some cases, secondary destruction of underlying cartilage. The management of some external ear tumors requires a multidisciplinary approach. Being aware of the rich clinical spectrum of auricular tumors may enable early diagnosis, preventing more aggressive surgery with accompanying undesirable cosmetic results and decreasing the risk of metastasis in malignant tumors. The diagnosis of associated systemic diseases and genodermatoses may also be possible.

Fully regressive melanoma is an exceedingly rare phenomenon characterized by the complete histopathologic disappearance of malignant melanocytes, replaced by fibrosis, melanophages, and lymphocytic infiltrates, without identifiable residual tumor cells. We report the case of a 71-year-old female who presented with a pigmented lesion of the right auricle, which was incidentally noted by her daughter. Clinical examination revealed a darkly pigmented, asymmetrical macule with retention of hair follicles, raising suspicion for a benign melanocytic nevus. Excisional biopsy revealed complete regression of a superficial spreading melanoma without measurable Breslow thickness or vertical growth phase. Immunohistochemical studies demonstrated positivity for melanocytic markers and a low proliferative index, while imaging with PET/computed tomography and MRI revealed no evidence of regional or distant metastasis. Given the absence of high-risk features, sentinel lymph node biopsy was not performed, and the patient underwent wide local excision with no residual malignancy identified. She remains disease-free under close clinical follow-up. This case highlights the diagnostic and management challenges associated with fully regressive melanoma and emphasizes the need for heightened clinical suspicion and individualized treatment strategies. Further research is required to better understand the prognostic significance and optimal follow-up protocols for this rare melanoma subtype.

Ménière's disease is a complex disorder of the inner ear, characterized by recurrent episodes of vertigo, progressive hearing loss, tinnitus, and aural fullness. The pathophysiology of this condition is dominated by endolymphatic hydrops, reflecting imbalances in fluid regulation and pressure within the membranous labyrinth, which impair cellular function and the transmission of vestibular and auditory signals. Although genetic predisposition provides a susceptible background, recent studies emphasize that non-genetic factors act as critical triggers of clinical events, determining both the onset of symptoms and the modulation of their severity. These factors directly influence pathophysiology by disrupting endolymphatic homeostasis and altering the intracellular and tissue dynamics of the membranous labyrinth, thereby contributing to the phenotypic variability observed among patients. The key to this process lies in the synergistic interaction between genetic predisposition and external or contextual influences, which determines the threshold at which the compensatory mechanisms of the inner ear fail, triggering the characteristic episodes. Understanding this interdependence, as well as the underlying disease mechanisms, provides essential insights for the identification of preventive and therapeutic strategies aimed not only at symptom control but also at modulating the factors that influence susceptibility to endolymphatic imbalance.

Aural myiasis is an uncommon parasitic infestation involving the external auditory canal by fly larvae, typically seen in tropical climates, especially among individuals with poor hygiene or immunocompromised status. Though rare, it can lead to serious complications, including tympanic membrane perforation or intracranial invasion. We describe a 55-year-old man with hypertension who had been experiencing pain and bleeding in his right ear for four days. Live maggots were found in the right external auditory canal during otoscopic examination. It was impossible to see the tympanic membrane. Systemic and topical antibiotics, supportive therapy, and aural toileting were all effective treatments for the patient. To avoid major complications, aural myiasis must be diagnosed early and treated quickly. In this instance, there was no deeper structure infection or involvement of the facial nerve, and the recovery went smoothly. The patient was receiving antihypertensive medication and had a history of angioplasty. Even though it is uncommon, patients who present with sudden-onset ear pain, bleeding, and a crawling sensation should be evaluated for aural myiasis, particularly in areas where it is endemic. For management, early detection and comprehensive debridement are essential.

Tinnitus is the perception of sound without a corresponding external sound source. This condition affects approximately 14% of adults, with approximately 2% experiencing severe symptoms. Underlying mechanisms of tinnitus suggest involvement of both peripheral and central processes, in which cochlear injury and deafferentation may trigger maladaptive plasticity, increased central gain, and thalamocortical dysrhythmia, modulated by limbic and salience networks. Neuroinflammation, somatosensory-auditory coupling and other factors, such as stress, may contribute to chronicity. Clinical expression is heterogeneous. Tinnitus is often comorbid with hearing loss, hyperacusis, migraine, anxiety, depression, mild cognitive impairment, insomnia and temporomandibular disorders, influencing assessment and care. Diagnosis comprises distinguishing objective (including pulsatile) from subjective tinnitus, recognizing red flags (for example, pulse-synchronous tinnitus requiring vascular imaging), quantifying hearing with audiometry and screening for modulating somatic factors. Multimodal management can reduce the effect of tinnitus: tinnitus-focused counselling and cognitive behavioural therapy are first-line treatments, and hearing rehabilitation and targeted treatment of somatosensory contributors are valuable adjuncts. Moreover, emerging neuromodulation, including bimodal stimulation, benefits selected subgroups. New areas of research include biomarkers, deciphering tinnitus genetic architecture, inner ear regeneration, closed-loop neuromodulation and digital therapeutics.

The auriculotemporal nerve is a tributary of the mandibular division of cranial nerve five, the trigeminal nerve. It contains sensory, vasomotor, and parasympathetic fibers. It has a superior and inferior root that originates from the trigeminal nerve, encircles the middle meningeal artery ultimately traveling inferior to the temporomandibular joint and up the temple providing sensation to parts of the ear, temporomandibular joint, scalp, as well as secretory and vasomotor innervation to the parotid gland. This nerve is clinically relevant in the setting of temporal mandibular joint disease repair, postoperative complications in a parotidectomy, and trigeminal neuralgia.