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DISEASES OF EXTERNAL EAR
Dr.Sudeep K.C.
DISEASES OF THE PINNA
A)Congenital disorders
B)Trauma to the auricle
C)Inflammatory disorders
A)Congenital Disorders
1) Bat Ear(lop ear):Abnormally protuding ear with poorly developed antihelix.
2)Preauricular Appendages: skin covered tag may contain small pieces of cartilage.
• 3)Preauricular pit or sinus : commonly seen at the root of helix and due to incomplete fusion of tubercles.
• 4)Anotia : complete absence of pinna
5)Macrotia: excessively large pinna6)Microtia : It is a major developmental anomaly and is frequently associated with anomalies of external auditory canal . Hearing loss is frequent
B)Trauma to the Auricle1)Haematoma of the Auricle : It is the
collection of blood between auricular cartilage and its perichondrium due to blunt trauma.
Extravasted blood may clot and organize , resulting in a typical deformity called cauliflower ear.
Treatment: Aspiration of haematoma and a pressure dressing.
2)Lacerations: They are repaired as early as possible . The perichondrium is stitched with absorbable sutures with broad spectrum antibiotics. special care is taken to prevent stripping of perichondrium
3)Avulsion of pinna: If there is partial avulsion primary reattachement is considered. For complete avulsion pinna can be reimplanted by microvascular technique.
4)Frost Bite: Injury varies between erythema , oedema , bullae formation ,necrosis of skin and complete necrosis with loss of affected part.
Treatment: Rewarming with cotton pieceAnalgesics for painSystemic antibioticsSurgical debridement
5)Keloid of Auricle: It may follow trauma or piercing of ear .Usual sites are lobule or helix.
Treatment:Surgical excisionRecurrence can be
avoided by pre and post operative radiation.
C)Inflammatory Disorders1)Perichondritis : It results from infection
secondary to lacerations , haematoma , or surgical incision .
Symptoms: Red, hot and painful pinna which feels stiff .
later abscess may form in between cartilage and perichondrium with necrosis of cartilage.
Treatment:Antibiotics and local application of
4%almunium acetate compresses. Abscess should be drained.
2)Relapsing polychondritis: It is a rare autoimmune disorder involving cartilage .The entire auricle except its lobule is inflammed and tender.External ear canal becomes stenotic.
Treatment: high doses of systemic steroids.
3)Chondro dermatitis nodularis chronica helicis:
Small painful nodules appear in the free border of helix in men about 50 yrs of age.Nodules are tender and patient unable to sleep on affected side.
Treatment: Excision of nodule with its skin and cartilage.