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.