Suppurative perichondritis of the auricle is an acute suppurative inflammation of the auricular perichondrium between the cartilage and the perichondrium. It often causes severe pain and can cause necrosis and deformity of the auricular cartilage, and should be diagnosed and treated promptly.
Etiology
The disease is often caused by secondary infection of trauma, surgery, frostbite, burns, and auricular hematoma. The most common pathogen is pseudomonas aeruginosa, followed by Staphylococcus aureus. After the abscess is formed, pus accumulates between the cartilage and the perichondrium. The cartilage gradually necrotizes due to blood supply obstruction, resulting in the destruction of the auricular support, thereby affecting the auricular morphology.
Clinical manifestations
There are initially swelling and pain in the auricle. As the redness, swelling, fever, and pain gradually exacerbate and the affected range increases, severe pain occurs, and may be accompanied by high fever and anorexia. Examination shows that the auricle is red and swollen, and there is obvious tenderness. After the abscess is formed, there is sense of fluctuation, and pus is discharged after the abscess is ruptured in some patients.
Figure 1 Suppurative perichondritis of the auricle
Treatment
In the early stage, when the abscess has not yet formed, sensitive antibiotics are used systemically to control the infection. Local physical therapy can also be performed to promote the resolution of local inflammation.
If an abscess has formed, semicircular incision along the navicular fossa on the inner side of the helix under general or local anesthesia can be performed to fully expose the abscess cavity, the pus, granulation tissue, and necrotic cartilage should be removed. If the cartilage in the helix can be preserved, the auricular deformity can be avoided. During the operation, the surgical cavity is thoroughly rinsed with antibiotic solution. After the operation, the skin is put back to the wound surface, and a drain is placed. Incomplete suture can be performed to prevent postoperative hemorrhage, hematoma, and wound contraction. Appropriate pressure dressing with loose gauze can be performed, and the frequency of dressing changes is once daily or once two days. A small tube with fine holes can also be placed in the surgical cavity. The surgical cavity is rinsed with antibiotic solution every day until the local and systemic symptoms subside, and the drain can be removed.
If the sequelae are serious and deformities affect the appearance, plastic surgery can be performed.
Prevention
During surgery or auricular piercing, strict disinfection should be performed to avoid damaging the cartilage. Auricular trauma should be treated promptly, and thorough debridement is needed to prevent infection.