Why cartilage inflammation is dangerous
The cartilage of the auricle receives oxygen and nutrients not from its own vessels, but through diffusion from the perichondrium. When inflammatory fluid or pus accumulates between the perichondrium and cartilage, this connection is interrupted. The cartilage tissue becomes necrotic and dissolves in a matter of days, and a scar forms in its place. The shell wrinkles, loses its usual relief and does not recover on its own - this can only be corrected with reconstructive surgery.
- Cartilage is nourished only through the perichondrium
- Pus separates the cartilage and its membrane
- Cartilage necrosis develops quickly
- The outcome without treatment is permanent deformity
- The earlobe does not contain cartilage and is not inflamed
Reasons
The infection occurs under the perichondrium with any damage that affects the cartilaginous part of the concha. The most common modern reason is piercing the upper part of the ear: a cartilage puncture takes a long time to heal and has a worse blood supply than a puncture in the lobe. Perichondritis also occurs after blunt trauma with a hematoma, burn, frostbite, insect bite with scratching, and with severe external otitis, when the inflammation extends beyond the ear canal. The risk is higher with diabetes and a weakened immune system.
- Piercing of the cartilaginous part of the auricle
- Ear injury with hematoma, including in wrestlers and boxers
- Burns and frostbite
- Scratching after insect bites
- Severe otitis externa and furuncle of the ear canal
- Ear surgeries and injuries, diabetes mellitus
Symptoms
The disease begins with a burning sensation and swelling in the ear. Within a few hours, the shell turns red, becomes dense, hot and sharply painful even when lightly touching the pillow. The swelling smoothes out the normal relief of the curl. An important identifying feature is that the earlobe remains soft and of normal color, because there is no cartilage in it. When suppuration occurs, an area of softening and fluctuation appears, and the temperature may rise. If the pain persists but the redness has decreased, this is not always an improvement.
- Redness and swelling of the auricle without involvement of the earlobe
- Severe pain when touched
- Local increase in skin temperature
- Smoothing the shell relief
- Area of softening in an abscess
- Fever and general malaise
Diagnostics
Most often, the diagnosis is obvious upon examination: the characteristic appearance of the shell and the connection with a recent puncture or injury. The doctor examines the ear canal to rule out otitis externa as a source of infection and determines whether there is a collection of pus. If there is discharge, a culture must be taken to determine sensitivity to antibiotics, since Pseudomonas aeruginosa is resistant to some of the usual drugs. A blood test shows the severity of inflammation. Bilateral lesions without trauma require the exclusion of systemic diseases.
- Examination by an ENT doctor, otoscopy
- Culture of discharge with antibiogram
- Complete blood count and C-reactive protein
- Assessing blood glucose levels for suspected diabetes
- Consultation with a rheumatologist for recurrent bilateral inflammation
Treatment and prevention
Treatment begins immediately and always with the participation of a doctor: systemic antibiotics active against Pseudomonas aeruginosa are prescribed, usually for a course of at least one to two weeks. If pus has accumulated under the perichondrium, it must be opened and drained, and the cavity is washed; Antibiotics alone are not enough in this case. Earrings and any cartilage jewelry are removed. Cartilage that has lost its viability is excised. Warm compresses and homemade lotions are contraindicated - they accelerate the spread of infection. Restorative surgery to shape the ear is performed no earlier than several months after the inflammation has subsided.
- Urgent examination and antibiotics as prescribed by a doctor
- Opening and draining the abscess, dressing
- Immediate removal of a piercing from an inflamed ear
- Refusal of warming compresses and self-medication
- Only pierce the lobe, not the cartilage; choose sterile conditions
- Ear protection for contact sports, treatment of any ear abrasions
