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Abstract:
A search of the literature reveals reports of only 191 cases of auricular perichondritis. The present study includes 15 further cases caused by pseudomonas and proteus. Stroud's excision technique was used in four cases and resulted in marked deformity, repeated debridement, and protracted treatment. Tubal drainage was used in the remaining ears with very good esthetic results. It has been demonstrated in experimental animals and in humans that new cartilage forms in the subperichondrial auricular space in the second postoperative week, being maximum in the fourth week. In the present study tubes were retained two to four weeks to maintain an elevation of the perichondrium from what remains of the auricular cartilage to ensure homogeneous cartilage formation and provide local antibiotic treatment. Hospitalization is required for only two days. The four weeks tubal drainage method should be the method of choice for all cases of perichondritis and the excision method abandoned, even in gram-negative infections. A case of relapsing polychondritis is also presented because it is important to distinguish auricular perichondritis from relapsing polychondritis as the treatment of the latter is not surgical but with steroids.
Insights
Tubal drainage is a superior treatment for auricular perichondritis, yielding better cosmetic results than excision. This method ensures proper cartilage formation and local antibiotic delivery for effective perichondritis management.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Plastic Surgery
Background:
- Auricular perichondritis is a rare condition with limited reported cases.
- Previous treatments, like Stroud's excision technique, have led to poor outcomes.
Observation:
- This study presents 15 new cases of auricular perichondritis, caused by Pseudomonas and Proteus.
- Tubal drainage was employed in 11 cases, showing excellent esthetic results.
Findings:
- New cartilage formation occurs between postoperative weeks 2 and 4.
- Tubal drainage, maintained for 2–4 weeks, promotes homogeneous cartilage regrowth and delivers local antibiotics.
- Tubal drainage resulted in significantly better cosmetic outcomes and shorter treatment durations compared to excision.
Implications:
- Tubal drainage should be the preferred method for treating auricular perichondritis, including gram-negative infections.
- Distinguishing auricular perichondritis from relapsing polychondritis is crucial due to differing treatment modalities (surgical vs. steroids).