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 pinna 6)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 Auricle 1)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 piece  Analgesics for pain  Systemic antibiotics  Surgical debridement

5)Keloid of Auricle: It may follow trauma or piercing of ear.Usual sites are lobule or helix. Treatment:  Surgical excision  Recurrence can be avoided by pre and post operative radiation.

C)Inflammatory Disorders 1)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.