Acute auricular trauma: Otohematoma, burns, lacerations and auricular deformities


Otohematoma

An injury frequently associated with contact sports, otohematoma is a result of blunt trauma or excessive traction that causes hemorrhage between your perichondrium and also the cartilage. Subperichondrial blood produces a clot that, if not treated, leads to the formation of neocartilage and eventual deformity of the ear's convolutions.

Treatment should be administered soon after injury. Needle aspiration drains the fluid but rarely removes the clots. Preferred treatment is incision and drainage followed by the placement of sutured bolsters or a thermoplastic splint for 7-10 days to maintain an extensive section of pressure.

Burns

The ear is uniquely susceptible to thermal injury because of its exposed, unprotected position. Deep ear burns destabilize your skin and are likely to involve the cartilage. Chondritis is really a serious infectious complication that occurs most commonly between your third and fifth weeks post-burn. General burn management will include liberal utilization of mafenide, frequent water and soap cleansing, and avoidance of pressure on the affected ear.

Adequate healing time should be allowed, along with a maximal amount of viable cartilage should be salvaged just before reconstruction. Should chondritis occur, systemic antibiotics should be administered. Severe infections may need incision, drainage and debridement of skin and cartilage.

Lacerations

The ear is protected from traumatic forces by its resilient, pliable cartilaginous framework. Nevertheless, lacerations are the commonest form of auricular trauma. Preservation of tissue is crucial to ensuring optimal aesthetic outcome in these injuries. The ear's rich blood supply enables excellent tissue recovery in many instances.

Compromised flaps of skin (with or without cartilage) usually survive, even if with different thin pedicle. At the initial duration of treatment, one should debride grossly necrotic tissues only. Animal or human bites require thorough irrigation and systemic antibiotics.

In laceration repair, discernable landmarks must be approximated meticulously to prevent poor aesthetic outcome or exposed cartilage. As with auricular burns, major reconstructive intervention is generally delayed until adequate healing is complete.

Acquired auricular deformities

Traditionally, deformities from the ear have been classified based on the location, and methods happen to be developed to address each anatomic site (e.g., helix or lobule). However, several methods could be applied in multiple locations, thus confusing the novice.

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Note: This article was sent to us by: Keith Hayes at 02142011

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