ear, nose, and throat disorders
Perichondritis of the Ear
Treatment of Perichondritis of the Ear
Prompt oral antibiotic therapy, typically a fluoroquinolone, sometimes with an aminoglycoside plus a semisynthetic penicillin For an abscess, prompt incision and drainage Patients with diffuse inflammation of the entire pinna are given empiric antibiotics (eg, fluoroquinolones, which have good cartilage penetration) and often a systemic corticosteroid for its anti-inflammatory effects. Any foreign material (eg, ring, splinter) should be removed. If the etiology is not clearly infectious (eg, an infected piercing), patients should be evaluated for an inflammatory disorder ( see Overview of Vasculitis ). Perichondrial abscessesare incised, and a drain is left in place for 24 to 72 hours. Systemic antibiotics are initiated with a fluoroquinolone or an aminoglycoside plus a semisynthetic penicillin. Subsequent antibiotic choice is guided by culture and sensitivity. Warm compresses may help. It is important to ensure that the perichondrium is reapproximated to the cartilage to maintain the blood supply to the cartilage and prevent necrosis. Reapproximation is ensured by inserting 1 or 2 mattress sutures through the entire thickness of the pinna, preferably through dental rolls on both sides of the pinna. 