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Chondritis of the External Ear

Chondritis of External Ear Unspecified Ear


Presentation

  • Infections such as chronic otitis externa may result in a similar presentation. Osteoma (external ear canal) Osteoma typically presents as a single, large pedunculated growth near the lateral end of the bony portion of the external auditory canal.[helpmehear.ca]
  • 26% of cases Joints Arthritis/arthropathy 81 Presenting sign in 23% of cases Nose Saddle nose, septal swelling 72 Presenting sign in 13% of cases Eye Episcleritis, iritis, conjunctivitis, keratitis 65 ...[emedicine.medscape.com]
  • The myriad of presenting symptoms and episodic nature may result in a significant delay in diagnosis.[academic.oup.com]
  • Here we present a case of chondritis limited to the ear cartilage caused by Lyme disease. The patient was treated with ceftriaxone with complete resolution of symptoms.[pediatrics.aappublications.org]
  • “Human immunodeficiency virus-associated non-Hodgkin’s lymphoma presenting as an auricular perichondritis.” Otolaryngology–Head and Neck Surgery 112.3 (1995): 493-495. ( PMID: 7870459 ) Wu, Douglas C., et al. “Pseudomonas skin infection.”[rebelem.com]
Severe Pain
  • Clinical signs include severe pain, discharge, erythema, swelling and tenderness. Previous surgical manipulation of the ear, diabetes, and burns are the most important underlying etiologies of this disease.[biomedpharmajournal.org]
  • Severe pain is common. It is the second most common cause of facial paralysis after Bell’s palsy. Treatment options include systemic corticosteroids and antiviral agents.[helpmehear.ca]
Sepsis
  • The underlying causes mentioned will cause early complications such as chondritis, followed by long-term complications including deformity, hypertrophic scar, discoloration of the ears, hematoma, epidermalcyst, colloid, cervical lymphadenopathy, sepsis[biomedpharmajournal.org]
  • 9 A0105 Typhoid osteomyelitis 10 A0109 Typhoid fever with other complications 11 A011 Paratyphoid fever A 12 A012 Paratyphoid fever B 13 A013 Paratyphoid fever C 14 A014 Paratyphoid fever, unspecified 15 A020 Salmonella enteritis 16 A021 Salmonella sepsis[hive-worx.com]
Cervical Lymphadenopathy
  • The underlying causes mentioned will cause early complications such as chondritis, followed by long-term complications including deformity, hypertrophic scar, discoloration of the ears, hematoma, epidermalcyst, colloid, cervical lymphadenopathy, sepsis[biomedpharmajournal.org]
Insect Bite
  • Causes of perichondritis include Insect bites Ear piercings through the cartilage Incision of superficial infections of the pinna Because the cartilage’s blood supply is provided by the perichondrium, separation of the perichondrium from both sides of[merckmanuals.com]
  • bite Overexposure to sunlight and extreme cold Cogan syndrome Autoimmune disorders such as lupus Vasculitides Leprosy[emedicine.medscape.com]
Ear Deformity
  • Aggressive early management may prevent gross ear deformity: Antibiotic regimen should cover for Pseudomonas. Fisher CG, Kacica MA, Bennett NM. Risk factors for cartilage infections of the ear. Am J Prev Med. 2005;29(3):204–209.[5minuteconsult.com]
  • Body piercing ending in chondritis is more common when the scalpha is invaded resulting in 100% of ear deformity in comparison when the hélix was involved (43%) [6, 7].[symbiosisonlinepublishing.com]
  • If the patient it is not treated, it causesdamage to the cartilage and permanent ear deformity [1].[biomedpharmajournal.org]
Suggestibility
  • A trial of conservative therapy for all patients is suggested [ 1, 8 ].[patient.info]
  • Traditionally, fluoroquinolones have been avoided in pediatric patients due to fears of arthropathy, however recent literature suggests that risk is abundantly low.[rebelem.com]
  • This suggests that any previous surgery on the ear is a common cause for the occurrence of external earchondritis in patients.[biomedpharmajournal.org]
  • Recent animal studies suggest that blocking IL-18 and IL-12 may be beneficial in the treatment of allergic contact dermatitis.[emedicine.medscape.com]
  • Some estimates suggest that upwards of 20 to 50% of patient visits to the family doctor’s office and the emergency department can be attributed to otolaryngic disorders.[helpmehear.ca]
Burning Sensation
  • It is an immunosuppressive agent; a burning sensation of the skin is its major side effect. It has relatively poor absorption and, therefore, the side effects often associated with systemic tacrolimus are not seen.[emedicine.medscape.com]

Workup

  • […] operate, and practice in a convenient care clinic or urgent care clinic Designed for courses at the NP-DNP level, PAs, clinic managers, CNOs, graduate nurse/PA educators and students Identifies 20 top conditions seen in retail health clinics and provides workup[books.google.com]
  • In addition to these 2 tests, a thorough workup includes potassium hydroxide preparation, fungal cultures, Gram stain, and bacterial cultures to exclude a superimposed infection.[emedicine.medscape.com]

Treatment

  • Antimicrobial treatment should continue for 2-4 weeks [5,9].Epidemiologic studies on the diagnosis and treatment of diseases and management strategies play the prime rolethat lead to accomplishing age, gender, ethnic, economic, and cultural patterns of[biomedpharmajournal.org]
  • Take advantage of expanded coverage of small molecule treatment, biologics, biomarkers, epigenetics, biosimilars, and cell-based therapies.[books.google.com]
  • […] practice in a convenient care clinic or urgent care clinic Designed for courses at the NP-DNP level, PAs, clinic managers, CNOs, graduate nurse/PA educators and students Identifies 20 top conditions seen in retail health clinics and provides workup and treatment[books.google.com]
  • Treatment consists of periodic removal of accumulated material.[helpmehear.ca]
  • […] is delayed Due to tissue ischemia (from above primary pathologic state) plus neutrophilic migratory defect plus virulence of Pseudomonas Treatment Antibiotics, surgical debridement, hyperbaric oxygen ( HNO 2003;51:315 ) Gross description Ulcerated skin[pathologyoutlines.com]

Prognosis

  • Prognosis depends on the extent at the time of diagnosis. History and etymology External auditory canal cholesteatomas were first reported by Toynbee in 1850.[radiopaedia.org]
  • Prognosis The condition is not life-threatening but can affect the quality of life [ 10 ]. Small studies suggest that many, or most, cases respond to conservative treatment [ 8 ]. The condition may recur after surgery.[patient.info]

Etiology

  • This result is consistent withPrasad HKC’s study [20], in whichtrauma was the most common underlying etiology with 46%.Respecting the significant association of underlying etiologies with external ear chondritis, any previous surgery, and manipulation[biomedpharmajournal.org]
  • If the etiology is not clearly infectious (eg, an infected piercing), patients should be evaluated for an inflammatory disorder (see Overview of Vasculitis ). Perichondrial abscesses are incised, and a drain is left in place for 24 to 72 h.[merckmanuals.com]
  • Classification: Erysipelas of external ear Cellulitis of external ear Perichondritis Chondritis Etiology: It commonly occurs due to trauma.[sites.google.com]
  • Although no clear etiology has been identified, a hormonal precipitating factor has been postulated.[emedicine.medscape.com]
  • Clinical and etiological examination: Pinna disorders: change in shape, otalgia. Cutaneous causes: eczema, psoriasis, boils, mycoses. Traumatic causes: subcutaneous haematoma (othematoma).[cochlea.eu]

Epidemiology

  • Methods This study is a descriptive epidemiologic study based on hospital data.[biomedpharmajournal.org]
  • Epidemiology [ 3 ] The condition is probably relatively common but is rarely documented in the literature. One study found that only 600 cases were reported between the years 1966 and 2004.[patient.info]
  • Several epidemiological studies track its occurrence as a nosocomial pathogen and indicate that antibiotic resistance is increasing in clinical isolates.Invasion of the skin and cartilage poses the potential for infection, inflammation and fluid accumulation[symbiosisonlinepublishing.com]
  • Differential Diagnoses of Common External Ear Inflammatory Conditions (Open Table in a new window) Disease Etiology and Epidemiology Lesion Description Differential Diagnoses Atopic dermatitis Systemic disorder commonly seen in families with history of[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Although food allergies and atopic dermatitis often coexist, the initial pathophysiology of atopic dermatitis is multifactorial and early skin dysfunction likely plays a vital role in the development of atopic dermatitis. [3] In women, menstruation and[emedicine.medscape.com]

Prevention

  • It is important to ensure that the perichondrium is reapproximated to the cartilage to maintain the blood supply to the cartilage and prevent necrosis.[merckmanuals.com]
  • Chondritis of the burned ear: A preventable complication. American jornal of surgery. 1985;152:257-259. Lee TC, Gold WL. Necrotizing pseudomonas chondritis after piercing of the upper ear. CMAJ. 2011;183:819-821. Stephen L, Edwin A.[biomedpharmajournal.org]
  • General postinjury preventive measures: Prevention of chondritis is of utmost importance: Difficult management and disfiguring potential Avoid pressure to the injured ea...[5minuteconsult.com]
  • Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis of Alcohol 0% Unclassified 100% Health Topic[codelay.com]
  • The goal of treatment is to restore the normal contours while preventing infection. Hematoma results in disfigurement by organization or chondritis. Evacuation and pressure dressings using sterile technique correct the condition.[ncbi.nlm.nih.gov]

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