MINORS MANUAL
Auricular pinna injuries are traumatic wounds affecting the ear, which consists of thin skin, cartilage, and connective tissue. These injuries can range from superficial lacerations to deep tears involving the cartilage. Due to the limited blood supply to the cartilage, these wounds can heal poorly if not treated properly, posing a risk of necrosis and deformity, such as “cauliflower ear.”
Diagnosis
Diagnosis is made by inspecting the wound to assess the extent and depth of the injury, determining whether the cartilage is exposed or damaged. It is important to rule out additional injuries, such as skull or temporal bone fractures, which can accompany significant trauma. Signs of infection or underlying haematomas should also be considered.
Differential Diagnosis
Pathology | Key Characteristics |
|---|---|
Simple laceration | Superficial cut, no involvement of cartilage |
Auricular tear | Loss of tissue continuity with exposed cartilage |
Auricular haematoma | Subperichondrial blood accumulation, no skin break |
Perichondritis | Cartilage infection, inflammation, pain, redness, fever |
Emergency Management
Haemorrhage control: Apply direct pressure with sterile gauze. If there is profuse bleeding or extensive damage, consider temporary suturing or compression.
Wound cleaning: Irrigate the wound with sterile saline to remove foreign bodies and reduce the risk of infection, especially in contaminated wounds.
Assess the extent of damage: If the cartilage is exposed or damaged, it is important to ensure that the skin covers the cartilage properly to prevent necrosis.
Suturing: Deep lacerations or those involving the cartilage require layered suturing. Cartilage wounds should be carefully covered, using absorbable sutures to secure the skin and prevent auricular collapse.
Antibiotic prophylaxis: In deep, contaminated wounds or with cartilage exposure, antibiotic prophylaxis is recommended to prevent perichondritis or cartilage infection.
Auricular haematoma: If a subperichondrial haematoma is present, it should be drained immediately to prevent fibrosis and deformity (cauliflower ear).
Definitive Treatment
Definitive treatment involves proper wound repair to preserve the anatomy and function of the auricular pinna. Injuries involving cartilage must be managed carefully to prevent necrosis and deformity. In severe cases, such as complete tears or tissue loss, the intervention of a plastic surgeon or otolaryngologist may be necessary for auricular reconstruction.
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