1- Ears (Ear abnormalities)

Question 1

Pinna (auricle) abnormalities causes

Answer 1

• Congenital
• Inflammatory
• Infective
• Traumatic

Question 2

congenital causes of pinna abnormality

Answer 2

There are several types of congenital ear deformity including:

• Anotia: a complete absence of the pinna.
• Microtia: underdevelopment of the pinna.
• Low-set ears: the ears are positioned lower on the head than usual. Low-set ears are a feature of several genetic syndromes including Down’s syndrome and Turner’s syndrome.

Question 3

infective causes of pinna abnormalities

Answer 3

• Ramsey hunt syndrome
• Perichondritis

Question 4

Ramsey hunt syndrome

Answer 4

Occurs when a shingles outbreak affects the facial nerve near one of your ears. In addition to the painful shingles rash, Ramsay Hunt syndrome can cause facial paralysis and hearing loss in the affected ear.

Presentation
Unilateral face droop and red ear with vesicles

Question 5

Perichondritis

Answer 5

• Layer which coats the cartilage and provides blood supply
• Causes by infection introduced by ear piercings/ insect bites
• Needs ABx

Question 6

causes of traumatic pinna abnormalities

Answer 6

Pinna haematoma

Question 7

Pinna haematoma

Answer 7

accumulation of blood between the cartilage and its overlying perichondrium from blunt injury

• Common in contact sport
• Subperichondrial haematoma deprive cartilage of blood supply, increase in blood build up = increased pressure= necrosis of tissue

Question 8

pathophysiology of pinna haematoma

Answer 8

Following initial trauma, the perichondrial blood vessels tear, resulting in haematoma forming between the auricular cartilage and the overlying perichondrium. Consequently, the blood supply to the underlying cartilage can become impaired.

Question 9

manageemt of pinna haematoma

Answer 9

Drainage of the haematoma should be performed within 24 hours of the injury.

After evacuation of a haematoma, gauze padding should be placed over the ear and a tight headband applied. If the haematoma re-accumulates, it will require re-drainage.

Question 10

If pinna haematomas are left untreated what can occur

Answer 10

due to the disrupted blood supply, avascular necrosis of the pinna can occur. Subsequent fibrocartilage overgrowth can lead to a structural deformity, colloquially termed **‘cauliflower ear’ **

Question 11

Cauliflower ear
Background

Answer 11

• Is an irreversible condition that develops as a result of repeated blunt ear trauma -. Pinna haematoma
• Blunt trauma causes bleeding under the perichondrium of the pinna, stripping away the ear’s cartilage.
• This cartilage normally relies on the perichondrium for its nutrient supply and as a result, once separated it becomes fibrotic, causing distortion of the ear’s architecture.