The burned ear (II): A prospective clinical study of 100 patients with 150 ear burns.

A prospective clinical study of 100 patients with 150 ear burns was carried out in the Burns Centre, Singapore General Hospital. The aims of this study were to document the nature of the injury, the results of various methods of treatment, the complications of ear burns and the changes that led to chondritis. Based on the findings of the experimental studies on the burned ear, it is possible to accurately classify the depth of the burn injury based on the surface appearance. The results show that fire was the commonest aetiologic agent for ear burns (65% cases) and hot water scalds second (25% cases). Scalds tended to cause unilateral ear burns whilst fire caused bilateral injuries. The single most important factor in healing of the burned ear was the depth of the injury. Erythema took six days, mid-dermal (MD) burns ten days, uncomplicated deep-dermal (DD) and full thickness (FT) burns 35 days. When chondritis developed deep dermal burns took 43.5 days to heal and full thickness burns took 57.8 days. Conservative treatment of 104 ears resulted in complete healing except for 15 which had pigmentary and/or hypertrophic scar problems. Surgical treatment was used in 23 ears. Three returned to normal appearance, eleven had mild and four had moderate deformities. Five ears were lost (3% cases). Chondritis was present in 12 ears (8% cases), six in DD and six in FT burns. Seven of these ears were successfully salvaged. Favourable results in this study were attributed to the following factors: early detection of chondritis by the EAR SPRINGING SIGN, early surgical intervention, radical cartilage removal, meticulous post-op care to prevent cross infection and avoidance of pressure to the ears.