Prasad Kishore Chandra, Karthik S, Prasad Sampath Chandra
Department ENT-Head and Neck Surgery, Kasturba Medical College, Mangalore, India.
Am J Otolaryngol. 2005 Jan-Feb;26(1):1-6. doi: 10.1016/j.amjoto.2004.04.015.
Pinna contributes enormously to the facial aesthesis. Lesions affecting the pinna can lead to overt disfigurement and change the entire appeal of the face. Gross deformity can occur because of a delay in diagnosis and mismanagement. The aim of our study was to determine the clinical presentation, relevant investigations, appropriate treatment, timing of surgical intervention, and complications encountered. Factors that predispose and aggravate the condition and their appropriate management are also discussed. The point to be emphasized is that a good clinical history and examination alone is sufficient to diagnose the conditions without the aid of any special investigation.
Our clinical study comprised of 307 cases of men and women patients presenting with swelling of the pinna, who attended the Ear, Nose, and Throat Department, Kasturba Medical College, Mangalore, India, during the period of February 1992 to June 2002. Wide bore needle aspiration was done for the majority of cases of seroma and hematoma. Patients who had recurrence were managed by window procedure. Incision and drainage with or without curettage of diseased cartilage was performed for perichondritis. Other lesions like keloid, hemangioma, dermoid cyst, sebaceous cyst, and malignancy were managed by complete excision. A firm pressure dressing was applied in all cases after surgery. Majority of the cases were done under local anesthesia.
Prompt surgical intervention under good antibiotic cover gave excellent results with minimal complications.
Surgical intervention at the earliest followed by a firm pressure dressing under antibiotic cover decreases the morbidity. Diabetes mellitus plays a significant role in few of the conditions and has to be simultaneously controlled.
耳廓对面部美观有极大贡献。影响耳廓的病变可导致明显的毁容，并改变面部的整体吸引力。由于诊断延迟和处理不当可能会出现严重畸形。我们研究的目的是确定临床表现、相关检查、适当的治疗方法、手术干预的时机以及所遇到的并发症。还讨论了易患和加重该病的因素及其适当的处理方法。需要强调的是，仅通过良好的临床病史和检查就足以诊断病情，无需任何特殊检查的帮助。
我们的临床研究包括1992年2月至2002年6月期间在印度芒格洛尔卡斯图尔巴医学院耳鼻喉科就诊的307例耳廓肿胀的男性和女性患者。大多数血清肿和血肿病例采用粗针抽吸。复发的患者采用开窗手术治疗。对软骨膜炎患者进行切开引流，可伴有或不伴有对病变软骨的刮除。其他病变如瘢痕疙瘩、血管瘤、皮样囊肿、皮脂腺囊肿和恶性肿瘤则通过完整切除进行处理。术后所有病例均应用加压包扎。大多数病例在局部麻醉下进行。
在良好的抗生素覆盖下及时进行手术干预，结果极佳，并发症极少。
尽早进行手术干预，随后在抗生素覆盖下进行加压包扎可降低发病率。糖尿病在少数情况下起重要作用，必须同时加以控制。
