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耳廓脓肿:我们能更好地处理它们吗?病例系列及文献综述

Pinna abscesses: can we manage them better? A case series and review of the literature.

作者信息

Mitchell Scott, Ditta Kashif, Minhas Satvir, Dezso Attila

机构信息

Walsall Healthcare NHS Trust, Walsall Manor Hospital, Walsall, WS2 9PS, UK.

出版信息

Eur Arch Otorhinolaryngol. 2015 Nov;272(11):3163-7. doi: 10.1007/s00405-014-3346-2. Epub 2014 Oct 28.

Abstract

Suppurative perichondritis of the pinna is a serious condition with potentially long-term cosmetic sequelae. Literature regarding the optimal treatment of these abscesses is scarce with most case series containing low numbers. This work reports the largest series from the UK to date; along with a review of recent literature. A 10-year retrospective review of case notes was undertaken. Demographic data, interventions and microbiology results were recorded along with outpatient descriptions of cosmetic outcomes. 20 patients were identified with male:female ratio of 4:1. Average patient age was 25.3 years (range 8-65). Average duration of symptoms prior to being seen by the ENT department was 9.95 days with an average length of stay in hospital of 2.5 days. 80% of patients had a surgical intervention performed. The commonest organism grown on microbiological culture was pseudomonas (33%). Of patients who attended follow-up, 28.6% had residual deformity. All of these had undergone surgical drainage of the abscess. Residual deformity was associated with longer time before presentation, piercing of the cartilage and a growth of pseudomonas. Prompt surgical management and appropriate antibiotic regimens to cover pseudomonas are the cornerstones of treatment in the event of pinna abscess formation.

摘要

耳廓化脓性软骨膜炎是一种严重疾病,可能会导致长期的美容后遗症。关于这些脓肿最佳治疗方法的文献很少,大多数病例系列数量较少。本文报告了英国迄今为止最大的病例系列;并对近期文献进行了综述。对病例记录进行了为期10年的回顾性研究。记录了人口统计学数据、干预措施和微生物学结果以及门诊对美容效果的描述。确定了20例患者,男女比例为4:1。患者平均年龄为25.3岁(范围8 - 65岁)。在耳鼻喉科就诊前症状的平均持续时间为9.95天,平均住院时间为2.5天。80%的患者接受了手术干预。微生物培养中最常见的病原体是铜绿假单胞菌(33%)。在接受随访的患者中,28.6%有残留畸形。所有这些患者都接受了脓肿的手术引流。残留畸形与就诊前时间较长、软骨穿孔和铜绿假单胞菌生长有关。如果形成耳廓脓肿,及时的手术治疗和覆盖铜绿假单胞菌的适当抗生素方案是治疗的基石。

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