Bassiouny A
Laryngoscope. 1981 Mar;91(3):422-31. doi: 10.1288/00005537-198103000-00013.
A search of the literature reveals reports of only 191 cases of auricular perichondritis. The present study includes 15 further cases caused by pseudomonas and proteus. Stroud's excision technique was used in four cases and resulted in marked deformity, repeated debridement, and protracted treatment. Tubal drainage was used in the remaining ears with very good esthetic results. It has been demonstrated in experimental animals and in humans that new cartilage forms in the subperichondrial auricular space in the second postoperative week, being maximum in the fourth week. In the present study tubes were retained two to four weeks to maintain an elevation of the perichondrium from what remains of the auricular cartilage to ensure homogeneous cartilage formation and provide local antibiotic treatment. Hospitalization is required for only two days. The four weeks tubal drainage method should be the method of choice for all cases of perichondritis and the excision method abandoned, even in gram-negative infections. A case of relapsing polychondritis is also presented because it is important to distinguish auricular perichondritis from relapsing polychondritis as the treatment of the latter is not surgical but with steroids.
文献检索显示仅报道了191例耳郭软骨膜炎病例。本研究纳入了另外15例由假单胞菌和变形杆菌引起的病例。4例采用了斯特劳德的切除技术，结果导致明显畸形、反复清创和治疗时间延长。其余耳朵采用了置管引流，美学效果非常好。在实验动物和人类中均已证实，术后第二周在耳郭软骨膜下间隙形成新的软骨，第四周时达到最大量。在本研究中，置管保留两到四周，以保持软骨膜与残留的耳郭软骨分离，确保软骨均匀形成并提供局部抗生素治疗。仅需住院两天。四周置管引流法应作为所有软骨膜炎病例的首选方法，即使在革兰氏阴性菌感染时也应摒弃切除法。还报告了1例复发性多软骨炎病例，因为将耳郭软骨膜炎与复发性多软骨炎区分开来很重要，因为后者的治疗不是手术而是使用类固醇。
