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

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.

Surgery as a Last Resort for Persistent Auricular Perichondritis

“…Alexandros Poutoglidis https://orcid.org/0000-0002-4591-8347 Nikolaos Tsetsos https://orcid.org/0000-0003-1884-6824 Pseudomonas aeruginosa and Staphylococcus aureus are the most common causative bacteria. 4 Treatment consists of culture-oriented antibiotics (oral or intravenous) and if an abscess is present, then surgical drainage is warranted. However, Pseudomonas cases seem to require longer hospitalization due to their strong resistance against common wide-spectrum antibiotics.…”

A guide to managing disorders of the ear pinna and canal

“…If the wound becomes abscessed, perform (or refer for) early surgical incision and drainage. 5 A failure to promptly recognize perichondritis or to mistakenly prescribe nonantipseudomonal antibiotics contributes to increased rates of hospitalization. 2 Cosmetic deformity is the most common complication of perichondritis.…”

Etiology, Microbiological Isolates, and Antibiotic Susceptibilities in Inpatients with Refractory Auricular Perichondritis: A 10-Year Retrospective Study

“…The absence of standardized guidelines for managing auricular perichondritis results in varying treatment strategies in clinical practice. 5 , 6 Generally, antibiotic therapy holds predominant precedence as the primary treatment. In addition, culture-directed antibiotic approaches have been particularly advocated.…”