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Full text of "Diseases Of The Nose Throat And Ear"

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Haematoma of the Auricle

This generally results from injury. An effusion of blood occurs under the
perichondrium and forms a swelling on the lateral or anterior surface of
the auricle which may have a bluish tinge (Fig. 164), and considerable pain
is experienced. Suppuration may take place, resulting in destruction of
cartilage, and finally in shrivelling of the auricle. If uncomplicated by inflam-
mation, the serum becomes absorbed, but a certain amount of permanent
thickening remains.

TREATMENT. In the early stages, before coagulation of the blood has
occurred, aspiration, with full aseptic precautions, may be employed, but
may have to be repeated owing to further oozing taking place. A firm ban-
dage is applied with pressure over the auricle. At a later stage free incision
and evacuation of the haematoma may be required, but this should not be
undertaken lightly because of the risk of introducing infection.

Perichondritis of the Auricle

This may follow a haematoma or result from the extension of infection
from a furuncle on the posterior meatal wall. Ps. pyocyanea is the common
causal organism, and the pus has a bluish tinge. There is severe pain in the
ear and a rise of temperature. The auricle swells rapidly, and becomes dusky
in colour, and its normal contour is lost, the swelling being apparent on
both surfaces (Fig. 165). As the infection progresses, necrosis of the cartilage
takes place, with the result that the auricle finally shrivels.

TREATMENT. This consists in a course of the appropriate antibiotic. Peni-
cillin may be given until the results of sensitivity tests have been obtained.
Ichthyol, 20 per cent in water, aluminium acetate, 8 per cent in water, or
magnesium sulphate paste may be used frequently as local applications to
relieve the discomfort. When fluctuation is apparent, incision and drainage
are required.