From the Guidelines
The treatment approach for conditions affecting the osseous auricle (bony part of the ear) should prioritize the management of potential complications such as infections, allergic reactions, and traumatic injuries, with a focus on preventing long-term damage and preserving cosmetic appearance. When considering the management of conditions affecting the osseous auricle, it is crucial to assess the specific condition and its potential complications. For instance, auricular perichondritis and perichondrial abscess, which can occur after ear piercings, require prompt treatment with fluoroquinolone antibiotics such as ciprofloxacin or levofloxacin 1. In cases where an abscess is present, surgical incision and drainage may be necessary to prevent further complications and preserve the cosmetic appearance of the auricle 1. Additionally, the use of earrings with locking backs or screw backs can help prevent accidental removal and reduce the risk of aspiration or ingestion of earring parts, especially in infants and young children 1. It is also essential to consider the potential for contact dermatitis resulting from nickel exposure and other metals, and to advise patients on the use of topical corticosteroids and avoidance of triggering metals 1. Overall, the management of conditions affecting the osseous auricle requires a comprehensive approach that prioritizes the prevention of complications, preservation of cosmetic appearance, and promotion of long-term health and well-being. Some key considerations in the management of these conditions include:
- Prompt treatment of infections and abscesses with appropriate antibiotics and surgical interventions
- Use of earrings with locking backs or screw backs to prevent accidental removal
- Avoidance of triggering metals and use of topical corticosteroids to manage contact dermatitis
- Thorough cleaning and assessment of the ear canal under microscopic visualization to ensure accurate diagnosis and effective treatment
- Consideration of the potential for long-term damage and cosmetic complications, and prioritization of interventions that promote preservation of appearance and function.
From the Research
Treatment Approaches for Osseous Auricle Conditions
The osseous auricle, or bony part of the ear, can be affected by various conditions, including osteomyelitis and ossification.
- Osteomyelitis is a bone infection that can be treated with antibiotics, such as ceftriaxone, which has been shown to be effective against most causative organisms 2, 3.
- Ceftriaxone can be used in combination with surgery to treat osteomyelitis, and its once-daily dosing makes outpatient therapy feasible for most patients 2.
- However, the optimal duration of treatment and the relevance of minimal inhibitory/bactericidal concentrations and serum inhibitory/bactericidal concentrations have not been fully determined 2.
Ossification of the Auricle
Ossification of the auricle, or replacement of cartilage with bone, is a rare condition that can result in a rigid auricle.
- This condition can be asymptomatic or cause mild discomfort, and its pathogenesis is unclear 4.
- In some cases, ossification of the auricle can lead to external auditory canal stenosis, which can be treated with meatoplasty 5.
Antibiotic Prophylaxis
Antibiotic prophylaxis is important in preventing infections in patients with open fractures, including those affecting the osseous auricle.
- Ceftriaxone plus vancomycin and cefazolin plus gentamicin are two commonly used antibiotic regimens for grade 3 open fractures 6.
- While there is no significant difference in treatment failure rates between these two regimens, the trend suggests that ceftriaxone plus vancomycin may be more effective in preventing infections 6.