Hi,
Thank you for your query.
There are a few issues that I would like to clarify here.
1. Cartilage has extremely poor blood supply as it grows very slowly. The only other tissue in the body with a lesser blood supply and growth rate is bone. Hence, antibiotics do not reach easily to the site of infection in cartilage and bone. Also, healing is slow as seen with fractures. Cartilage may heal with fibrosis or not heal at all.

2. Clindamycin achieves high levels in bones and body fluids such as synovial fluid and saliva. An infection may be due to resistant organisms and may thus not respond.

3. If the skin over the ear cartilage was broken, the chances of infection are higher. A closed wound is less likely to be infected.

4. The bumps are more likely to be tense collections of inflammatory fluid under the perichondrium ( the layer which covers the cartilage). They may be drained and a pressure bandage given to prevent re-accumulation. Any drained fluid should be sent for culture and antibiotic sensitivity.
5. Separation of the perichondrium on both sides of the cartilage may devitalize it. Dead cartilage need not be removed unless it is infected.
6. I would also like to know if you have been prescribed any anti-inflammatory medication?

I hope I have answered your query. If you have any further questions, I will be available to answer them.

Regards

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Hi,

Thank you for writing back.

1. Discuss with your specialist that you are expecting that a perichondritis or celulitis has developed.

2. Other conditions to be ruled out are a sub-perichondrial hematoma, seroma or a pseudocyst.

3. If there is pus, severe pain or fever, surgical drainage will be necessary. You may have to continue IV antibiotics. Steroids and anti-inflammatory medication may be added. A local antibiotic ointment may be used locally.

4. Prompt treatment will ensure full recovery and no deformity of the pinna (auricle / external ear).

I hope I have answered your query. If you have any further questions, I will be available to answer them.

Regards

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Hi,

Thank you for writing back.

You should follow up with your specialist. You may also share the reports and, if possible, a close-up image of your left ear.

I sincerely hope that you have a good recovery.

Regards.

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Hi,

Thank you for following up.

Perichondritis (inflammation of the perichondrium and cartilage) frequently occurs following trauma. Sometimes there is a lot of inflammatory fluid and exudate collection in the area of the injury which delays healing. As explained above, healing time is prolonged and may take between two to eight weeks with treatment. Is there any history of keloid (hypertrophic scar) formation with you or any one in your family? If so, then intra-lesional steroid injections may also help prevent scarring.

Wishing you a speedy recovery.

Regards.

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