Perichondritis

At a Perichondritis it is an inflammation on the skin of the cartilage (medical term perichondrium). In the majority of cases, an inflammation of the cartilage on the auricle develops as part of the disease. Perichondritis also occurs in other areas of the body, such as the larynx or nasal cartilage.

What is perichondritis?

When perichondritis occurs on the auricle, the inflammatory processes are also heralded by changes in the relief of the mussel. However, the perichondritis usually does not extend to the earlobe.
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Basically develop in the context of Perichondritis inflammatory processes on the skin of the cartilage. Inflammation of the auricle occurs most frequently. However, perichondritis can also develop in other areas containing cartilage. The nose and larynx are affected.

Perichondritis is usually accompanied by pain that originates from the inflamed areas on the cartilage. The skin of the cartilage, the so-called perichondrium, is particularly affected. When perichondritis occurs on the ear, in most cases the external ear canal is also involved in the condition. The cause is primarily bacterial pathogens that penetrate the skin.

Small injured areas on the skin form the point of attack for the bacteria. It is also possible that perichondritis occurs in connection with systemic diseases. So-called recurrent perichondritis was described for the first time in 1923 by a specialist in internal medicine, von Jaksch. The disease is now one of the autoimmune diseases.

causes

The causes for the development of perichondritis lie in the majority of cases in bacterial infections. These are mostly staphylococci or Pseudomonas. The pathogens often penetrate the human organism through the skin. Affected patients are particularly often infected by the bacteria through skin injuries.

For example, injured areas on the auricle are possible. Some pathogens also penetrate the skin through mosquito bites. In addition, in some cases, perichondritis develops following surgery. People often become infected with perichondritis when piercing their ears.

The risk of illness increases significantly if the hygienic conditions are not satisfactory when pricking. In addition, the bacterial germs can enter the body through micro-injuries in the auricle. If a so-called othematoma is present and injured, perichondritis is also possible. Sometimes mycobacteria are responsible for the causative infection.

Symptoms, ailments & signs

Perichondritis is associated with various complaints for the affected patients. The diseased areas of the cartilage usually swell. In most cases, the corresponding areas turn red. In addition, the sick people suffer from more or less severe pain that radiates from the inflammation of the cartilage membrane.

When perichondritis occurs on the auricle, the inflammatory processes are also heralded by changes in the relief of the mussel. However, the perichondritis usually does not extend to the earlobe. If the perichondritis is not adequately treated, the inflammation focus spreads to the neighboring areas. In the worst case, the inflammation progresses to the point that necroses develop on the cartilage, for example of a septic nature.

For the most part, the earlobe is not affected by the perichondritis, as it has no cartilage tissue whatsoever. This also makes the differential diagnosis easier, because in erysipelas the earlobe is usually affected by the inflammation. The necrosis that is possible in the context of perichondritis implies, in many cases, changes in the shape of the auricle. In some sick people a so-called cauliflower ear develops.

Diagnosis & course of disease

A visit to a doctor is recommended for people with typical symptoms and signs of perichondritis. As part of the anamnesis, the attending physician clarifies the individual symptoms with the patient and finds out whether injuries have occurred in the area of ​​the affected cartilage. The doctor then inspects the affected areas.

At this point, he may already be making a suspected diagnosis. Laboratory analyzes of the relevant tissue are necessary to clearly confirm the diagnosis of perichondritis. First, the doctor takes swabs from the inflamed areas and then has them examined. In this way, the responsible bacterial germs can be identified.

Complications

Ear perichondritis is an inflammation of the ear cartilage and the surrounding tissue. The earlobe is not affected because it does not contain any cartilage. The disease is usually harmless at first, but it can lead to considerable complications if it is not treated adequately in a timely manner. In the initial stage, blisters form around the infected area and the ear begins to hurt, and sometimes the earlobe also turns red.

If not properly treated, there is a risk that the perichondritis could spread to the entire cartilage membrane of the auricle and the ear canal. A frequent consequence is tissue death (necrosis). This can go hand in hand with a permanent change in the ear cartilage and lead to the so-called cauliflower ear, which is otherwise only seen in martial artists.

In severe cases it may be necessary to completely or partially amputate the ear. If the patient does not want to live with the visual and usually also acoustic impairment, the ear can be replaced with an ear prosthesis. Surgical intervention is associated with general surgical risks.

Diabetics and people with a weakened immune system are at particularly high risk of developing severe perichondritis. Cosmetic interventions on the ear such as piercings or tattoos also involve an increased risk due to the often inadequate hygiene.

When should you go to the doctor?

In the event of redness or painful swelling of the auricle, an appointment with a doctor is recommended. Perichondritis is not a serious disease, but if left untreated it can lead to cartilage necrosis and other complications. Affected people should consult a doctor at the first signs of inflammation. The external redness is a clear warning sign and a reason for a quick visit to the doctor. A bacterial disease should be treated at an early stage so that the pathogens cannot even penetrate to the auricle. Oral antibiotic treatment is then often possible, which can destroy the pathogens.

Advanced diseases require intravenous antibiotic therapy. Surgical intervention is necessary if necrosis has already occurred. Perichondritis is treated by the family doctor or the ENT doctor. Advanced diseases are treated in-patient by a surgeon and other specialists. As part of the follow-up care, a few check-ups are usually sufficient, through which the degree of recovery is assessed and the medication is adjusted if necessary.

Treatment & Therapy

Perichondritis can be treated with various means and methods. Antibiotics are usually used if the disease is still in its relatively early stages. These are given to patients orally. If the inflammation in the context of the perichondritis has progressed, the antibiotics are usually injected into the veins. This improves the effectiveness of the medication.

In this context, active ingredients such as ciprofloxacin or levofloxacin have proven particularly useful. Because these are able to penetrate the cartilage. However, if necrosis has developed on the cartilage, surgical removal of the relevant areas is necessary. This allows the destruction of the auricle to be contained. It is also recommended to use medical rinsing on the diseased areas to accelerate the healing process.

Outlook & forecast

In the case of perichondritis, the further course in most cases depends very much on when the disease is recognized and how quickly it is treated. As a rule, self-healing of this disease cannot occur, so that the person affected is always dependent on medical treatment by a doctor. Therefore, a doctor should be contacted at the first symptoms and signs. If the disease is not treated, the inflammation usually spreads to other regions of the body and can significantly reduce the quality of life of the person affected. Treatment then also proves to be relatively difficult.

If the disease is recognized and treated correctly by a doctor right from the start, it can usually be limited and cured with the help of antibiotics. There are no further complications or other complaints. However, a renewed infection of the perichondritis is possible even after complete healing. If the disease is not treated, the auricle can be completely and irreversibly destroyed. In most cases, the disease itself does not reduce the life expectancy of the person affected.

prevention

Perichondritis cannot always be prevented. However, the risk of inflammation is reduced if, for example, when piercing piercings are meticulously observed, hygienic standards.

Aftercare

In most cases of perichondritis, those affected have only a few and only limited options for follow-up care. The person affected should first and foremost consult a doctor at an early stage so that there are no complications or other complaints in the further course. The sooner a doctor is consulted, the better the further course of the disease is usually.

Treatment of perichondritis is usually carried out by taking various medications, mainly antibiotics. In doing so, regular intake with the correct dosage must always be observed, whereby antibiotics should not be taken together with alcohol. If you have any questions or if you have any side effects, you should first consult a doctor with perichondritis in order to avoid complications.

Regular checks by a doctor are also very important. If the disease is treated with an operation, the person affected should take it easy after the operation and especially protect the affected area. This can prevent infection and inflammation.

You can do that yourself

In the case of perichondritis, it is usually sufficient to take the prescribed medication and inform the doctor about side effects. The patient does not need to take any further action as the inflammation subsides on its own within a few days.

Further self-help measures only make sense in the event of complications or a late diagnosis. In the case of severe inflammation in the area of ​​the ear, the emergency medical service must be contacted. If the hearing ability deteriorates massively, a hospital visit is indicated. If perichondritis was diagnosed late, necrosis may already have formed. These must be surgically removed. After a surgical procedure, patients should take it easy and otherwise follow the doctor's recommendations regarding wound care. Rinsing with agents such as Rivanol have a supportive effect and natural preparations can be added in consultation with the doctor.

If inflammation occurs again, there may be a serious condition that must first be diagnosed. The patient should contact the ear specialist or consult an internist. A complaint diary serves as a guide for the doctor, who can make a diagnosis based on the information about the symptoms and their severity.