Journal of the Chinese Medical Association
Volume 69, Issue 9 , Pages 423-427, September 2006

Postoperative Auricular Perichondritis After an Endaural Approach Tympanoplasty

  • Chih-Chieh Tseng

      Affiliations

    • Section of Otolaryngology, Yuan-Shan Veterans Hospital, Ilan, Taipei, Taiwan, R.O.C.
    • Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • An-Suey Shiao

      Affiliations

    • Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr An-Suey Shiao, Department of Otolaryngology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

Received 23 January 2006; accepted 4 July 2006.

Article Outline

Background

Postoperative auricular perichondritis is a problematic and embarrassing surgical complication after an endaural approach tympanoplasty. However, a search through the literature showed only a few papers regarding postoperative auricular perichondritis, and the reported treatment experience is scarce. This study reviews the clinical aspects of postoperative auricular perichondritis and the different treatment methods.

Methods

The medical records of 8 patients with postoperative auricular perichondritis over a 5-year period were reviewed. Five patients were treated using the wide excision method, 2 underwent tubal drainage, and 1 was placed on antibiotics alone.

Results

In 8 patients with postoperative auricular perichondritis after an endaural approach tympanoplasty, the time between the previous ear operation and the symptoms of infection ranged from 2 to 37 days, with a mean of 17.3 days. The wide excision method was performed after the abscess localized, an average of 8.4 days after initial antibiotic treatment. The culture results found fungus in 4 patients. Multiple excision procedures were required in 4 patients, and the mean number of surgical procedures was 2.6. The mean hospital stay of patients having wide excision was 15.2 days. Two patients had stenosis of the external auditory canal resulting from repeated excision procedures. Two patients underwent tubal drainage, and their mean hospital stay was 51 days.

Conclusion

In postoperative auricular perichondritis after an endaural approach tympanoplasty, wide excision seems to be a better choice to treat this problem. Repeated limited excisions could result in ear deformity. Cartilage exposure during chronic ear surgery should be avoided, and early precautions after operation should be taken in order to prevent complications.

Key Words:  auricular perichondritis , endaural approach , postoperative complications , tympanoplasty , wide excision

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PII: S1726-4901(09)70285-0

doi:10.1016/S1726-4901(09)70285-0

Journal of the Chinese Medical Association
Volume 69, Issue 9 , Pages 423-427, September 2006

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