Common causes usually involve trauma to the tissue and include:
Ear piercing, especially high up on the cartilage portion of the ear Surgical trauma Sports injury or other blunt trauma Insect bites Burns Cuts or lacerations of any kind on the ear Poorly treated otitis externa (swimmer’s ear) Autoimmune disease, such as granulomatosis with polyangiitis and relapsing polychondritis
Diagnosis
The diagnosis of perichondritis is uncomplicated and based on the history of trauma to the ear and the appearance of the area infected. In its beginning stages, perichondritis looks similar to cellulitis. Your healthcare provider will take a thorough history to identify any risk factors listed above and examine your ear. Even though it may likely hurt a little, your healthcare provider will likely squeeze on your ear to see if there is any “give,” or fluctuance, as this can indicate an abscess or chondritis. If you have had multiple cases of perichondritis, your healthcare provider will refer you to a rheumatologist to determine if you have an autoimmune disease.
Symptoms
Since piercing the cartilage of the outer ear is a very common practice, it seems to be the most common cause of perichondritis at this time. Perichondritis is caused by the bacterium Staphylococcus aureus.
Perichondritis may be manifested by the following common symptoms:
RednessSwellingPainPus or other fluid discharge (in severe cases)Fever (in severe cases)Deformation of the ear structure (in severe cases)
If you are experiencing relapsing perichondritis, you may experience other less common symptoms, including:
Floppy ear Sudden hearing loss Vertigo Impaired balance Tinnitus Ear drainage Middle ear infections
Treatment
Treatment for your perichondritis will be based on your physical examination. If your healthcare provider suspects an abscess, a small incision will be made to drain the pus. Your healthcare provider will then pack the area that was drained with antibiotic-coated gauze or ribbon. If packing is used, your healthcare provider will set up a follow-up appointment to remove the packing. Over time, the ear will heal on its own without sutures..
Regardless of the presence of pus, your healthcare provider will prescribe antibiotics for you. Augmentin or Keflex are common antibiotics prescribed to treat perichondritis. Depending on the severity of the infection, antibiotics are prescribed to be taken orally or given intravenously.
Autoimmune perichondritis is treated using steroid medication such as prednisone to repress the immune response and stop it from attacking the cartilage of the ear (and other parts of the body). After starting treatment, your healthcare provider will also refer you to a rheumatologist for further follow-up in relation to your autoimmune disease.
Preventing Perichondritis
Sometimes perichondritis cannot be prevented, such as in the case of accidental injury. However, piercing the cartilage in your ear, particularly in the upper part of your ear, puts you at significantly greater risk of developing perichondritis. You can also increase your risk of developing perichondritis by having multiple piercings in close proximity in your upper ear. By keeping your ear piercings in your earlobe, you can greatly reduce your risk of having any complications related to your ear piercings. Prognosis of perichondritis is good if treated promptly; a full recovery is typically expected.
