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18 - Fundamentals of head and neck surgery

Published online by Cambridge University Press:  03 May 2011

By
John K.S. Woo  and
Walter W.K. King
Edited by
Andrew Kingsnorth  and
Douglas Bowley
John K.S. Woo
Affiliation:
Chinese University of Hong Kong
Walter W.K. King
Affiliation:
Chinese University of Hong Kong
Andrew Kingsnorth
Affiliation:
Derriford Hospital, Plymouth
Douglas Bowley
Affiliation:
Heart of England NHS Foundation Trust
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Summary

Inflammatory disorders of the ear, nose, sinuses and throat

The ear

Preauricular sinus

Preauricular sinus is a common congenital condition; there is no requirement for treatment unless it becomes infected (Figure 18.1). It may then present with pain, swelling and discharge. If seen at an early stage, infected preauricular sinus may be controlled with antibiotics. If a patient presents with a preauricular abscess, incision and drainage together with antibiotic will then become necessary. The site of incision should be through the sinus opening so as to minimize branching of the sinus tract. This is particularly important with recurrent preauricular abscesses. Abscess formation or recurrent infections are indications that the sinus tract should be excised. It is important that all tracts connected to the sinus should be excised to prevent recurrence. If in doubt, any soft tissue adherent to the tract should be excised as deep as the temporalis fascia.

Auricular haematoma

The pinna, because of its exposed and protruding position, is frequently traumatized. Blunt injury may lead to formation of an auricular haematoma. The haematoma typically forms in the subperichondrial plane. If treatment is delayed, the haematoma may dissect along the subperichondrial plane and result in unsightly deformity. Thus auricular haematoma needs to be evacuated promptly and a pressure dressing applied to conform with the shape of the pinna by means of through and through stitches.

Type
Chapter
Information
Fundamentals of Surgical Practice
A Preparation Guide for the Intercollegiate MRCS Examination
 , pp. 306 - 329
Publisher: Cambridge University Press
Print publication year: 2011

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