Skip to main content

Advertisement

SpringerLink
Log in

Pinna abscesses: can we manage them better? A case series and review of the literature

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Suppurative perichondritis of the pinna is a serious condition with potentially long-term cosmetic sequelae. Literature regarding the optimal treatment of these abscesses is scarce with most case series containing low numbers. This work reports the largest series from the UK to date; along with a review of recent literature. A 10-year retrospective review of case notes was undertaken. Demographic data, interventions and microbiology results were recorded along with outpatient descriptions of cosmetic outcomes. 20 patients were identified with male:female ratio of 4:1. Average patient age was 25.3 years (range 8–65). Average duration of symptoms prior to being seen by the ENT department was 9.95 days with an average length of stay in hospital of 2.5 days. 80 % of patients had a surgical intervention performed. The commonest organism grown on microbiological culture was pseudomonas (33 %). Of patients who attended follow-up, 28.6 % had residual deformity. All of these had undergone surgical drainage of the abscess. Residual deformity was associated with longer time before presentation, piercing of the cartilage and a growth of pseudomonas. Prompt surgical management and appropriate antibiotic regimens to cover pseudomonas are the cornerstones of treatment in the event of pinna abscess formation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Davidi E, Paz A, Duchman H, Michal L, Potasman I (2011) Perichondritis of the auricle: analysis of 114 cases. IMAJ 13:21–24

    PubMed  Google Scholar 

  2. van Wijk MP, Kummer JA, Kon M (2008) Ear piercing techniques and their effect on cartilage, a histologic study. J Plast Reconstr Aesthet Surg 61(Suppl 1):S104–S109

    Article  PubMed  Google Scholar 

  3. Hanif J, Frosh A, Marnane C, Ghufoor K, Rivron R, Sandhu G (2001) Lesson of the week: “high” ear piercing and the rising incidence of perichondritis of the pinna. BMJ 322:906–907

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Janssen K, Kon M (2004) Three patients with complications following piercing of the auricular cartilage [Dutch] 3 Patienten met complicaties als gevolg van piercing van het oorkraakbeen. Nederlands Tijdschrift voor Geneeskunde 148/27:1351–1354

    Google Scholar 

  5. Pino Rivero V, Marcos García M, Trinidad Ruiz G, Pardo Romero G, González Palomino A, Guerra Camacho M, Barrantes Celaya G, Blasco Huelva A (2005) Auricular perichondritis in adults. An evaluation-study of 12 hospitalized patients. An Otorrinolaringol Ibero Am 32(1):1–6

    CAS  PubMed  Google Scholar 

  6. Eckhardt LR, Haug S, Nielsen KO (2002) Perichondritis caused by high ear piercing. Therapeutic and legal aspects. Ugeskr Laeger 164(44):5144–5145

    PubMed  Google Scholar 

  7. Sørensen T (1990) Auricular perichondritis caused by acupuncture therapy. Ugeskr Laeger 152(11):752–753 (Danish)

    PubMed  Google Scholar 

  8. Johansen M, Nielsen KO (1990) Perichondritis of the ear caused by acupuncture. Ugeskr Laeger 152(3):172–173 (Danish)

    CAS  PubMed  Google Scholar 

  9. Andersen HT (2002) Ear piercing and auricular chondritis caused by Pseudomonas aeruginosa. Ugeskr Laeger 164(44):5145–5147

    PubMed  Google Scholar 

  10. Chowdhury WA, Hossain MM, Chowdhury MR, Chowdhury EH (2004) High ear piercing–a dangerous craze. Mymensingh Med J 13/2(201–2), 1022-4742 (abstract only)

  11. Hussain K, Mulla O, Nix P, Sandoe J, Kaye T (2012) Improving the management of pinna abscess—a case series. Clin Otolaryngol 37/(41), 1749-4478 (abstract only)

  12. Hickling G, Elloy M, De M (2012) Management of an outbreak of perichondritis and pinna abscess following ear piercing. Clin Otolaryngol 37/(156), 1749-4478. (abstract only)

  13. Kaplan AL, Cook JL (2004) The incidences of chondritis and perichondritis associated with the surgical manipulation of auricular cartilage. Dermatol Surg 30(1):58–62; discussion 62

  14. Wu J, Collins NP, Wilson SF (2003) Perils of pinna piercing and pseudomonas perichondritis. Aust Fam Physician 32(7):516–517

    CAS  PubMed  Google Scholar 

  15. Warwick-Brown NP, Richards AE (1986) Perichondritis of the ear following acupuncture. J Laryngol Otol 100(10):1177–1179

    Article  CAS  PubMed  Google Scholar 

  16. Cossette JE (1993) High ear-piercing. Otolaryngol Head Neck Surg 109(5):967–968

    CAS  PubMed  Google Scholar 

  17. Yahalom S, Eliashar R (2003) Perichondritis: a complication of piercing auricular cartilage. Postgrad Med J 79:29

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. Cumberworth VL, Hogarth TB (1990) Hazards of ear-piercing procedures which traverse cartilage: a report of Pseudomonas perichondritis and review of other complications. Br J Clin Pract 44:512–513

    CAS  PubMed  Google Scholar 

  19. Turkeltaub SH, Habal MB (1990) Acute Pseudomonas chondritis as a sequel to ear piercing. Ann Plast Surg 24:279–282

    Article  CAS  PubMed  Google Scholar 

  20. Fisher CG, Kacica MA, Bennett NM (2005) Risk factors for cartilage infections of the ear. Am J Prev Med 29:204–209

    Article  PubMed  Google Scholar 

  21. More DR, Seidel JS, Bryan PA (1999) Ear-piercing techniques as a cause of auricular chondritis. Pediatr Emerg Care 15(3):189–192

    Article  CAS  PubMed  Google Scholar 

  22. Stewart GM, Thorp A, Brown L (2006) Perichondritis—a complication of high ear piercing. Pediatr Emerg Care 22(12):804–806

    Article  PubMed  Google Scholar 

  23. Davis O, Powell W (1985) Auricular perichondritis secondary to acupuncture. Arch Otolaryngol 111(11):770–771

    Article  CAS  PubMed  Google Scholar 

  24. Kent SE, Rokade AV, Premraj K, Butcher C (2001) “High” ear piercing and perichondritis of the pinna. BMJ 323:400

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Liu ZW, Chokkalingam P (2013) Piercing associated perichondritis of the pinna: are we treating it correctly? J Laryngol Otol 127:505–508

    Article  CAS  PubMed  Google Scholar 

  26. Widick MH, Coleman J (1992) Perichondrial abscess resulting from a high ear-piercing—case report. Otolaryngol Head Neck Surg 107:803–804

    CAS  PubMed  Google Scholar 

  27. Rowshan HH, Keith K, Baur D, Skidmore P (2008) Pseudomonas aeruginosa infection of the auricular cartilage caused by “high ear piercing”: a case report and review of the literature. J Oral Maxillofac Surg 66:543–546

    Article  PubMed  Google Scholar 

  28. Staley R, Fitzgibbon JJ, Anderson C (1997) Auricular infections caused by high ear piercing in adolescents. Pediatrics 99:610–611

    Article  CAS  PubMed  Google Scholar 

  29. Keene WE, Markum AC, Samadpour M (2004) Outbreak of Pseudomonas aeruginosa infections caused by commercial piercing of upper ear cartilage. JAMA 291(8):981–985

    Article  CAS  PubMed  Google Scholar 

  30. Folz BJ, Lippert BM, Kuelkens C, Werner JA (2000) Hazards of piercing and facial body art: a report of three patients and literature review. Ann Plast Surg 45:374–381

    Article  CAS  PubMed  Google Scholar 

  31. Sandhu A, Gross M, Wylie J, Van Caeseele P, Plourde P (2007) Pseudomonas aeruginosa necrotizing chondritis complicating high helical ear piercing case report: clinical and public health perspectives. Can J Public Health 98:74–77

    PubMed  Google Scholar 

  32. Manca DP, Levy M, Tariq K (2006) Case report: infected ear cartilage piercing. Can Fam Physician 52:974–975

    PubMed Central  PubMed  Google Scholar 

  33. Prasad HK, Sreedharan S, Prasad HS, Meyyappan MH, Harsha KS (2007) Perichondritis of the auricle and its management. J Laryngol Otol 121(6):530–534 (Epub 2007 Feb 26)

    Article  PubMed  Google Scholar 

  34. Vargas J, Carballo M, Hernández M, Rojas N, Jiménez O, Riera J et al (2005) Rapid development of auricular infection due to imipenem resistant Pseudomonas aeruginosa following self-administered piercing of high ear. Clin Infect Dis 41:1823–1824

    Article  PubMed  Google Scholar 

  35. Fernandez AP, Castro Neto I, Anias CR, Pinto PC, Castro Jde C, Carpes AF (2008) Post-piercing perichondritis. Braz J Otorhinolaryngol 74:933–937

    Google Scholar 

  36. Pena FM, Sueth DM, Tinoco MI, Machado JF, Tinoco LE (2006) Auricular perichondritis by piercing complicated with pseudomonas infection. Braz J Otorhinolaryngol 72:717

    PubMed  Google Scholar 

  37. British Medical Association; Royal Pharmaceutical Society of Great Britain (2000) British National Formulary 39. BMA-RPS, London, p 280

  38. Adefurin A, Sammons H, Jacqz-Aigrain E, Choonara I (2011) Ciprofloxacin safety in paediatrics: a systematic review. Arch Dis Child 96:874–880

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This is not under consideration from any other journal and this work received no funding or support from any source including: The National Institutes of Health (NIH), the Wellcome Trust and the Howard Hughes Medical Institute (HHMI).

Author information

Authors and Affiliations

  1. Walsall Healthcare NHS Trust, Walsall Manor Hospital, Walsall, WS2 9PS, UK

    Scott Mitchell, Kashif Ditta, Satvir Minhas & Attila Dezso

Authors
  1. Scott Mitchell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kashif Ditta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Satvir Minhas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Attila Dezso
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Scott Mitchell.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mitchell, S., Ditta, K., Minhas, S. et al. Pinna abscesses: can we manage them better? A case series and review of the literature. Eur Arch Otorhinolaryngol 272, 3163–3167 (2015). https://doi.org/10.1007/s00405-014-3346-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-014-3346-2

Keywords

Search

Navigation