Pinna


Label 1-8

  1. Helix
  2. Antihelix
  3. Tragus
  4. Triangular fossa
  5. Scaphoid fossa
  6. Cymba concha
  7. Cavum concha
  8. Lobule

Describe two anatomical differences between a protruding/ ‘bat’ ear compared to a normally developed one.

Describe two anatomical differences between a protruding/ ‘bat’ ear compared to a normally developed one.

  • Underdevelopment or absence of the antihelical fold
  • Deep conchal bowl


What is the diagnosis?

Pinna haematoma

What is the potential consequence if left untreated and what is the pathophysiology?

  • May lead to a cauliflower ear – deformity due to necrosis of the cartilage.
  • This occurs as the cartilage obtains its blood supply from the auricular perichondrium. When a pinna haematoma accumulates in the subperichondrial space, this disrupts the blood supply leading to necrosis of the fibrocartilage causing fibrosis of the cartilage if untreated. 

Describe three treatment options.

  • Conservative if small, or if patient declines treatment
  • Needle aspiration
  • Incision and drainage

Supporting Information

Embryology of the ear

Structure

Origin

Malleus, incus, stapedius

1st pharyngeal arch

Stapes, tensor tympani

2nd pharyngeal arch

Middle ear

1st pharyngeal pouch

External ear- pinna and external auditory canal. 

Nerve supply pinna- 

Upper lateral – auriculotemporal nerve from mandibular trigeminal 

Lower lateral and medial surface- greater auricular nerve from C2/C3

Posterior ear- lesser occipital nerve C2

Ear trauma- 

  • Lacerations– not affecting cartilage- suture nylon stitch
  • Bites– left open- abx
  • Pinna haematoma– I+D back of the ear, drain if necessary. May need to stitch dental rolls to both sides of the ear and use a pressure bandage. Failure to do so–>  death of cartilage due to perichondrium stripped from cartilage (blood supply)–>cauliflower ear. 
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