Burn of the auricle.
Silvadene cream and Sulfamylon make up the treatment regimen for one contributor (Dr. Crumley). No systemic antibiotics would be given. Any areas of obvious third-degree burns would be debrided and grafted. The tympanic membrane perforation would be treated with antibiotic/steroid drops. The second author concurs with use of Silvadene cream and would avoid any pressure on the area (Dr. Abemayor). While he agrees that systemic antibiotics should be avoided, he also would not prescribe ear drops. He recommends evaluation for a pulmonary or ophthalmologic injury. There is a disagreement regarding imaging studies. One expert would order a CT scan to rule out facial fractures (Dr. Crumley). His counterpart would not order a CT but would check a baseline chest x-ray if there were any sign of pulmonary compromise (Dr. Abemayor). Both experts would obtain an audiogram after the acute problems are treated. In the case of foul drainage, burn reconstruction would be delayed. In addition to treating the otorrhea with ear drops, one physician would add oral antibiotics (Dr. Abemayor). The other author believes tympanoplasty should be performed prior to reconstruction (Dr. Crumley). There were several procedures suggested for the reconstruction. Both authors discuss a method of creating a postauricular pocket, burying the ear pedicle, and using costal cartilage for an inlay helical graft. Another approach involves minimal debridement of the cartilage and letting the wound mature for 6 to 8 months. At that time the area would be debrided and the postauricular skin used for external coverage (Dr. Crumley). If the facial scar is a cosmetic problem 1 year after the injury, triamcinolone injections and local massage should be considered.(ABSTRACT TRUNCATED AT 250 WORDS)
Crumley
R L
RL
Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine.
Abemayor
E
E
D000328:Adult; D002056:Burns / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D004431:Ear, External / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008272:Mafenide / Q000627:therapeutic use*; D008297:Male; D012837:Silver Sulfadiazine / Q000627:therapeutic use*; D013227:Steam / Q000009:adverse effects*; D014432:Tympanic Membrane / Q000293:injuries
D013227:Steam; D008272:Mafenide; D012837:Silver Sulfadiazine