Нужно составить пересказ текста Auricular Hematoma. Hematoma of the auricle usually develops after blunt trauma and is common among wrestlers and boxers. The mechanism usually involves traumatic disruption of a perichondrial blood vessel. Blood accumulation in the subperichondrial space results in separation of perichondrium from the cartilage. The most effective treatment for auricular hematoma is adequate incision and drainage with through-and-through suturesecured bolsters such as dental rolls. Frostbite. The auricle is particularly susceptible to frostbite because of its exposed location and lack of subcutaneous or adipose tissue to insulate the blood vessels. The frostbitten ear should be rapidly warmed. Wet sterile cotton pledgets at 38 to 42°C are applied until the ear is thawed. The ear should be treated gently owing to the risk of further damage to the already traumatized tissue. Necrotic tissue is débrided, the topical thromboxane inhibitor aloe vera is applied, and antiprostaglandin drugs such as ibuprofen may be beneficial.
Burns. Burns caused by scalding liquids or fire are often full thickness. Untreated, they may lead to perichondritis. It is important to avoid pressure on the ear, and gentle cleansing and topical antibiotic applications are advocated. Prophylactic use of antipseudomonal antibiotics is recommended. The antibiotics may be injected subperichondrially at several different injection sites over the anterior and posterior surfaces of the auricle.
Cerumen. Cerumen is a combination of the secretions produced by sebaceous (lipid producing) and apocrine (ceruminous) glands admixed with desquamated epithelial debris. This combination forms an acidic coat that aids in the prevention
of external auditory canal (EAC) infection. The pH of the cerumen is high in diabetic patients compared with 6.5 to 6.8 in the normal EAC.
Several techniques are available for the removal of cerumen and may be used in a variety of ways such as mechanical removal with ring curet and alligator forceps, irrigation, and suction. Before starting to remove cerumen, one should make sure that the patient does not have a history of tympanic membrane perforation. If perforation is suspected, the irrigation method should not be used. If impaction of hard cerumen persists or is too painful to remove, the patient may
be sent home with instructions for using an agent to soften the cerumen. Following its use for a few days, the cerumen can be removed with irrigation or suction.
Foreign Bodies. Foreign bodies in the EAC are found most frequently in the pediatric age group or in mentally retarded institutionalized patients. The removal of a foreign body can be safely done under direct visualization, preferably under an operating microscope with the patient in a supine position. A live insect in the EAC should be immobilized before removal by instilling mineral oil or alcohol into the canal. The best chance for removal of a foreign body in the EAC is the first attempt. When it fails, the ear may become extremely painful, and proper anesthesia may be necessary.
