Human bite to ear. No obvious cartilage tear, good skin cove | Figure 1

forderit

Emergency Medicine

Human bite to ear. No obvious cartilage tear, good skin coverage can be achieved by closure, what are the subsequent steps in management of this patient from the infectious disease and ENT viewpoints? What is special about the blood supply to ear cartilage?

Cases:

1. Bilateral floppy ear after relapsing-polychondritis\ This very rare autoimmune disorder eats away the cartilage in his ribs, trachea, and nose. Treated by high-dose prednisone. If I can think of a simple way to correct his lop-ears...? Most cartilage of helix and antihelix is replaced by fibrous tissue.
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2. 60ish yo gent with ear injury\ Had a piece of glass shoot out of a lawn mower and took a bite out of his ear. Showed up to the ER the day after it happened when he took the bandage off and his helix came off. Don't know how all that skin survived on that tiny little pedicle but it came back together OK. Put a couple Vicryl in the cartilage and the rest chromic gut.
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3. Ear wound with exposed cartilage\ Good approximation of edges and full coverage of underlying cartilage can be achieved, there is cartilage tear though. Would you still excise a wedge and close or happy with skin closure? What is the aim of follow-up and how soon should this be?
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4. Right radical parotidectomy of 75 y.o. Male\ History of BCCA of nose. At 10:30 position is part of the ear cartilage.
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