External Ear Chondritis/Abscess

Ovid: 5-Minute Sports Medicine Consult, The

External Ear Chondritis/Abscess
Arturo J. Aguilar
  • Inflammation and infection of the pinna
  • Commonly a complication of otic trauma, burns, or neighboring infection
  • It may present as a complication of draining a periauricular hematoma (cauliflower ear) in sports such as wrestling and rugby.
  • Occasionally, chondritis may be a complication of untreated or resistant otitis externa in swimmers.
  • Cartilage of the external ear is easily damaged and at risk for infection owing to:
    • Lack of overlying subcutaneous tissue
    • Relative avascularity
    • Exposed position
  • Common causes of chondritis include:
    • Chemical or thermal burns
    • Otitis externa
    • Deep abrasions
    • Frostbite
    • High piercing of the earlobe
    • Human bites
    • Iatrogenic from incision and drainage treatment of hematoma
    • Mastoid surgery
  • Bacteria involved:
    • Pseudomonas aeruginosa
    • Staphylococcus spp.
    • Proteus spp.
Typical physical findings in combination with preceding causes
Physical Exam
  • Initially a dull pain that increases in severity
  • Pinna:
    • Painful
    • Exquisite tenderness
    • Erythematous
    • Warmth
    • Loss of contours caused by edema often with sparing of the lobule
  • Increase in the auriculocephalic angle
  • Fluctuant areas develop with eventual breakdown and suppuration.
  • Entire ear involvement if untreated: Disfigurement can occur.
  • Fever/chills
Diagnostic Tests & Interpretation
  • CBC with differential for systemic symptoms
  • Wound culture for signs of localized infection
  • Blood culture if systemic signs of infection
Differential Diagnosis
  • Periauricular hematoma: “Cauliflower ear”
  • Malignant otitis externa


  • 380.03 Chondritis of pinna
  • 380.10 Infective otitis externa, unspecified
  • 380.11 Acute infection of pinna

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