Radiation burns of the auricle and external ear canal

Radiation burns are caused by the energy of UV and radioactive radiation (intense infrared radiation causes a thermal burn). UV burns occur with individual intolerance to this type of radiation or with its prolonged exposure (UV therapy - erythemal therapeutic dose, insolation - beach burn). In the latter case, most victims develop grade II damage (hyperemia). However, with increased individual sensitivity to UV rays, small blisters surrounded by brightly hyperemic skin may form on the affected areas.

Burns caused by radioactive radiation are more severe. Such burns can occur with local single exposure to doses of 800-1000 rem and more. The nature and extent of tissue damage in radiation burns, their clinical course and outcome depend on the amount of energy absorbed by the tissues, the type of ionizing radiation, exposure, size and localization of the lesion.

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Symptoms

Radiation burns of the auricle are usually accompanied by corresponding damage to the face, which manifests itself several minutes after irradiation by hyperemia caused by the expansion of the capillaries of the skin and subcutaneous tissue. Subsequently, after several hours or days, the irradiated tissues remain unchanged.

Then, gradually, necrobiotic and dystrophic processes begin to manifest themselves in them. First of all, pathological and morphological changes develop in the nerve tissues: the myelin sheaths of the skin nerves swell, the endings of the sensory and trophic nerves disintegrate.

At the same time, pathological changes occur in all tissues of the dermis: hair follicles, sebaceous and sweat glands, etc. die. Capillary dilation and stasis in them are noted, which causes a second wave of hyperemia of the affected area of the skin. In severe radiation burns, the arterial wall changes and tissue necrosis occurs. Due to the death of trophic nerve endings, the regeneration process is very sluggish and long-term, the formation of a leukocyte shaft at the border of necrosis does not occur, and the restored areas of the dermis and scars are often subject to repeated ulceration.

Treatment

First-degree UV burns do not require treatment and heal spontaneously, just like second-degree burns. In the latter case, if an unpleasant subjective reaction occurs in the form of burning and tingling, the hyperemic area of skin can be irrigated from time to time with 70% ethyl alcohol or cologne, which has a dehydrating property and reduces perineural edema, compression of nerve endings and painful sensations.

Limited areas of burns can be lubricated with ointments containing corticosteroids, as well as corn oil or baby cream. For third-degree burns, treatment is carried out as for thermal burns of III A degree. In all cases, UV burns of the indicated degrees disappear without a trace within a few days.

Treatment of radiation burns is much more complicated. Treatment begins immediately after irradiation. General treatment is aimed at combating shock and is carried out in specialized therapeutic departments.

To prevent sensitization of the body by protein breakdown products and the harmful effects of histamine-like substances accumulating in the body, diphenhydramine, intravenous infusions of calcium chloride solution, glucose, vitamin mixtures, and enterally - large amounts of liquid in various forms are prescribed.

Novocaine blockades (locally or in a regional artery) of the affected tissues are of great therapeutic value during the initial period of development of edema and hyperemia.

If blisters form, antitetanus serum is administered and broad-spectrum antibiotics are prescribed. The blisters are removed aseptically, and the same ointments as for thermal burns are applied to the surface of the exposed erosion. The dressings are changed no more than once or twice a week.

At the first signs of regeneration, closure of the defect using autoplastic skin material is indicated. In case of deep burns and extensive necrosis, extended necrectomy is indicated, but within the limits of healthy or regenerating tissues.

However, even this measure does not prevent the further development of various complications in the form of trophic ulcers and the occurrence of skin cancer at the site of the former burn.

Forecast

In case of shallow and small radiation burns the prognosis is relatively favorable; in other cases it is cautious and even questionable. The danger lies in the remote consequences, fraught with the development of non-healing ulcers or the occurrence of skin cancer.

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