What is Chondrodermatitis (CNH)?
Chondrodermatitis Nodularis Helicis Chronica, CNH or Winkler’s Disease as it is also known is a pressure sore that forms on your ear. This painful lesion is the result of friction and pressure acting against the ear’s skin as it touches the pillow. Each night, this rubbing causes the skin to breakdown, leading to a pressure sore. The sore initially presents itself as a painful, warm and possibly scaly red patch of skin. This red patch will not only persist for as long as your ear rubs against the pillow, it will gradually get worse as the skin degrades further. This is particularly the case in older people as the skin is less elastic and less able to repair itself, therefore the night-time damage is not fully mitigated during the day.
If left untreated, Chondrodermatitis goes through four stages of severity. Stage one has been described above, stage two advances upon this and reflects a further breakdown of the skin and underlying tissue. The pressure sore will weep at this point and be incredibly painful to the touch. It will not be possible to lie on the ear at this point.
At stage three the ear pressure sore will be quite deep and the cartilage will have been effected. It may require surgery to fix and healing time can be measured in months. Stage four is an extension of this and represents the most serious case of CNH. The tissue will be dead or dying and the pain will be extreme. Sleep at this point will surely be impossible.
How is it treated?
Early intervention is absolutely crucial as treatment becomes increasingly difficult with each phase entered into. At its earliest stage CNH can be cured in a matter of days, stage two is measured in weeks, stage three is months and stage four is several months. The typical treatment programme is steroid creams and if that fails, surgery such as excision or cryotherapy. Steroid creams can be effective however they do not address the root cause of the problem – the pressure and friction or the pillow. What good work the cream does during the day, the pillow undoes at night. Surgery, beyond the inconvenience of having it performed, is also going to be affected by the pillow. Healing will take longer and be more prone to complication if the ear is constantly rubbing against the pillow.
A Pressure Sore Pillow?
It is clear that the cause of CNH is the pressure of a conventional pillow pushing against the ear. But how can you sleep without exerting that pressure? The answer is a specially designed CNH pillow with an ear hole. This kind of pillow relieves pressure on the ear while supporting the head. They may take a little getting used to but once you get comfortable they are a cost effective way of treating CNH. Recurrence drops from 33% to 0% and the cure rate is also extremely high. Remove the source of friction and pressure and your body will do the rest.