Damage to the external auditory canal: causes, symptoms, diagnosis, treatment

Damage to the external auditory canal occurs much less frequently than damage to the auricle. They are caused by a blunt or sharp object striking the area of the external aperture of the external auditory canal, bullet and fission injuries. Damage can be limited to the dermal-membranous part of the external auditory canal or to seize its bone part with the presence of fracture of its bone walls or without it. As a rule, fractures of the bone walls are accompanied by more extensive lesions of surrounding anatomical formations bordering one or another wall. Often, when falling on the chin or a strong impact on it, there is a fracture of the anterior wall of the osseous part of the external auditory canal with the incision of the head of the lower jaw into the retroauric region.

Symptoms of damage to the external auditory canal

The injuries of the external auditory canal are accompanied by bleeding from it and the formation of a blood clot in the lumen, which causes almost complete conductive hearing loss. When the clot is removed, the hearing is restored completely only in the absence of rupture of the tympanic membrane.

Victims complain of pain in the ear, its sharp stiffness. When otoscopy in the external auditory passage, blood clots are determined, and by their removal - traumatized skin areas. Palpation with a probe probe in some cases allows to exclude or establish damage to the bone wall or the presence of a wounding projectile, but the actual state of the injured area can only be determined by radiographic examination.

Damage to the external auditory canal is often combined with damage to the auricle and is considered a traumatic illness of the external ear. However, they pay special attention to the functional state of the hearing organ and the vestibular apparatus in order to exclude damage to the middle and inner ear. For this, an X-ray examination of these parts of the temporal bone is used. With blunt injuries of the external ear, attention is drawn to the CNS condition, since such traumas often show signs of concussion and even bruising of the brain. All patients with this type of external ear injuries are to be examined by a neurologist.

Diagnosis of traumatic injuries of the external ear is based on anamnesis, otoscopic picture, sounding of the wound channel and radiography. In the presence of obschevenrologicheskih symptoms (headache, nausea, vomiting, a state of disorientation, prostration, difficult communication, etc.) is shown after a specialized ENT-benefit hospitalization in the neurological department with simultaneous observation of an ENT specialist.

Treatment of damage to the external auditory canal

General rules of treatment for injuries and open injuries of any part of the body consist in the primary treatment of the wound surface and the stopping of bleeding (if any), and also in the introduction of a special tetanus toxoid system.

With shallow wounds of the external auditory canal, turunces impregnated with sintomycin emulsion or solutions of broad-spectrum antibiotics in a mixture with hydrocortisone are inserted into it after the toilet. The same treatment is followed and with deeper damage to the skin and membranous-cartilaginous tissues of the external auditory canal. Dressings are performed once a day with the mandatory toilet of the external auditory canal and the removal of the remnants of the medicines used (ointments, emulsions, liniments). In case of tearing of the skin-membranous formations of the external auditory canal, their anatomical integrity is sought to be restored endoscopically by means of microtools followed by a fixing tamponade of the external auditory canal with turundas with a synthomycin line for 48 hours. Remove the turundas gently, step by step, after their permeation with hydrogen peroxide through a thin needle, Do not displace the fragments of the external auditory canal laid in the required order.

In case of fractures of the bone walls of the external auditory canal, the measures described above with simultaneous immobilization of the mandible for 1-2 weeks are performed, while only liquid food that excludes the chewing process is prescribed. Later, when consolidating soft and bony tissues to prevent stricture and atresia of the external auditory canal, a bougier tube of indifferent plastic, for example, polyvinyl chloride, is inserted into it. As the scarring process continues after epidermis of the damaged skin for several weeks, this protector is stored in the ear canal approximately the same time with periodic extraction for disinfection and toilet of the external auditory canal.

The prognosis is generally favorable, however, if untimely specialized care or wrong treatment of infected lesions occurs in a significant number of cases, a disfiguration of the auricle or stenosis, or atresia of the external auditory canal, requires subsequent appropriate surgical interventions.

[1], [2], [3], [4], [5], [6], [7], [8]