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Injuries to the external ear: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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The external ear, and in particular the auricle, because of its unprotected anatomical position, is often subjected to various kinds of injuries and lesions. These include bruises, detachments (complete, partial), wounds (gunshot, piercing-cutting weapons), burns (thermal, chemical), frostbite. The mechanism of these lesions is extremely diverse, hence, and their pathogenesis is characterized by principal distinctive features. Each of these injuries can lead either to loss of the organ, or to its significant disfigurement with a partial loss of auditory function. For example, getting into the external auditory canal of alkali or acid can lead to complete atresia of the external auditory canal and to hearing loss to the injured ear of grade III or IV according to the conductive type.
Injury to the external ear can lead to the development of a hematoma, injury, separation or fracture.
A dull trauma to the auricle can lead to a subperichondral hematoma; the accumulation of blood between the perichondria and cartilage turns the ear into a formless red mass. Since the cartilage is supplied with blood through the perichondrium, subsequent development of infectious complications, abscess or avascular necrosis is possible. As a result of destruction, the ear becomes a kind of cauliflower, characteristic for wrestlers and boxers. Treatment consists in the evacuation of clots through the incision, prevention of repeated blood clusters by sewing to the haematomas of the gauze rolls, or installing Penrose drainages with a pressure bandage that keeps the cartilage next to the source of blood supply. Since these lesions are prone to infection, antibiotics effective against staphylococcus (for example, cephalexin 500 mg 3-4 times a day) are prescribed for 5 days.
If the wound of the auricle extends to the cartilage and skin on both sides, the skin facia is stitched, the cartilage is sewed with a cotton swab soaked in benzoyin tincture, on top of which a protective bandage is applied. Stitches on the wound should not penetrate into the cartilaginous tissue. Antibiotics appoint according to the above scheme.
Restorative operations for full or partial tearing of the auricle are performed by surgeons specialized in otorhinolaryngology or plastic surgery.
Strong strokes in the area of the lower jaw can be transmitted to the anterior wall of the ear canal (posterior wall of the articular fossa). Mixing fragments with a fracture of the anterior wall can lead to stenosis of the auditory canal, they must be reponned or surgically removed under general anesthesia.
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Contusion of the auricle
Under the contusion (contusio) is understood the closed mechanical damage of soft tissues or organs, not accompanied by a visible violation of their anatomical integrity. Most often this kind of damage to the auricle refers to a domestic or sports injury, which is not accompanied by a violation of the integrity of the cartilage and subcutaneous or hemodial hemorrhage. Such trauma, as a rule, does not require any special treatment, except for cases when abrasions are present on the skin of the auricle. It should be treated with 5% alcohol solution of iodine and apply a dry, non-dehydrated bandage to the ear shell for several hours. In this case, the auricle must be protected from hypothermia, since bruised tissues have a lower tolerance to low temperatures.
At strong mechanical damages, accompanied by fractures or crushing of the cartilage of the auricle, there are specific signs that allow to determine the extent of the lesion. One of these signs is hemorrhage in the auricle (othematoma).
Partial or complete detachments of the auricle
This type of injury is observed with strong scalpating contusions of the auricle with hard, mostly metal, objects in the workplace or when trying to injure an unauthorized person. This type of injury refers to injuries and requires a surgical manual: in an acute case, while retaining the auricle or a part thereof, they are sewn to the "mother" basis, with delayed consequences, the methods of plastic surgery.
When auricle is detached, try to keep it in a soft, clean, preferably sterile, tissue in the cold (less than 3-5 ° C) and deliver with the injured to a traumatological station or a specialized surgical hospital. If the connection of the auricle with the underlying tissue is preserved, then it is applied to the corresponding place and the bandage is bandaged with a pressure bandage. Hemostasis before the provision of specialized care is performed by tight bandaging.