Trauma to the external ear: causes, symptoms, diagnosis, treatment

The outer ear, and in particular the auricle, due to its unprotected anatomical position, is quite often subject to various types of damage and injury. These include bruises, tears (complete, partial), wounds (gunshot, stabbing and cutting weapons), burns (thermal, chemical), frostbite. The mechanism of these injuries is extremely diverse, therefore, their pathogenesis is characterized by fundamental distinctive features. Each of these injuries can lead either to the loss of the organ or to its significant disfigurement with partial loss of hearing function. For example, the ingress of alkali or acid into the external auditory canal can lead to complete atresia of the external auditory canal and to hearing loss in the affected ear of the III or IV degree of conductive type.

Trauma to the outer ear can cause the development of a hematoma, injury, avulsion or fracture.

Blunt trauma to the auricle may result in a subperichondrial hematoma; a collection of blood between the perichondrium and cartilage, turning the ear into a misshapen, red mass. Because the cartilage is supplied with blood through the perichondrium, subsequent infection, abscess, or avascular necrosis may develop. The resulting destruction gives the ear the cauliflower appearance of wrestlers and boxers. Treatment consists of evacuating the clot through an incision and preventing re-accumulation of blood by suturing gauze rolls to the area or inserting Penrose drains with a pressure bandage to hold the cartilage close to its blood supply. Because these injuries are prone to infection, antibiotics effective against staphylococci (eg, cephalexin 500 mg 3-4 times daily) are given for 5 days.

If the auricle wound extends to the cartilage and skin on both sides, the skin filiform is sutured, the cartilage is splinted with a cotton swab soaked in benzoin tincture, over which a protective bandage is applied. The stitches on the wound should not penetrate the cartilage tissue. Antibiotics are prescribed according to the above scheme.

Reconstructive surgeries for complete or partial auricular avulsions are performed by surgeons who specialize in otolaryngology or plastic surgery.

Strong blows to the lower jaw area can be transmitted to the anterior wall of the auditory canal (posterior wall of the glenoid fossa). Mixing of fragments during a fracture of the anterior wall can lead to stenosis of the auditory canal, they must be repositioned or surgically removed under general anesthesia.

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Contusion of the auricle

A contusion is a closed mechanical injury to soft tissues or organs that is not accompanied by a visible disruption of their anatomical integrity. Most often, this type of injury to the auricle is related to a domestic or sports injury that is not accompanied by a disruption of the integrity of the cartilage and subcutaneous or subperichondrium hemorrhage. Such an injury, as a rule, does not require any special treatment, except for cases when there are abrasions on the skin of the auricle. They should be treated with a 5% alcohol solution of iodine and a dry pressure bandage should be applied to the auricle for several hours. In this case, the auricle must be protected from hypothermia, since bruised tissues have a reduced tolerance to low temperatures.

In case of severe mechanical damage, accompanied by fractures or crushing of the cartilage of the auricle, specific signs are observed that allow determining the degree of damage. One of such signs is hemorrhage in the auricle (hematoma).

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Partial or complete detachments of the auricle

This type of injury is observed in severe scalping contusions of the auricle by hard, most often metal, objects at work or when an attempt to cause injury by a third party. This type of injury is related to wounds and requires surgical intervention: in acute cases, when preserving the auricle or part of it - their sewing to the "mother" base, in case of delayed consequences - plastic surgery methods.

If the auricle is torn off, it is kept in soft, clean, preferably sterile tissue in the cold (below 3-5°C) and delivered together with the victim to a trauma center or specialized surgical hospital. If the auricle is still connected to the underlying tissue, it is applied to the appropriate place and bandaged with a pressure bandage. Hemostasis is achieved by tight bandaging until specialized care is provided.