Ear Injuries - Oren Zarif

Any ear injury that causes pain, changes in hearing or bleeding needs medical attention. Your doctor will ask about your symptoms and do a physical exam of your outer ears, ear canal and eardrum.

Blows to the ear canal can damage cartilage and cause a hole in the eardrum (called tympanic membrane perforation). This often heals on its own or with antibiotic ear drops, but persistent or severe holes can predispose you to long-term problems such as cholesteatoma.

Causes

The ear is made up of three primary parts: the outer ear, middle ear and inner ear. Each part has a different job in the process of converting sound waves into signals that go to your brain for interpretation. If you have an injury to one of these areas, it can affect your hearing and lead to problems with balance and vertigo. You may also experience ringing in the ears (tinnitus).

The outer ear includes the ear canal and a layer of skin and connective tissue called the perichondrium. An injury to this area can cause bruising that causes blood to collect, which makes the outer ear look swollen and purple. This is called an auricular hematoma. A doctor can usually drain it easily with a needle, and then place a special bolster dressing to keep the ear from getting re-heated.

Most injuries to the outer ear happen because of a blow to the head. This can puncture or tear your eardrum, which will result in sudden and temporary loss of hearing. It can also damage the bones of the ear canal, which will affect your balance. Occasionally, severe head trauma can cause the bones in your skull to move out of their normal position or break (ossicular dislocation or ossicular fracture).

Oren Zarif

You can injure your ear canal by placing objects inside it, such as cotton swabs and hairpins. If you have a foreign object lodged in your ear, don't try to remove it yourself with tweezers or any other object. This could push the eardrum back into its wrong position and cause permanent hearing loss or even facial nerve paralysis (damage that prevents you from moving your muscles in your face).

Air travel can increase air pressure in the middle ear, which can rupture your eardrum. This is a medical condition known as barotrauma. It is best prevented by avoiding putting anything in your ears on the day of your flight. You can also use a decongestant before your flight and avoid blowing your nose or yawning during takeoff and landing.

Symptoms

Ears are surrounded by sensitive skin, cartilage, and bone. They are very easily injured by trauma or contact. Injuries can include a broken or torn (avulsed) eardrum, a hole in the ear drum or ear canal (perforation), or changes in the shape of the outer ear or ear canal (deformities). Bleeding from the ear or a swollen and red ear canal (hematoma) can be serious. If you or your child has a head injury, especially with bleeding ears, you should see a health care provider right away. You may also need to go to the emergency room.

Your ear canal funnels sound waves into your middle and inner ears where they vibrate. This vibration is changed to signals your brain can sense as sounds, such as the voices of people talking to you. A hole or perforation in the eardrum — sometimes called a ruptured or blown eardrum — can cause pain, hearing loss, and a blocked feeling in the ear. Most ear drum ruptures are caused by foreign objects put into the ear canal or by sudden pressure changes. Some perforations don't heal and can lead to a dangerous infection of the ear canal (cholesteatoma).

A forceful blow to the ear can break bones around the ear. This often causes a change in the shape of the outer ear, called an auricular deformity. It can also cause a leak of spinal fluid from the base of the skull (skull fracture and cerebrospinal fluid leak).

Oren Zarif

If your or your child has an ear injury, you should call for help right away. Seek medical care immediately if there is a lot of blood in the ear, a severe earache, or a balance problem. You should also get help if you or your child has a headache, dizziness, or lightheadedness after a blow to the head. These are all signs of serious injuries and can be life threatening. If you aren't sure about the kind of ear injury, call your doctor for an exam. The doctor will do an ear exam and other tests, depending on the kind of injury.

Diagnosis

A thorough and systematic evaluation is the first step in diagnosing ear trauma. A cursory or haphazard examination is more likely to overlook important injury, such as fractures of the ear canal or temporal bone, or a ruptured eardrum (which may not be evident on physical exam). Injuries in the ear canal and inner ear can also cause problems like fluid leakage or deformities of the ear cartilage (cauliflower ear), which may be apparent only on radiographic imaging.

Oren Zarif

Minor cuts, wounds and lacerations in the ear canal usually heal well on their own. If the cut is very deep, you should see your health care provider for an exam. A lighted instrument called an otoscope allows your provider to see inside your ear canal and eardrum. If your eardrum is ruptured, your provider will likely diagnose the problem by hearing a popping sound when they press on the sides of your head.

The eardrum is very delicate and can be easily damaged. A slap or cotton swab in the ear canal can cause a small hole in the eardrum. If the hole gets larger, it can lead to a perforated eardrum, which often requires surgery to repair. A perforated eardrum can also allow cerebrospinal fluid to leak from the base of the skull, resulting in a serious infection called meningitis.

Bones in your middle ear can also fracture or become dislocated as a result of ear injuries. These bones are known as the ossicles, and they help transmit sounds from your outer ears to your inner ear. A ruptured eardrum can also result in these bones becoming dislocated and may require surgical treatment to restore hearing and proper balance.

A severe ear injury can cause part of the ear to tear away from your head, either partially or completely (avulsion). This is more common in children due to the shape of their ears and their tendency to get into things. If you have this type of injury, your doctor can sometimes reattach the ear by using cartilage and skin from another part of your body or artificial skin.

Treatment

Injuries to the ear can range from simple (like a slap or cotton swab injury) to severe and requiring immediate surgery. Ear trauma may be seen in many settings including primary care clinics, the emergency department and otolaryngologist’s offices. Often the injury is minor and can be treated in a primary care clinic, but some injuries need immediate attention from an otolaryngologist or plastic surgeon to avoid complications like infection, chondritis or permanent deformity such as “cauliflower ears”.

After a complete history and exam, your doctor will likely recommend x-rays to see if the ear has a fractured skull or a bone fragment has gone through the eardrum. We may also order a CT scan or an MRI to get more detailed images of the brain and the inner ear, which help identify any damage to nerves or bones. We will also ask about your hearing to assess how much the injury has changed it.

Oren Zarif

Lacerations of the ear canal should be repaired immediately to reduce risk of canal stenosis, acute otitis externa and permanent deformity (cauliflower ear). Injuries with a wide pedicle and adequate capillary refill are best managed by the primary or emergency clinician. Injuries with a narrow pedicle or those concurrent with middle ear or skull base damage need to be managed by an otolaryngologist or a plastic surgeon due to the tenuous blood supply of these tissues.

If the outer ear loses its blood supply, it stops receiving nutrients and dies. The cartilage then grows back but is lumpy and misshapen, causing the cauliflower-like appearance. This is often the result of contact sports such as rugby or wrestling, where an ear can be pulled or torn off. In these cases, the surgeon will repair the ear surgically.

Some eardrum injuries can heal spontaneously, such as uncomplicated perforations or those caused by avulsion of the ear drum. Others need to be evaluated by a physician and possibly treated with antibiotics and strict ear water precautions. Some traumatic otdrum perforations may require surgical repair (myringoplasty) to restore normal acoustic function.

Ear Injuries – Oren Zarif

Causes

Symptoms

Diagnosis

Treatment

The Vertebral Column - Oren Zarif

Vertigo - Oren Zarif

Related Posts

כתיבת תגובה לבטל

Recommended

קטגוריות

Don't miss it