1. External, middle and inner Ear Traumas: By Catherine Kerubo Ml 410

2. Externalear trauma The external ear, consisting of the auricle and external auditory canal (EAC), is generally more vulnerable to physical trauma. The auricle is very vulnerable to both blunt and sharp trauma.

3. The most common complication from blunt trauma to the ear is the formation of auricular hematoma. Failureto recognize and treat this condition early usually leads to an ugly deformity of the pinna known as a “cauliflower” ear.

4. Post-traumatic auricular hematoma Primarily sutured lacerated ear canal.

5. Etiology Tympanic Membrane is much more traumatized than the Inner Ear 1.4 - 8.6 per 100,000 -Men> Women - Children are curious

6. Classification of TM Perforations Quadrant Size Marginal vs. Central

7. Traumatic TM Perforations Compression Injuries Barotrauma Penetrating Injuries Thermal Injuries Lightning/Electrical Injuries

8. Traumatic perforation of the tympanic membrane due to welding injury. Otoscopic picture of longitudinal temporal bone fracture

9. Middle Ear Trauma Is usually associated with TM or inner ear trauma unless Iatrogenic Ossiculardiscontinuity Facial Nerve Injury Chorda tympani Nerve Injury Barotraumato Stapes footplate

10. Inner Ear Trauma Blunt Trauma Penetrating Trauma Barotrauma

11. Blunt Trauma Temporal Bone Fractures Longitudinal Transverse Oblique

12. Longitudinal fractures 80% of Temporal Bone Fractures Lateral Forces along the petrosquamous suture line 15 20% Facial Nerve involvement 15- EAC laceration

13. Transverse fractures 20% of Temporal Bone Fractures Forces in the Antero - Posterior direction 50% Facial Nerve Involvement EAC intact

14. Penetrating Trauma Increase in violence and firearms Associated with more dismal outcome More likely to involve intracranial lesions

15. Barotrauma Rapid pressure fluctuations with the inner ear Air travel or SCUBA diving “the bends”

17. Mastoid Ecchymosis (Battle’s Sign)

18. Hemotympanum

19. Tuning Fork exam

21. Symptoms Hearing Loss Dizziness CSF Otorrhea and Rhinorrhea Facial Nerve Injuries

25. Tulio’s Phenomenon

26. Management

27. 40% spontaneously close

29. Can occur any time following injury

30. Dix Hallpike

33. Antibiotics

34. Surgery