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External, middle and inner Ear Traumas: By Catherine Kerubo Ml 410
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.
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.
Post-traumatic auricular hematoma         Primarily sutured lacerated ear canal.
Etiology Tympanic Membrane is much more traumatized than the Inner Ear  1.4 - 8.6 per 100,000             -Men> Women            - Children are curious
Classification of TM Perforations Quadrant  Size  Marginal vs. Central
Traumatic TM Perforations Compression Injuries  Barotrauma Penetrating Injuries  Thermal Injuries  Lightning/Electrical Injuries
Traumatic perforation of the tympanic membrane due to welding injury. Otoscopic picture of longitudinal temporal bone fracture
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
Inner Ear Trauma Blunt Trauma  Penetrating Trauma  Barotrauma
Blunt Trauma Temporal Bone Fractures  Longitudinal  Transverse  Oblique
Longitudinal fractures 80% of Temporal Bone Fractures  Lateral Forces along the petrosquamous suture line  15 20% Facial Nerve involvement 15- EAC laceration
Transverse fractures 20% of Temporal Bone Fractures  Forces in the Antero - Posterior direction 50% Facial Nerve Involvement  EAC intact
Penetrating Trauma Increase in violence and firearms  Associated with more dismal outcome  More likely to involve intracranial lesions
Barotrauma Rapid pressure fluctuations with the inner ear  Air travel or SCUBA diving  “the bends”
Physical Examination Basilar Skull Fractures  ,[object Object]
   Mastoid Ecchymosis (Battle’s Sign)
Hemotympanum
Tuning Fork exam
Pneumatic Otoscopy,[object Object]
Symptoms Hearing Loss  Dizziness  CSF Otorrhea and Rhinorrhea Facial Nerve Injuries
Hearing Loss Formal Audiometry vs. Tuning Fork  71% of patients with Temporal Bone Trauma have hearing loss  TM Perforations  ,[object Object],[object Object]
80% of CHL resolve spontaneously Transverse Fractures  ,[object Object]
Less likely to improve,[object Object]

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External, middle and inner ear traumas