Ear Injury

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External Ear Injuries[edit | edit source]

Injuries are divided into open and closed:

  1. opentearing, cutting or biting,
  2. closedcreated by a blunt blow:
  • othaematoma auriculae occurs most often
  • the basis is a blood effusion between the cartilage and the perichondrium – bluish-red swelling with fluctuation, changes the shape of the auricle,
  • can fester → abscess or absces či perichondritis,
  • can organize → ligament forms → pernament cartilage deformity ("boxer´s ear").
Boxer´s Ear

Treatment[edit | edit source]

  • Open ones are sutured, in case of cartilage injury - resection and then suture,
    • smaller othematomas – compression, larger ones – puncture, they are drained, drenují se,
      • ATB cover is suitable

Injury to the Ear Canal[edit | edit source]

  • independently or in more complicated traumas,
  • open wounds - often accidentally when cleaning the ear canal,
    • middle ear injury must be ruled our,
  • blunt trauma - swelling or hemorrhagic blister
  • injury to the bony part - part of the temporal bone fractures - typically a stair deformity with lost lumina occurs,
  • treat open wounds with antiseptics, drain larger subepidermal hematomas,
  • the result can be fibrous stenosis - a surgical solution.

Perforation of the Eardrum[edit | edit source]

  • directly – when cleaning the ear, during injuries,
  • indirectly – by a sudden increase in pressure (barotrauma, acoustic trauma, blow with the surface of the palm),
  • it can be part of a larger injury (middle ear, fractures…).

Symptoms[edit | edit source]

  • pain, bleeding from the ear canal, conductive hearing loss (depends on the size),
  • otoscopically - perforation of various sizes with uneven bloody edges,
  • in case of secondary infection, pus flows out,
  • the discharge of clear fluid raises the suspicion of cerebrospinal fluid or perilymphatic fluid leakage.

Therapy[edit | edit source]

Cave!!!.png If a perforation of the eardrum is suspected, we do not rinse the ear canal!

  • careful cleaning,
  • adapt the edges of the perforation, or cover the perforation with paper (prevents dirt from entering),
  • uninfected, centrally located tend to heal spontaneously (several weeks),
  • at worst surgery – myringoplasty.

Middle Ear Injuries[edit | edit source]

  • mechanisms are similar to the drum,
  • indirect damage can also occur behind an intact eardrum,
  • as a rule, the injury is accompanied by an effusion of blood into the middle ear - hemotympanum,
  • the chain of auditory ossicles can be broken (most often between the anvil and the stirrup),
  • the stirrup can be torn out of the oval window,
  • the facial nerve and inner ear may be affected.

Symptoms[edit | edit source]

  • pain, bleeding from the ear canal, hearing impairment;
  • conductive hearing loss, when there is also a perceptual component, the inner ear is also affected;
  • when the eardrum is intact - on otoscopy - blue-red coloration behind the eardrum.

Therapy[edit | edit source]

  • simple hematympanon - no need to intervene, it resorbs spontaneously (possibly ATB),
  • we remove foreign bodies,
  • disruption of bones - surgical reconstruction.

Inner Ear Injuries[edit | edit source]

(Labyrinth shock, coma)

  • most often as part of larger skull injuries,
  • there will be a violation of the micromechanical structure of the membranous membranous system,
    • e. g. breach of the barrier between endo and perilymph, bleeding into the labyrinth,
    • we usually cannot diagnose the cause.

Symptoms[edit | edit source]

  • functional disabilities of varying extent (impairment of balance functions, perceptual hearing impairment, possibly both...),,
  • hearing usually improves within 2 weeks, dizziness lasts longer,
  • acute symptoms are usually covered by symptoms of cerebral coma or brain contusion.

Acoustic Drama[edit | edit source]

  • acute ear damage from sound,
  • in isolation, the inner ear is mainly affected by a bang that lasts a shorter time (shot)
  • during the explosion, the middle ear is still damaged by the pressure,
  • functional loss is most often in the area of the basal turn of the cochlea (typical hearing loss with a maximum around 4 kHz).

Symptoms[edit | edit source]

Therapy[edit | edit source]

  • the influence of the treatment on the condition has not yet been unequivocally proven.

Fractures of the temporal bone and the laterobasal injuries[edit | edit source]

  1. Longitudinal type:
    • the fracture line runs through the area of the external auditory canal,l
    • violates the annulus tympanicus, can damage the eardrum and middle ear,
    • goes further to the tip of the pyramid to the foramen lacerum,
    • the inner ear is not usually affected, the facial nerve is rarely affected,
    • main symptom – hemotympanum, perforation of the tympanic membrane, conductive hearing loss, liquorice,
    • there is a risk of ascending infection and meningitis.
  2. Transverse type:
    • the refraction line is perpendicular to the long axis of the pyramid,
    • can go through the labyrinth, the middle ear is not affected,
    • involvement of N. VII and N. VIII is common,
    • symptoms – severe dizziness, nausea, vomiting dominates,
      • severe perceptual hearing loss,
    • the balance is compensated centrally within a few days, the hearing impairment remains,
  • therapy – mostly conservative - cover the ear canal sterilely, ATB prophylaxis.

Inflammation of the Middle Ear (Otitis Media)[edit | edit source]

  • we have either catarrhal (non-purulent) or purulent inflammations,
  • each is either acute or chronic,
  • purulent chronic is either mesotympanic or epitympanic.

Links[edit | edit source]

Source[edit | edit source]

Reference[edit | edit source]

  • KLOZAR, Jan. Speciální otorinolaryngologie. 1. edition. Praha : Karolinum, 2005. 224 pp. ISBN 80-246-1125-2.