Otologic Trauma

Description

• Ear cartilage has no blood supply and is nutritionally dependent on perichondrium
• Hematomas often disrupt perichondrium and cartilage that can lead to:
  • Ischemia
  • Perichondritis
  • Necrosis
  • Cauliflower ear
• Penetrating injuries or bite wounds may lead to infection of cartilage

• Air-space cavity containing ossicles; susceptible to injuries disrupting middle-ear pressure (blast, diving)
• Bordered by medial cranial fossa (including temporal and mastoid bones)
• Traumatic fractures can lead to CSF leak (otorrhea/rhinorrhea) and may disrupt enclosed vestibular system
• Facial nerve passes through cavity – injury to cavity may cause peripheral nerve paralysis

Etiology

• Blunt trauma: Most commonly motor vehicle crashes or fights/contact sports (wrestling, boxing)
• Penetrating trauma such as tympanic membrane (TM) perforation from cotton swabs or bobby pins
• Human or animal bites
• Blast injury
• Lightning injury: TM and ossicular disruptions occur in 50% of lightning strikes
• Chemical exposure
• Thermal injury
• Diving injuries:
  • Inner-ear barotrauma
  • TM rupture