5-Minute Emergency Consult
Otologic Trauma
Otologic Trauma is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
PinnaDescription
- 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
Middle Ear
- 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
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
Pediatric Considerations
Consider nonaccidental trauma
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Basics
Description
PinnaDescription
- 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
Middle Ear
- 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
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
Pediatric Considerations
Consider nonaccidental trauma
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Citation
Rosen, Peter, et al., editors. "Otologic Trauma." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307548/all/Otologic_Trauma.
Otologic Trauma. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307548/all/Otologic_Trauma. Accessed August 11, 2020.
Otologic Trauma. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult (5th edition). Lippincott Williams & Wilkins. Retrieved August 11, 2020, from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307548/all/Otologic_Trauma
Otologic Trauma [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2020 August 11]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307548/all/Otologic_Trauma.
* Article titles in AMA citation format should be in sentence-case
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