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Otologic Trauma

Otologic Trauma is a topic covered in the 5-Minute Emergency Consult.

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  • Ear cartilage has no blood supply and isnutritionally dependent on perichondrium
  • Hematomas often disrupt perichondrium and cartilage
    • 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 pressure (blast, diving)
  • Bordered by medial cranial fossa (including temporal and mastoid bones)
  • Traumatic fractures can lead to CSF leak (otorrhea/rhinorhea)
    • May disrupt enclosed vestibular system
  • Facial nerve passes through cavity—injury to cavity may cause peripheral nerve paralysis


  • Blunt trauma:
    • Contact sports such as wrestling
    • Motorcycle helmets
  • Penetrating trauma such as tympanic membrane (TM) perforation from cotton swabs
  • 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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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. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307548/all/Otologic_Trauma. Accessed April 23, 2019.
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. Available 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 2019 April 23]. 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
TY - ELEC T1 - Otologic Trauma ID - 307548 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307548/all/Otologic_Trauma PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -