5-Minute Emergency Consult
Otologic Trauma
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
Schaider, Jeffrey J., et al., editors. "Otologic Trauma." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307548/all/Otologic_Trauma.
Otologic Trauma. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307548/all/Otologic_Trauma. Accessed July 27, 2025.
Otologic Trauma. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307548/all/Otologic_Trauma
Otologic Trauma [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2025 July 27]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307548/all/Otologic_Trauma.
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