Auricle trauma
Introduction
Introduction to auricular trauma The auricle is susceptible to various contusions, cuts, lacerations, broken injuries and firearm injuries. Improper treatment, can occur with perichondritis, cartilage necrosis, leaving auricular deformity. Auricle contusion can rupture blood vessels, blood deposits between the cartilage and the perichondrium, forming a hematoma, in addition to local pain, no other symptoms. Hematoma occurs mostly in the upper part of the auricle, and the anterior lateral side is a semicircular purple-red mass that is soft. If the hematoma is not treated, it can cause thickening and deformation of the auricle. Suppurative perichondritis can occur if an infection occurs. After the tympanic membrane is damaged, the external auditory canal should be kept clean. The external auditory canal should be disinfected with alcohol. The soil, foreign body, blood stasis or sputum contained in the ear canal should be removed, and the sterile cotton ball should be placed in the external auditory canal. Do not rinse or drop the medicine in the ear to avoid bringing the outer ear canal bacteria into the middle ear to cause middle ear infection. Antibiotics are applied throughout the body, swimming is prohibited, and sewage is prevented from entering the ear. basic knowledge Sickness ratio: 0.1% Susceptible people: no special people Mode of infection: non-infectious Complications: chronic otitis externa deafness
Cause
Cause of auricular trauma
Auricle contusion can rupture blood vessels, blood deposits between the cartilage and the perichondrium, forming a hematoma, in addition to local pain, no other symptoms. Hematoma occurs mostly in the upper part of the auricle, and the anterior lateral side is a semicircular purple-red mass that is soft. If the hematoma is not treated, it can cause thickening and deformation of the auricle. Suppurative perichondritis can occur if an infection occurs. The hematoma can be punctured under strict sterilization, and the liquid is withdrawn and pressure-wrapped. If the blood is not repeatedly used, the auricle can be cut under aseptic operation to remove the blood or remove the blood clot, and then pressure bandaged. Antibiotics are used to prevent infection during treatment.
Ear auricle cuts and lacerations, light as a crack, severe tissue defects, or auricle tear or total avulsion break. After the wound should be strictly disinfected, debridement and suture should be carried out to preserve the cartilage tissue as much as possible. For example, the skin is large and the cartilage is still intact. The pedicle flap or free flap can be transplanted from behind the ear. For example, some cartilage and skin are completely broken. The edge is wedge-cut, and the fine needle is used to suture the suture. The suture cannot penetrate the cartilage.
If the ear is off the fracture, the broken ear will be washed with hydrogen peroxide and normal saline, and bubbled in the antibiotic solution for one quarter of an hour. If the auricular artery can be found, it can be washed with heparin, the blood vessel is anastomosed, and the broken skin and subcutaneous tissue are broken. Stitched in place. Or the skin of the broken ear is removed, and the auricle cartilage is implanted under the skin of the ear. After being alive, the implanted auricle cartilage and skin are picked up and transplanted into the original auricle wound to form a new auricle. If the time of disconnection is too long, or the wound has been infected, it is not suitable for suturing. The skin around the external auditory canal is sutured with the mastoid skin to avoid narrowing of the external auditory canal.
In the wartime, the tympanic membrane is ruptured and perforated directly by the impact of the detonation pressure wave, or the tympanic membrane is damaged by the shrapnel, metal shavings or slag splashing into the external auditory canal due to the bulging of the stomata. Usually, it is the ear, the foreign body of the ear canal or the foreign body, the damage of the sputum, the palm of the ear, the ear profile first before the water surface, the eustachian tube blowing or blowing the nose too hard, can also make the tympanic membrane rupture.
Prevention
Auricular trauma prevention
1. Strengthen health education and ban the sharps such as matchsticks and hairpins.
2, when taking foreign bodies or sputum in the external auditory canal, be careful and appropriate to avoid injury to the tympanic membrane.
Complication
Auricular trauma complications Complications Chronic otitis externa deafness
Will be combined with external ear canal fracture infection, can occur severe deafness.
Symptom
Auricular trauma symptoms Common symptoms Tinnitus hearing loss Deafness Ear suffocation Earaches Ou Guo prominent ear circumference depression
After the injury, there is a sudden sensation in the ear, short-term earache, or a small amount of blood flowing out of the external auditory canal, followed by ear nausea, deafness, and tinnitus. In severe cases, there may be dizziness. Symptoms decrease or disappear after hours or days, and a few can have tinnitus affecting work and study. In the case of simple tympanic membrane rupture, the hearing loss is relatively light. If the ear of Inner Mongolia Autonomous Region is damaged at the same time, severe deafness may occur.
There was a little blood in the external auditory canal during the examination, such as a combined external auditory canal fracture, or a large amount of bleeding in the skull base fracture and cerebrospinal fluid otorrhea. The perforation of the tympanic membrane is mostly irregularly ruptured, the surface is bloody, and the direct trauma causes the perforation, mostly located in the posterior part of the tympanic membrane, and the knocking is mostly located in the front lower part. The color of the tympanic membrane is normal. If the infection is combined, there is severe congestion and pus.
Examine
Auricular trauma examination
(1) Tympanic membrane: the relaxation part or the full tympanic membrane invagination, which is characterized by shortening of the light cone, deformation or disappearance, the hammer stem is displaced backward and upward, the humerus short protrusion is obviously protruding, and the angle between the front and the back fold becomes smaller, and the tympanic volume When the liquid is in the tympanic membrane, it loses its normal luster. It is single yellow, orange red oil is bright or amber, and the light cone is deformed or displaced. In chronic cases, it may be grayish blue or milky white. The tympanic membrane has dilated microvessels. The short protrusion is more than the sacral color. Embossed, if the liquid is serous and does not fill the tympanic cavity, the liquid level can be seen through the tympanic membrane. The liquid surface is like a curved hair, called the hairline, and the concave surface is upward. When the head position changes, it is grounded. The parallel relationship is unchanged, the air bubbles are visible through the tympanic membrane, the air bubbles can be increased after the eustachian tube is blown, and the tympanic membrane activity of the tympanic membrane is limited.
(2) The sound of the bottle stopper: the pressure is released after the tragus is pressed, and the ears are tested separately. The patient consciously has an ear sound similar to that of the bottle stopper.
(3) Hearing examination: the tuning fork test and the pure music listening valve test results show that the conductivity is paralyzed, the hearing loss is different, and the heavy one can reach 40dB.
HL or so, because the amount of fluid often changes, so the hearing threshold can have a certain fluctuation, hearing loss is generally low frequency, but due to the middle ear ship structure and the impedance changes of the two springs, high frequency air conduction and bone conduction hearing can also The objective decline, the hearing is improved after the discharge of fluid, the sound guide Kentu has important value for diagnosis, the flat type (B type) is a typical curve of secretory otitis media; the high negative type (C3 type) shows the dysfunction of the pharyngeal tube, Some patients with tympanic effusion and significant hearing impairment should undergo auditory brainstem response and otoacoustic emission examination to determine whether they have an effect on the inner ear.
(4) CT scan showed that the air cavity of the middle ear system had different degrees of density increase.
Diagnosis
Diagnosis of auricular trauma
There was a little blood in the external auditory canal during the examination, such as a combined external auditory canal fracture, or a large amount of bleeding in the skull base fracture and cerebrospinal fluid otorrhea. The perforation of the tympanic membrane is mostly irregularly ruptured, the surface is bloody, and the direct trauma causes the perforation, mostly located in the posterior part of the tympanic membrane, and the knocking is mostly located in the front lower part. The color of the tympanic membrane is normal. If the infection is combined, there is severe congestion and pus. No need to identify.
