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Ear Injury

by Sam P. Most, MD

A number of different injuries can affect the outer ear.

A blunt blow to the external ear can cause bruising between the cartilage and the layer of connective tissue around it (perichondrium). When blood collects in this area, the external ear becomes swollen and purple. The collected blood (hematoma) can cut off the blood supply to the cartilage, allowing that portion of the cartilage to die, leading in time to a deformed ear. This deformity, called a cauliflower ear, is common among wrestlers, boxers, and rugby players.

A doctor cuts open the hematoma and removes the blood. After the blood is removed, the doctor applies a tight bandage, which is left on for 3 to 7 days to keep the hematoma from coming back. The dressing keeps the skin and perichondrium in their normal positions, allowing blood to reach the cartilage again. These injuries are prone to infection, so doctors usually give an antibiotic to prevent infection.

If a cut (laceration) goes all the way through the ear, the area is cleaned thoroughly, the skin is sewn back together, and a bandage is applied to protect the area and allow the cartilage to heal. The cartilage is also sewn unless the skin covering the cartilage has been torn away. Sometimes antibiotics are needed to prevent infection, particularly if the injury was caused by a bite. Sometimes cosmetic surgery is needed after the wound heals.

Sometimes an ear is torn away from the head (avulsion). An ear may be partially or completely torn. Such tearing is more likely because ears are less protected than other body structures. A surgeon (usually one who specializes in plastic surgery or disorders of the ear) can often reattach an avulsed ear, but not all surgeries are successful. Sometimes, surgeons can use cartilage and skin from another part of the body or use artificial skin to construct a new ear.

A forceful blow to the jaw may break (fracture) the bones around the ear canal and distort the canal’s shape, often narrowing it. The shape can be corrected surgically.