Search
SectionsIndexSymptoms
  • Cardiovascular Disorders
  • Clinical Pharmacology
  • Critical Care Medicine
  • Dental Disorders
  • Dermatologic Disorders
  • Ear, Nose, and Throat Disorders
  • Endocrine and Metabolic Disorders
  • Eye Disorders
  • Gastrointestinal Disorders
  • Genitourinary Disorders
  • Geriatrics
  • Gynecology and Obstetrics
  • Hematology and Oncology
  • Hepatic and Biliary Disorders
  • Immunology; Allergic Disorders
  • Infectious Diseases
  • Injuries; Poisoning
  • Musculoskeletal and Connective Tissue Disorders
  • Neurologic Disorders
  • Nutritional Disorders
  • Pediatrics
  • Psychiatric Disorders
  • Pulmonary Disorders
  • Special Subjects
ABCDEFGHI
JKLMNOPQR
STUVWXYZ
  • Abdominal Pain, Acute
  • Abdominal pain, Chronic
  • Alopecia
  • Amenorrhea
  • Amnesia
  • Anosmia
  • Bleeding, Excessive
  • Breast Lumps
  • Chest Pain
  • Constipation in Adults
  • Constipation in Children
  • Cough in Adults
  • Cough in Children
  • Crying
  • Diarrhea in Adults
  • Diarrhea in Children
  • Diplopia
  • Dizziness
  • Dry Mouth
  • Dysmenorrhea
  • Dyspepsia
  • Dysphagia
  • Dyspnea
  • Dysuria
  • Earache
  • Ear Discharge
  • Edema
  • Edema During Late Pregnancy
  • Epistaxis
  • Erectile dysfunction
  • Eyelid Swelling
  • Eye Pain
  • Fever
  • Fever, Acute, in Adults
  • Fever, Chronic (FUO)
  • Fever in Infants and Children
  • Floaters
  • Gas
  • Gastrointestinal Bleeding
  • Halitosis
  • Headache
  • Hearing Loss
  • Hearing Loss: Sudden Deafness
  • Hematospermia
  • Hematuria
  • Hemoptysis
  • Hiccups
  • Hirsutism
  • Insomnia and Excessive Daytime Sleepiness
  • Itching
  • Itching, Anal
  • Jaundice in Adults
  • Jaundice in Neonates
  • Joint Pain, Monarticular
  • Joint Pain, Polyarticular
  • Knee pain
  • Lump in Throat
  • Nasal Congestion and Rhinorrhea
  • Nausea and Vomiting During Early pPregnancy
  • Nausea and Vomiting in Adults
  • Nausea and Vomiting in Infants and Children
  • Neck and Back Pain
  • Neck Mass
  • Nipple Discharge
  • Orthostatis Hypotension
  • Pain
  • Pain, Chronic
  • Palpitations
  • Pelvic Pain
  • Pelvic Pain During Early Pregnancy
  • Polyuria
  • Priapism
  • Red Eye
  • Scrotal Pain
  • Sore Throat
  • Stomatitis
  • Stridor
  • Syncope
  • Tearing
  • Tinnitus
  • Toothache
  • Tremor
  • Urinary Frequency
  • Urinary Incontinence in Adults
  • Urinary Incontinence in Children
  • Urinary Retention
  • Urticaria
  • Vaginal Bleeding
  • Vaginal Bleeding During Early Pregnancy
  • Vaginal Bleeding During Late Pregnancy
  • Vaginal Itching and Discharge
  • Vision, Blurred
  • Vision Loss, Acute
  • Weakness, Generalized
  • Wheezing
In This Topic
Injuries; Poisoning
Facial Trauma
External Ear Trauma
Subperichondral hematomas
Lacerations
Avulsions
Trauma secondary to mandibular fractures
Back to Top
Resources
  • About The Merck Manual
  • Ready Reference Guides
  • Trade Names of Some Commonly Used Drugs
  • Normal Laboratory Values
  • Clinical Calculators
  • Multimedia
  • Selected Links
Manuals available online
'/home/index.html' + bookPageLink
 
'/professional/index.html'
These and other Manuals available
in print, online, and as mobile applications.

See more at MerckManuals.com
Sections in Health Care Professionals
  • Cardiovascular Disorders
  • Clinical Pharmacology
  • Critical Care Medicine
  • Dental Disorders
  • Dermatologic Disorders
  • Ear, Nose, and Throat Disorders
  • Endocrine and Metabolic Disorders
  • Eye Disorders
  • Gastrointestinal Disorders
  • Genitourinary Disorders
  • Geriatrics
  • Gynecology and Obstetrics
  • Hematology and Oncology
  • Hepatic and Biliary Disorders
  • Immunology; Allergic Disorders
  • Infectious Diseases
  • Injuries; Poisoning
  • Musculoskeletal and Connective Tissue Disorders
  • Neurologic Disorders
  • Nutritional Disorders
  • Pediatrics
  • Psychiatric Disorders
  • Pulmonary Disorders
  • Special Subjects
Chapters in Injuries; Poisoning
  • Approach to the Trauma Patient
  • Lacerations
  • Fractures, Dislocations, and Sprains
  • Traumatic Brain Injury (TBI)
  • Spinal Trauma
  • Facial Trauma
  • Eye Trauma
  • Abdominal Trauma
  • Genitourinary Tract Trauma
  • Burns
  • Electrical and Lightning Injuries
  • Radiation Exposure and Contamination
  • Heat Illness
  • Cold Injury
  • Altitude Diseases
  • Motion Sickness
  • Drowning
  • Injury During Diving or Work in Compressed Air
  • Sports Injury
  • Bites and Stings
  • Poisoning
Topics in Facial Trauma
  • Introduction
  • External Ear Trauma
  • Fractures of the Jaw and Contiguous Structures
  • Fractures of the Nose
  • Temporal Bone Fractures
     
    • Merck Manual
    • >
    • Health Care Professionals
    • >
    • Injuries; Poisoning
    • >
    • Facial Trauma
    • 4
     
    External Ear Trauma

    Share This

    Trauma to the external ear may result in hematoma, laceration, avulsion, or fracture.

    Subperichondral hematomas: Blunt trauma to the pinna may cause a subperichondrial hematoma; the accumulation of blood between the perichondrium and cartilage renders all or part of the pinna a shapeless, reddish purple mass. Because the perichondrium supplies blood to the cartilage, infection, abscess formation, or avascular necrosis of the cartilage may follow. The resultant destruction causes the cauliflower ear characteristic of wrestlers and boxers.

    Treatment consists of evacuating the clot through an incision and preventing reaccumulation of the hematoma with through-and-through ear sutures over dental gauze rolls or insertion of a Penrose drain plus a pressure dressing. Because these injuries are prone to infection, an oral antibiotic effective against staphylococci (eg, cephalexinSome Trade Names
    KEFLEX
    KEFTAB
    Click for Drug Monograph
    500 mg tid) is given for 5 days.

    Pearls & Pitfalls
    • Failure to drain a subperichondral hematoma may lead to permanent external ear deformity.

    Lacerations: In lacerations of the pinna, the skin margins are sutured whenever possible. If the cartilage is penetrated, it is repaired unless there is not enough skin to cover it. Damaged cartilage, whether repaired or not, is splinted externally with benzoin-impregnated cotton, and a protective dressing is applied. Oral antibiotics are given as for a hematoma.

    Human bite wounds are at high risk of infection, including infection of the cartilage, a potentially severe complication. Treatment includes meticulous debridement of devitalized tissue, prophylactic antibiotics (eg, amoxicillin/clavulanateSome Trade Names
    AUGMENTIN

    500 to 875 mg po bid for 3 days) and possibly antivirals (see Bites and Stings: Antimicrobials). Wounds < 12 h old can be closed but older wounds should be allowed to heal secondarily, with cosmetic deformities treated later.

    Avulsions: Complete or partial avulsions are repaired by an otolaryngologist, facial plastic surgeon, or plastic surgeon.

    Trauma secondary to mandibular fractures: Forceful blows to the mandible may be transmitted to the anterior wall of the ear canal (posterior wall of the glenoid fossa). Displaced fragments from a fractured anterior wall may cause stenosis of the canal and must be reduced or removed surgically after a general anesthetic is given.

    Last full review/revision March 2013 by Sam P. Most, MD

    Content last modified March 2013

    Buy the Book

    Mobile Versions

    Back to Top

    Previous: Introduction

    Next: Fractures of the Jaw and Contiguous Structures

    Audio
    Figures
    Photographs
    Sidebars
    Tables
    Videos

    Copyright     © 2010-2013 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, N.J., U.S.A.    Privacy    Terms of Use