Trauma patterns, symptoms, and complications associated with external auditory canal fractures

• Published in: The Laryngoscope 2015-07, Vol.125 (7), p.1579-1582
• Main Authors: Burchhardt, Daniela M., David, John, Eckert, Robert, Robinette, Natasha L., Carron, Michael A., Zuliani, Giancarlo F.
• Format: Article
• Language: English
• Subjects: Adult; condylar trauma; EAC trauma; EAC trauma, external auditory canal fracture; Ear Canal - injuries; Ear Diseases - diagnostic imaging; Ear Diseases - etiology; Ears & hearing; external auditory canal fracture; Female; Fractures; Hearing loss; Humans; Male; Mandibular Fractures - complications; Mandibular Fractures - diagnostic imaging; mandibular trauma; Middle Aged; Patients; Retrospective Studies; Skull Fractures - complications; Skull Fractures - diagnostic imaging; Temporal Bone - injuries; temporal bone trauma; Tomography, X-Ray Computed; Trauma; Trauma Severity Indices; Young Adult
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.25246

Objectives/Hypothesis External auditory canal (EAC) trauma, although rare, can have significant long‐term adverse outcomes. This study aims to investigate the frequency, treatment, and complications of external ear canal injury in association with mandibular and temporal bone trauma. Study Design Retrospective chart review. Methods Computed tomography images with mandibular or temporal bone trauma were reviewed for EAC fractures. Patient data were collected from initial presentation and subsequent follow‐up clinic visits. Results Thirty‐nine percent of temporal bone fractures and 3.3% of mandible trauma involved the EAC. In particular, 10% of condylar or subcondylar trauma included an EAC fracture (P = 0.0006). One patient sustained bilateral EAC fractures despite an isolated, unilateral condylar fracture. The most common presenting sign was blood in the external auditory canal. Two patients underwent exam under anesthesia and removal of debris and stenting as treatment, whereas 42% of the patients were placed on otic drops and 5% received packing or a stent. Follow‐up data were only available for 16% of the patients. Hearing loss from otic capsule involvement or ossicular chain disruption were follow‐up complaints, and one patient had persistent canal stenosis. Conclusions External auditory canal trauma is present in a significant proportion of mandibular and temporal bone trauma, including both condylar and noncondylar fractures with a higher incidence of condylar fractures. One case was seen with bilateral EAC fractures despite a unilateral mandibular fracture. Complications of these fractures can include hearing loss and canal stenosis; however, additional outpatient follow‐up is needed to further elucidate long‐term complications and shape treatment recommendations. Level of Evidence 4. Laryngoscope, 125:1579–1582, 2015