EAR INJURY |
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DESCRIPTIONEars are easily injured because they are so exposed. The injuries may be serious and painful and may lead to disfigurement unless you follow a careful treatment plan for your child. The skin and cartilage of the external ear, the perichondrium (the thin membrane layer between the cartilage and the skin), the nerves, blood vessels, connective tissue, and parts of the internal ear (the ear drum, middle ear, and inner ear) are involved. Appropriate health care includes: self-care after diagnosis; physician's monitoring of general condition and medications.
SIGNS & SYMPTOMS
Contusion or laceration: Pain, swelling, bleeding, and bruising of skin around the child's ear.
Internal injury: loss of hearing, ringing in the ear, loss of equilibrium, or bleeding from a ruptured eardrum.
CAUSES
Direct blow to the child's ear.
Accidental insertion of a sharp object into the ear.
Sudden, excessive changes in pressure.
RISK FACTORS
Contact sports, especially wrestling or boxing; diving.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should wear protective headgear for contact sports. Some injuries cannot be prevented.
BASIC INFORMATION
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor, including consultation with an ear specialist or plastic surgeon if necessary; X-rays of the skull to detect an accompanying skull fracture.
POSSIBLE COMPLICATIONS
Chronic infection of the injured ear if the skin is broken from laceration or contusion.
"Cauliflower ear," resulting from repeated contusions with bleeding through soft tissues. The tissues under the skin and the lining of the child's ear cartilage thicken permanently. (There is no treatment for this condition--only prevention.)
Infection from contusion, laceration, or other injury to the child's eardrum or other internal ear structures.
Temporary or permanent hearing loss.
PROBABLE OUTCOME
Your child's contusions and lacerations may require 10 to 14 days to heal. Sutures from lacerations are usually removed in about 10 days.
TREATMENT
FIRST AID
Don't try to stop bleeding from inside the child's ear.
Don't allow the injured child to hit or thump the head to try to restore hearing.
Cover the child's external ear with a clean cloth or sterile bandage.
Apply an ice pack of ice cubes or chips in a plastic bag or moist towel.
Compress the area loosely with an elastic wrap. Don't wrap too tightly.
Keep the injured child in a partial reclining position while transporting to an emergency facility.
CONTINUING CARE
For contusions: The doctor will aspirate blood between the child's skin and ear cartilage if needed. If swelling persists, multiple small incisions may prevent a cauliflower ear from developing. The child should sleep with the head elevated with 2 pillows until symptoms subside. Change bulky bandages on your child's ear often to keep them soft and protective.
For lacerations: Your doctor must carefully repair the child's cut to prevent deformity. Keep the wound dry and covered for 48 hours. After 48 hours, replace the bandage when it gets wet. When you change the child's bandage, apply a small amount of petroleum jelly or non-prescription antibiotic ointment to the bandage. Ignore small amounts of bleeding but control heavier bleeding by firmly pressing a facial tissue or clean cloth to the bleeding spot for 10 minutes.
MEDICATION
Your doctor may prescribe:
Antibiotics to treat infection.
Pain relievers.
ACTIVITY
Your child can resume normal activities as soon as possible.
DIET & FLUIDS
No restrictions.
OK TO GO TO SCHOOL?When strength and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has an ear injury.
Any of the following occur after treatment: increased pain or pain that persists longer than 2 days; hearing loss; increased bleeding or swelling; signs of infection (headache, muscle aches, dizziness, fever, general ill feeling).
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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