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Penetrating and blast ear trauma: 7-year review of two pediatric practices
Paul Mick1, Paul Moxham, Jeff Ludemann
1Division of Otolaryngology, University of British Columbia and British Columbia's Children's Hospital, Vancouver, British Columbia.
Insights
Penetrating ear trauma (PET) and blast ear trauma (BET) in children are often underreported. Most cases of PET involve cotton-tipped applicators (CTAs) and occur in younger children; urgent surgery is not typically needed for ear trauma.
Area of Science:
- Pediatric Otolaryngology
- Trauma Surgery
- Audiology
Background:
- Ear trauma in children is a significant concern.
- Understanding the causes and outcomes of pediatric ear trauma is crucial for appropriate management.
Purpose of the Study:
- To review the experience with penetrating ear trauma (PET) and blast ear trauma (BET) in children.
- To analyze the etiologies, clinical presentations, and management outcomes of pediatric ear trauma.
Main Methods:
- Retrospective review of pediatric ear trauma cases from 2000 to 2007.
- Data collected included micro-otoscopic findings and audiologic data.
- Cases were categorized into penetrating ear trauma (PET) and blast ear trauma (BET).
Main Results:
- 18 cases of PET and 6 cases of BET were identified.
- Cotton-tipped applicators (CTAs) were the most common cause of PET in younger children (average age 5).
- Blast ear trauma occurred in older children (average age 11) and primarily resulted in tympanic membrane perforations that healed spontaneously.
Conclusions:
- Pediatric ear trauma, particularly PET from CTAs, is underreported and affects younger children.
- Blast ear trauma affects older children, with spontaneous healing of tympanic membrane perforations.
- Non-surgical management is appropriate for pediatric ear trauma unless neuro-otologic signs are present; public education on CTA avoidance is recommended.
Objective:
To review our experience with ear trauma in children.
Design/Methods:
Retrospective review of two practices from 2000 to 2007.
Setting:
Pediatric tertiary care hospital.
Main Outcome Measures:
Micro-otoscopic findings and audiologic data.
Results:
There were 18 cases of penetrating ear trauma (PET) and 6 cases of blast ear trauma (BET). The average age of the children with PET was 5 years. Fifteen of the 18 cases involved cotton-tipped applicators (CTAs); 8 patients had tympanic membrane perforations from CTA use. Six of the perforations healed spontaneously, and the other two patients were lost to follow-up. For 15 of the 18 PET patients, audiograms were available, and all eventually returned to normal. The average age of the six patients with BET was 11 years. BET caused five tympanic membrane perforations, all of which healed spontaneously. Three patients had audiograms, which were normal. The other three were lost to follow-up. None of the patients had vertigo, nystagmus, facial weakness, or cerebrospinal fluid otorrhea; this factored into our nonsurgical approach.
Conclusions:
PET and BET in children are underreported. PET usually involves CTA and occurs in younger children than does BET. Urgent surgical intervention is not indicated unless a child presents with neuro-otologic signs or symptoms. CTA avoidance should be taught systematically to the public.
