Penetrating and blast ear trauma: 7-year review of two pediatric practices.

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.