Bruce Black MD EAC TRAUMA

Transcription

1 EAC TRAUMA

2 Bruising in the deep canal due to cotton bud/q-tip selfcleaning attempts. No action required.

3 A granuloma of the deep Lt. EAC. Superficial trauma has become secondarily infected. Clean thoroughly, debride if possible, use topical ciprofloxacin to settle the site.

4 Ulceration of the floor of the EAC secondary to pressure trauma from a hearing aid mould. Clear debris and re-fit the aid.

5 Middle canal stenosis complicating previous tympanoplasty surgery. Likely to retain debris and cause chronic myringitic changes. Trans-canal excision and grafting.

6 Well-healed longitudinal fracture of the left temporal bone. A distinct line is noted from 12 o clock, passing posterosuperiorly. Note the subtle drum kink at the umbo.

7 Past left temporal bone fracture line evident in the posterosuperior EAC. There has been considerable drum trauma and the incus appears dislocated posteriorly.

8 A healed substantial fracture line from the attic along the posterosuperior canal. The pars tensa remains intact. Hairs in the EAC.

9 Substantial fracture trauma involving the posterior EAC and superior mesotympanum. The incus appears to have become dislocated into the middle ear posteriorly. Umbo drum kink.

10 Fracture line in the posterior scutum. The defect extends along the EAC at 3 o clock. The malleus handle is displaced laterally, away from the incus and slightly wrinkling the drum at the umbo.

11 Past major disruption of the attic and upper pars tensa secondary to a fracture line passing superior to the attic.

12 Severe left temporal bone trauma. A substantial EAC wall defect is present, passing posteriorly from the attic. Narrow EAC with some exostosis formations.

13 Severe left drum and chain trauma. The incus has been displaced into the upper EAC and re-epithelialised. Tubal insufficiency and air bubbles behind the drum.

14 A severe Lt. longitudinal fracture. The incus has dislocated into the EAC and a large wall defect is present behind. A chronic effusion has resulted from Eustachian tubal trauma.

15 A longitudinal fracture extending from posterosuperiorly, across the attic and disrupting the anterosuperior EAC.

16 Severe ossicular disruption. A fracture extending from the rear EAC wall has disrupted the chain and upper drum. Probable malleus-incus dehiscence and dislocation.

17 Temporal bone trauma in an exostosis case. The fracture has disrupted the drum, forming adhesions on to the anterior bony boss. Chain details are obscured.

18 Anterior facial trauma. A blow to the mandible has dislocated the condyle into the EAC, causing obliteration of the anterior angle.

19 Anterior angle blunting that has resulted from a fracture line (just visible above the attic) that has extended along the anterior drum causing substantial fibrosis.

20 Lateral displacement of the malleus, due to a fine posterosuperior fracture. The handle is angled laterally, pulling the pars tensa out of the normal concavity.

21 CSF otorrhoea. A covert temporal bone fracture is leaking into the EAC, causing a profuse watery discharge.

22 CSF rhinorrhoea secondary to a temporal bone fracture. The ear has remained dry, albeit partially deaf. Free watery nasal drip, indicating a patent defect requiring surgery.

23 Covert CSF leak into the middle ear. A large healed attic defect is present. A watery effusion and fluid level is evident behind the posterior pars tensa, plus a fluid post-nasal drip.

24 Longitudinal fracture (arrowed) of a right temporal bone, postero-inferior view, plain film. Extension into the attic may cause facial palsy or chain disruption. Concussion may produce sensorineural deafness.

25 Longitudinal fracture of the left temporal bone, lateral plain film. Classically, the fine hairline fracture extends superiorly from the mastoid across the squamous temporal.

26 Transverse fracture of the right temporal bone. These generally result from severe anteroposterior trauma, frequently fatal.

27 Transverse fracture of the right temporal bone, axial CT. Disruption of the otic capsule causes profound sensorineural loss, vertigo, tinnitus and facial palsy.

28 Transverse fracture of the temporal bone due to a severe head injury. SND, vertigo, VII palsy and CNS sequelae.

29 Depressed right temporal bone fracture, 3D CT reconstruction. Golf ball injury. No ear trauma effects.