Assessment and management of auricle (ear) lacerations
- Kelly Michele Malloy, MD
Kelly Michele Malloy, MD
- Associate Professor
- Department of Otolaryngology - Head and Neck Surgery
- University of Michigan Medical School
- Judd E Hollander, MD
Judd E Hollander, MD
- Professor and Vice Chair Department of Emergency Medicine
- Thomas Jefferson University
- Section Editors
- Anne M Stack, MD
Anne M Stack, MD
- Section Editor — Pediatric Procedures
- Associate Professor, Department of Pediatrics
- Harvard Medical School
- Allan B Wolfson, MD
Allan B Wolfson, MD
- Section Editor — Adult Procedures
- Professor of Emergency Medicine
- University of Pittsburgh
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — Adult and Pediatric Emergency Medicine
- Senior Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
This chapter will cover assessment and management of simple and complex auricle (ear) lacerations. Once serious head or middle ear injury is excluded, careful closure of ear lacerations after copious but gentle irrigation and minimal debridement should ensure coverage of any exposed cartilage to preserve cosmetic appearance.
Minor wound management, methods of suture placement, repair of adjacent anatomic sites, and evaluation of middle ear trauma are discussed in detail separately:
- Janfaza P, et al. Surgical Anatomy of the Head and Neck, Lippincott Williams & Wilkins, Philadelphia 2001.
- Brown DJ, Jaffe JE, Henson JK. Advanced laceration management. Emerg Med Clin North Am 2007; 25:83.
- Erdmann D, Bruno AD, Follmar KE, et al. The helical arcade: anatomic basis for survival in near-total ear avulsion. J Craniofac Surg 2009; 20:245.
- Raveendran SS, Amarasinghe L. The mystery of the split earlobe. Plast Reconstr Surg 2004; 114:1903.
- Moskop JC. Informed consent in the emergency department. Emerg Med Clin North Am 1999; 17:327.
- Code of ethics for emergency physicians. American College of Emergency Physicians. Ann Emerg Med 1997; 30:365.
- Tsai AK, Schafermeyer RW, Kalifon D, et al. Evaluation and treatment of minors: reference on consent. Ann Emerg Med 1993; 22:1211.
- Martinez NJ, friedman MJ. External ear procedures. In: Textbook of Pediatric Emergency Procedures, 2nd edition, King C, Henretig FM. (Eds), Lippincott, Williams & Wilkins, Philadelphia, PA 2008. p.593.
- Lavasani L, Leventhal D, Constantinides M, Krein H. Management of acute soft tissue injury to the auricle. Facial Plast Surg 2010; 26:445.
- Xu JH, Shen H, Hong XY. The aesthetic repair of complete traumatic cleft earlobe with a three-flap method. Ann Plast Surg 2010; 65:318.
- Agarwal R, Chandra R. A new technique for repair of acquired split-ear-lobe deformity: the free conchal cartilage sandwich graft. J Plast Reconstr Aesthet Surg 2010; 63:499.
- Lammers R. Methods of wound closure. In: Clinical Procedures in Emergency Medicine, 5th edition, Roberts JR, Hedges JR. (Eds), Saunders Elsevier, Philadelphia, PA 2010. p.592.
- Steffen A, Katzbach R, Klaiber S. A comparison of ear reattachment methods: a review of 25 years since Pennington. Plast Reconstr Surg 2006; 118:1358.
- Shelley OP, Villafane O, Watson SB. Successful partial ear replantation after prolonged ischaemia time. Br J Plast Surg 2000; 53:76.
- Kind GM. Microvascular ear replantation. Clin Plast Surg 2002; 29:233.
- Stierman KL, Lloyd KM, De Luca-Pytell DM, et al. Treatment and outcome of human bites in the head and neck. Otolaryngol Head Neck Surg 2003; 128:795.
- Stewart GM, Thorp A, Brown L. Perichondritis--a complication of high ear piercing. Pediatr Emerg Care 2006; 22:804.
- Fisher CG, Kacica MA, Bennett NM. Risk factors for cartilage infections of the ear. Am J Prev Med 2005; 29:204.
- Physical examination
- Ancillary studies
- INDICATIONS FOR SUBSPECIALTY CONSULTATION OR REFERRAL
- WOUND REPAIR
- Indications for primary closure
- Contraindications and precautions
- - Anesthesia and analgesia
- Local anesthesia
- Regional auricular block
- Procedural sedation
- - Wound preparation
- - Equipment
- - Simple lacerations
- - Split earlobe
- - Complex lacerations
- - Avulsion injuries
- OTHER CONSIDERATIONS
- Tetanus prophylaxis
- Prophylactic antibiotics
- Bite wounds
- Auricular notching
- Auricular hematoma
- Perichondritis or chondritis
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS