Penetrating Middle Ear Trauma: A Report of 2 Cases

• Published in: Ear, nose, & throat journal Vol. 84; no. 1; pp. 32 - 35
• Main Authors: Neuenschwander, Michael C., Deutsch, Ellen S., Cornetta, Anthony, Willcox, Thomas O.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2005; Sage Publications, Inc; SAGE PUBLICATIONS, INC
• Subjects: Care and treatment; Child, Preschool; Ear Ossicles - injuries; Health aspects; Hearing Loss - etiology; Hearing Loss - surgery; Humans; Male; Otitis media; Pediatrics; Psychic trauma in children; Risk factors; Tympanic Membrane - injuries; Wounds, Penetrating - complications; Wounds, Penetrating - surgery; United States
• ISSN: 0145-5613; 1942-7522
• DOI: 10.1177/014556130508400112

Penetrating middle ear injury can result in hearing loss, vertigo, and facial nerve injury. We describe the cases of 2 children with penetrating trauma to the right ear that resulted in ossicular chain disruption; one injury was caused by cotton-tipped swabs and the other by a wooden matchstick. Symptoms in both children included hearing loss and otalgia; in addition, one child experienced ataxia and the other vertigo. Physical examination in both cases revealed a perforation in the posterosuperior quadrant of the tympanic membrane and visible ossicles. Audiometry identified a moderate conductive hearing loss in one child and a mild sensorineural hearing loss in the other. Both children underwent middle ear exploration and reduction of a subluxed stapes. We discuss the diagnosis, causes, and management of penetrating middle ear trauma. To reduce the morbidity associated with these traumas, otologic surgeons should act promptly and be versatile in choosing methods of repairing ossicular chain injuries.