MIDDLE EAR TRAUMA

© Bruce Black MD

Minor drum trauma secondary to self cleaning attempts. The pars tensa is intact. Observe only.

© Bruce Black MD

A scale of dried blood on the postero-superior pars tensa secondary to a fine penetrating injury. Hearing normal.

Remove the scale once this is lifting off the drum. © Bruce Black MD

A small anterior drum perforation secondary to a slapping injury to the ear. Hearing is slightly muffled but only

minimally depressed. Observe, should heal in 1-2/12. © Bruce Black MD

A longitudinal tear in the anterior drum. Ear struck by a ball. No evidence of infection. Avoid water in the EAC, high

probability of spontaneous healing. © Bruce Black MD

Small perforation in an atrophic area in the posterior pars tensa. Barotrauma effect. No infection, await spontaneous

healing. © Bruce Black MD

A recent penetrating injury to the right drum. Clean perforation, no evidence of ossicular disruption. Good

prospect of uneventful healing. © Bruce Black MD

Penetrating injury to the lower drum, 3/7 later. Moist, probable impending infection. Manage with amoxycillin-

clavulanic acid, antibiotic drops. © Bruce Black MD

Recent severe gouging penetrating injury to the deep EAC and drum. Profuse blood clot previously removed. Observe

closely, active treatment if evidence of infection. © Bruce Black MD

Acute spiny plant penetrating injury to the right ear. Profound sensori-neural deafness and vertigo due to

stapedial depression into the cochlea. © Bruce Black MD

Penetrating injury to the anterior pars tensa. Concurrent unrelated old chronic otitis media with a postero-superior

drum defect revealing an intact incudo-stapedial joint. © Bruce Black MD

A healing past drum perforation. A crust has formed on the intact drum causing an irritating rustling sensation on positive

Valsalva pressure. Relieved by removal of the debris. © Bruce Black MD

Mild conductive deafness, Rt. Ear, after forcible extraction of a wet finger during a shower. Mild drum crinkling at the

umbo. Hypermobile fractured handle of the malleus. © Bruce Black MD

20 db conductive deafness felt after vigorously rubbing the ear. Handle of the malleus displaced laterally, hyper-mobile,

minimal drum irregularity at the umbo. Fracture below the lateral process. © Bruce Black MD

Broken malleus handle secondary to a hairline fracture at 12 o’clock. The incus appears displaced superiorly off the

head of the stapes. Crinkling at the umbo. © Bruce Black MD

Post-traumatic disruption of the left ossicular chain in the attic, coronal CT. The incudo-malleolar joint has separated,

causing a substantial conductive loss. © Bruce Black MD

Detail of the previous case, axial view through the attic. Separation of the incus and malleus is seen. Managed with

a malleus-stapes Spanner assembly technique. © Bruce Black MD

Previous case, view of the normal right side attic showing the normally apposed incus and malleus.

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD

© Bruce Black MD