What are traumatic ear injuries?
Left: Lateral view of right ear after traumatic human bite. Right: Post-operative view after ear reconstruction.
Traumatic ear injuries may be caused lacerations, tears, bites, or other forceful motions or impact (such as motor vehicle accidents). These injuries can result in malformations and disfigurement of the ear.
One common type of traumatic ear injury is a split earlobe. Most split earlobes occur gradually due to large or heavy earrings. The skin heals as the hole slowly enlarges. In some instances, earlobes may be split due to trauma such as when an earring gets caught or pulled forcefully.
Traumatic ear injuries are often initially evaluated and treated in the emergency department. In many cases, these injuries can be treated with removal (debridement) of unhealthy tissue from the wound; irrigation of the wound to help clean the wound and remove any deeper tissue, blood or debris; and careful closure of the skin and torn cartilage. This will usually result in a satisfactory shape.
If parts of the ear are completely detached or if the entire ear has been amputated, a range of complex treatment options may be used. Treatment may include debridement of any tissue or debris and closure of the residual wound; skin grafting to cover any exposed cartilage; and removal of the skin from the detached part. Reconstruction of the ear may require borrowing cartilage from other parts of the body such as the ribs in order to reshape the ear.
In some scenarios, doctors may attempt to reattach the ear (replantation) using microsurgical techniques to restore circulation to the severed part. Antibiotics are often prescribed to reduce the rate of infection.
Treatment of split earlobes
A split earlobe from an earring that has suddenly pulled through can be repaired immediately because the edges are still raw. For example, this may occur with a mother whose baby has grabbed her earring.
Repair of split earlobes requires excision of the defect to freshen up the edges, followed by careful suture repair. Complete and near-complete splits of the earlobe require a pie-wedge excision. Small splits do not always require a complete cut through the earlobe.
From left to right: (1) Split earlobe in two locations from earring. (2) Post-repair of split earlobe. (3) Wide and stretched earlobe deformity from plugs (gauge). (4) After surgical repair of stretched ear deformity.
Some surgeons will try to save the pierce hole, while others will completely repair the ear and re-pierce it after several months. Depending on your child’s age and the extent of her injury, repair may either be done under local anesthesia in the doctor’s office, or in the operating room. Repair of a split earlobe will leave a permanent scar.
Earlobe holes that have been intentionally dilated using progressively larger earrings are challenging to reconstruct. Repair involves excision of the edges of the defect and careful rearrangement of the residual earlobe tissue to form a more conventional shape and contour. This will leave permanent scars.