Lacerations to the ear may involve the skin, fibrocartilaginous tissue or fatty tissues of the external ear, or any of the combination. Lacerations may also involve structures that lie beneath the skin such as the muscles, tendons, blood vessels, and nerves. When the doctor evaluates an ear laceration, it may be important to determine if the laceration has damaged the cartilage in the ear. Minor cuts, wounds, and deep cuts (lacerations) are common to the outer part of the ear.
Most of these injuries may be handled at home with simple first-aid treatment; however, deeper cuts might require medical intervention:
- Stay calm, avoid panicking, and apply pressure with a clean cloth or bandage for several minutes on the injury to stop bleeding.
- After washing the hands, the wound should also be washed with soap and clean water. Remove any dirt particles from the area and let the water run over it for several minutes. It is not recommended to scrub the wound; a dirty cut or scrape that is not thoroughly cleaned can cause scarring and infection.
- Once cleaned, the area may need to be dried, and an antiseptic lotion or cream can be applied.
- Cover the area with an adhesive bandage or a gauze pad. The area around the wound may need to be clean and dry.
Deep lacerations should be immediately checked by a doctor. An ear laceration if seen days later by a doctor may result in cosmetic deformity.
- Most of the ear lacerations are repaired immediately under local anesthesia. It is essential for the bridge of tissue to remain attached.
- In lacerations of the external ear, the skin margins are sutured whenever possible. If the cartilage is penetrated, it is repaired unless there is not enough skin to cover it. Damaged cartilage, whether repaired or not, is splinted externally, and a protective dressing is applied.
- Usually, wedge excision may be performed (“V or extended V”-like a cut) depending upon the type of injury.
- Ear lacerations are repaired with sutures once the wound is cleaned. If the cartilage is involved, absorbable sutures are placed in the cartilage to repair the defect.
- Complicated ear lacerations may require partial avulsion (plastic surgery repair). Reconstruction of the ear presents the surgeon with unique challenges not encountered elsewhere in other regions. The anatomy of the ear, with its relatively thin layer of skin overlying the cartilage, tends to increase the risk of poor surgical outcomes. An understanding of the severity of the wound and complications of ear reconstruction is necessary to prevent a poor surgical result.
- Ear lacerations should be repaired within 12 hours (mostly immediately) to prevent infection, necrosis, or deformities such as a “cauliflower ear.”
When should a patient visit a doctor after ear laceration?
Any deep ear cuts that cannot be treated at home require a doctor’s intervention. Medical intervention may be immediately needed if
- The ear cut is bleeding heavily and doesn't stop after 5-10 minutes of direct pressure or if the blood is gushing.
- There is a deeper or longer cut more than half-inch that requires a doctor’s supervision.
- The patient is complaining of hearing loss and/or severe pain.
- The injury is caused by dirty or rusty objects or involves debris, such as dirt, stones, or gravel.
- There is an animal or a human bite that may require immediate treatment and vaccination.
- The injury involves a fracture or is a head or bone injury, in which the patient should be taken to a hospital right away.
- The patient shows signs of infection, such as increased warmth, redness, swelling, bad odor, or drainage (even if the cut or wound is small) even after initial treatment.