Ear Injuries and Trauma (2024)

Some kinds of ear trauma cause minor cuts, wounds, or deep cuts (lacerations). These injuries may happen to your outer ear or ear canal. Minor cuts usually heal on their own or with at-home first aid. You may need treatment if you have a more serious wound or laceration that:

• Causes hearing loss or severe pain
• Happened from an animal or human bite
• Has dirt or debris stuck inside
• Has ragged or separated edges
• Is deep or is longer than a half inch
• Occurred with a head trauma
• Shows signs of infection, such as redness, swelling, drainage, or a bad smell

The tympanic membrane, also called your eardrum, is a very thin piece of skin that separates your ear canal from your middle ear. Tympanic membrane perforation, or eardrum rupture, happens when you get a hole in your eardrum.

Several kinds of trauma can cause a hole, including a foreign object going inside your ear or a rapid change in air or water pressure. This injury often heals on its own, but you may need treatment to fix it. Treatment can also manage complications of eardrum rupture, including otitis media (ear infection), cholesteatoma (a skin cyst), or conductive hearing loss.

Your middle ear has three small bones called ossicles. These bones line up in a certain way to help you hear.

Ear trauma can cause these bones to move out of their normal location (ossicular dislocation). Trauma can also break these bones (ossicular fracture).

These ear injuries usually happen from a blow to your head or an object going inside your ear. Ossicular dislocation and ossicular fracture cause hearing loss, but treatment can help.

A temporal bone fracture (break) happens from a blow to your head and can be a life-threatening injury. Since the temporal bone surrounds the inside of your ear, a fracture can damage several parts of your ear. The injury may cause:

• Blood buildup in the middle ear
• Eardrum rupture
• Fracture of the middle ear bones or inner ear structures
• Movement of the middle ear bones (ossicular dislocation)

You may also experience facial nerve paralysis (nerve damage that makes you unable to move your face). Your facial nerve, which allows you to move your face muscles, runs through your temporal bone. It may get cut or swell after head trauma.

In addition, temporal bone fracture can cause leaking of cerebrospinal fluid (thin, clear liquid surrounding your brain). Cerebrospinal fluid may drip from your ear or out of your nose after an injury. If left untreated, a cerebrospinal fluid leak can lead to dangerous infections, such as meningitis.

Acoustic trauma happens when very loud sound harms the structures in your inner ear. Acoustic trauma leads to sensorineural hearing loss, or hearing loss caused by inner ear damage. It can also cause ringing in your ears (tinnitus). Very loud noises near your ear cause this type of injury, such as:

• A gunshot fired near your ear
• An explosion
• Long-term exposure to loud sounds

Risk factors are things that increase your risk for ear injuries. Anything that puts you in danger of head or ear trauma makes you more likely to get an ear injury. These risk factors include:

• Exposure to very loud noises
• Playing contact sports, such as football, wrestling, or boxing
• Putting objects inside your ears

Ear injuries and trauma happen accidentally. However, you can take precautions to avoid ear trauma, such as:

• Chewing gum, sucking on hard candy, or yawning while flying during takeoff and landing (if you usually feel pain or pressure on airplanes)
• Keeping objects and your fingers out of your ears, including cotton swabs (your ears naturally get rid of wax and clean themselves)
• Teaching your children to never put items inside their ears
• Using ear protection around loud noises, such as at concerts or construction sites
• Using protective helmets or headgear when playing contact sports or working in construction zones
• Wearing a helmet during activities that increase your risk for head trauma, such as biking, skateboarding, or skiing

If your doctor suspects inner ear injury, bone fractures, or nerve damage, you may get imaging tests. These tests could include a computed tomography (CT) scan or magnetic resonance imaging (MRI).

Your doctor will do hearing tests if an ear injury has changed your ability to hear. Hearing tests look at your response to several aspects of sound, such as tone, pitch, and loudness.

Hearing tests may include:

• Acoustic reflex test (ear muscle reflex test): We look at your ear’s automatic response to loud sounds, called the acoustic reflex.
• Pure-tone test: This test plays tones of different pitch and loudness.
• Speech and word recognition tests: You’ll listen to words spoken at different volumes.
• Tuning fork tests: These tests (also called Rinne and Weber tests) play a tone using a tuning fork to see which kind of hearing loss you have.