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(Barré) #1
HEAD, EYE, EAR, NOSE, AND THROAT

EMERGENCIES

■ Meningitis (most common intracranial complication)
■ Brain abscess, encephalitis, subdural emphysema
■ Venous sinus thrombosis


Auricular Hematoma


ETIOLOGY


Accumulation of blood after blunt trauma


SYMPTOMS/EXAM


Hematoma and swelling of ear (see Figure 14.3)


TREATMENT


■ Aspirate blood or I+D.
■ Apply conforming pressure dressing and recheck in 24 hours.


COMPLICATIONS


■ Reaccumulation of blood →cauliflower ear deformity.
■ Infection


Ear Foreign Bodies


ETIOLOGY


Insects, cleaning materials (Q tips), anything a child can put in an ear


SYMPTOMS/EXAM


■ Pain
■ Decrease or change in hearing
■ Malodorous or purulent discharge
■ Direct visualization of object


FIGURE 14.2. Otitis media with red, bulging tympanic membrane. (See also color insert.)


(Courtesy of Richard A. Chole, MD, PhD as published in Knoop KJ, Stack LB, Storrow AB.
Atlas of Emergency Medicine,2nd ed. New York: McGraw-Hill, 2002:118.)


Exposed cartilage is dead
cartilage. The primary goals in
managing an ear laceration
are (1) approximate the
cartilage with absorbable
suture and (2) cover the
cartilage with skin.
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