Auricular trauma can occur independently or accompany head and facial injuries. Due to the ear's exposed position, it is susceptible to mechanical injuries, frostbite, and burns, and contusions and lacerations are the most common. Auricular trauma can also involve adjacent tissues, such as the external auditory canal, leading to stenosis or atresia.
Contusion
Contusion is often caused by blunt force. Mild cases may involve only skin abrasions or localized swelling, which usually heal spontaneously. Severe cases may result in subperichondrial or subcutaneous hematomas, potentially affecting the external auditory canal. Due to limited subcutaneous tissue and poor blood circulation, hematomas are slow to resorb. If not treated promptly, hematoma organization can lead to thickening and deformation of the auricle. Large hematomas may lead to secondary infection, causing cartilage necrosis and auricular deformity. Small hematomas should be aspirated with a thick needle under sterile conditions, followed by 48 hours of compression dressing. If there is persistent hemorrhage or a large hematoma, surgical incision and drainage, along with thorough hemostasis and compression dressing, are necessary. Antibiotics should be administered to prevent infection.
Laceration
Mild cases involve a simple tear in the auricle, while severe cases may include tissue loss or partial to complete detachment of the auricle. Early debridement and suturing are essential, aiming to preserve soft tissue. Accurate alignment should be achieved with fine sutures, and local dressing should avoid excessive pressure. Antibiotics are used postoperatively to prevent infection. For large skin defects with intact cartilage, a pedicled flap from behind the ear or a free skin graft can be used for repair. For small defects involving both skin and cartilage, wedge excision and re-suturing can be performed. Completely detached auricles should have blood vessels reattached promptly. During surgery, the severed ear artery can be irrigated with heparin solution. The donor artery is usually the anterior branch of the superficial temporal artery or the posterior auricular artery. Postoperative care should avoid compression dressing and hemostatic drugs, and include intravenous low molecular weight dextran to prevent vascular thrombosis.