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Traumatic acute external auditory canal stenosis is a narrowing of the whole external auditory canal as the result of acute injury. In our case, the patient developed conductive hearing loss in the acute setting. Our report describes the presentation, diagnosis, and management of traumatic acute external auditory canal stenosis. At the time the current report was written, traumatic acute external auditory canal stenosis due to penetrating trauma from the contralateral neck had not been described in the literature.
During the resuscitation of critically ill trauma patients, it is sometimes necessary to delay the secondary survey because of life-threatening injuries. Certain injuries, such as those to the ear, can be easily missed when this occurs. Traumatic external ear canal stenosis, or atresia, has been described by McKennan and Chole,1 and their case report indicates that the acute diagnosis of external ear canal atresia was missed during the initial events surrounding their patient's injuries. The following is a case report of a critically injured patient with multiple penetrating injuries, including injury to the external auditory canal that proved to be initially elusive to the members of his health care team.
The patient was a 23-year-old male who presented to a regional trauma center by emergency medical services. He was transferred from the scene and was in critical condition upon arrival. The patient presented with ballistic injuries to the left neck zone 2, left shoulder, right thorax, and abdomen. After initial resuscitation and placement of bilateral chest tubes in the trauma bay, the patient was temporarily stabilized and taken for computerized tomographic angiography that revealed a small right internal carotid artery dissection, significant tissue emphysema throughout the neck, hematoma on the left neck, grade 5 liver laceration, pancreatic head injury, and a duodenal injury in D1, D2, and D3 segments....