A tear of the skin lining the external auditory canal.
While the skin of the deep meatus is extremely thin and easily traumatized it is well protected from external trauma and it is usually the skin of the more accessible superficial meatus which is the site of lacerations. These lacerations occur most frequently as the result of inadvertent self manipulation by the patient.
A fingernail, hairpin, matchstick or cotton tipped applicator is often the direct cause of the injury.
Less commonly, lacerations may result from the clumsy insertion of a speculum, ear syringe or wax hook into the canal.
They may also result from unskilled attempts at foreign body removal.
In most cases a small tear in the superficial canal skin will be seen and occasionally a flap of skin may have been raised.
There may be evidence of hematoma recent bleeding, blood clot, or crust which may have accumulated within the meatus.
The ear should be carefully examined to ensure that the laceration is confined to the external canal skin and does not involve the tympanic membrane or middle ear.
The bleeding from a laceration is generally self limiting and the ear should simply be kept dry to avoid possible infection. In those cases in which the laceration may have been contaminated, the use of a suitable topical antibiotic ear drop is recommended.
Note the droplet of fresh blood which is oozing from a small laceration in the floor of the bony canal.
If the bleeding is not stopped, the canal may fill with blood.