Characterizing the epidemiology of traumatic ear injuries: A 20 year analysis of emergency department visits in the U.S

Background: The ear is one of the most technically difficult areas to reconstruct following traumatic injury. Utilizing the largest national multicenter patient sample to date, this study seeks to provide a critical overview of the epidemiology of traumatic ear injuries. Methods: The NEISS database was searched from 2003-2022 to identify patients with related traumatic ear injuries. Three age groups were examined: geriatric (65+), adult (18-64), and pediatric (2-17). Variables including race, sex, incident location, commercial products involved, and emergency department disposition were evaluated between the groups utilizing two-proportion z-tests with Bonferroni correction. Results: 25,285 patients who sustained ear injuries were identified from the NEISS database. The top five types of ear injuries were laceration, contusion, puncture, hematoma, and burn. Geriatric patients experienced a significantly higher frequency of ear lacerations (82.5 % vs 68.6 %, p < 0.001) relative to non-geriatric adults, while children had a significantly greater frequency of hematomas (3.7 % vs 2.8 %, p = 0.001), and contusions (18.0 % vs 16.0 %, p = 0.006). The top five products involved for ear injuries were tables, first aid equipment, bed/bedframe, jewelry, and chairs. Geriatric adults had a significantly higher frequency of ear injuries from bed frames relative to non-geriatric adults (20.0 % vs 3.2 %, p < 0.001) and were over five times more likely to be admitted to the hospital.. Conclusions: This study offers novel insights into the epidemiology of traumatic ear injuries in the U.S especially across different age demographics. The greater prevalence of ear injuries from tables, first aid equipment, and with sporting activities among children highlights needs for childproofing homes and providing greater patient education and regulation on ear safety. The increased fragility of tissue and greater prevalence of fall injuries among geriatric patients demonstrates need for ongoing physical therapy and fall risk measures to be implemented. Collectively, the results help inform public health strategies to prevent such injuries as well as provide invaluable clinical context for reconstructive surgeons.