Makindo Medical Notes.com

Traumatic auricular hematoma, commonly known as cauliflower ear, occurs when blood collects between the cartilage and the perichondrium of the outer ear following blunt trauma. This condition is often seen in contact sports such as wrestling, boxing, and rugby. If left untreated, the hematoma can lead to permanent deformity of the ear, resulting in the characteristic "cauliflower" appearance.

About

• Preventable cause of ear deformity
• Also called Cauliflower ear

Causes

• Contact Sports: Wrestling, boxing, rugby, and mixed martial arts due to repeated blows or friction to the ear.
• Accidents: Falls, motor vehicle accidents, or other forms of trauma.
• Physical Altercations: Fights or assaults that involve blows to the head or face.

Aetiology

• Haematoma under perichondrium splits cartilage from perichondrium
• Leads to necrosis and deformity

Clinical

• Swelling: outer ear, tender, and discolored.
• Pain: at the site of the injury, which may be exacerbated by pressure on the ear.
• Deformity: the swelling can become hard and fibrous, leads to a cauliflower ear.
• Fluctuance: may feel soft and compressible to the touch in the early stages.
• Loss of Normal Ear Contour: normal ridges and valleys may be obscured by the swelling.

Investigations

• In some cases, ultrasound or MRI may be used to assess the extent of the haematoma

Management

• Removal of haematoma. Compressive Dressing: Aim is to drain the hematoma to prevent fibrosis and subsequent deformity. A needle or syringe is used to aspirate the accumulated blood from the haematoma. Application of a compressive dressing to prevent reaccumulation of blood. Alternatively a small incision and drainage of haematoma and firm bandage around head is needed. ENT follow up needed.
• Compressive Dressing: : compressive dressing or mold is applied to maintain pressure on the ear, preventing reaccumulation of blood and promoting adherence of the skin to the cartilage.
• Antibiotics: may be prescribed, especially if an incision is made, to prevent infection.
• Follow-Up: monitor closely for signs of reaccumulation, infection, or inadequate drainage, which may require additional intervention.
• Prognosis:important for athletes involved in contact sports to wear protective headgear or ear guards during contact sports can help prevent direct trauma to the ears. Prognosis for auricular hematoma is good if treated promptly.