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Cauliflower ear or Auricular Hematoma

Cauliflower ear: what exactly is it?

Cauliflower ear, known as perichondrial hematoma or wrestler's ear, is a deformity of the ear caused by injury, which results in the pooling of blood (similar to fibrosis) between the perichondrium of the auricle and the cartilage.

The typical appearance of a cauliflower ear

The ear that is impacted by this condition exhibits an atypical and swollen appearance, often appearing folded back on itself. Moreover, noticeable irregular curves are present, closely resembling the distinctive shape of a cauliflower, thus giving rise to the disorder's name. The swelling and misshapen contours combine to create a unique and recognizable aspect of this condition.

What causes cauliflower ears?

Cauliflower ear arises as a consequence of a forceful impact or repetitive trauma to the ear, resulting in vascular damage and the separation of the auricle from the perichondrium. The condition is triggered when the ear experiences significant physical stress, causing harm to its blood supply and causing the ear's outer structure to detach from its underlying tissue.

What sports give you cauliflower ear?

Cauliflower ear is common in sports like rugby, wrestling, and mixed martial arts, mainly affecting men. Studies suggest that up to 84% of male wrestlers have reported this deformity.

Can you get cauliflower ear from a piercing?

Cauliflower ear is most commonly caused by blunt trauma to the ear, but it can also occur from poorly executed or infected piercings. While these complications are usually minor and heal quickly, it's essential to wait for the ear to return to normal before getting any piercing.

How to treat cauliflower ear

Cauliflower ear can be effectively treated in two ways:

  • The first method involves a minor surgical procedure known as otoplasty. In otoplasty, the accumulated blood clot is carefully removed with a precise incision, and the ear is subsequently sutured back into its original shape. This technique is particularly beneficial when the condition is detected early and there is no severe damage to the ear's structure.

  • The second treatment option involves draining the accumulated blood using Penrose drainage, coupled with the application of a compression dressing. This approach is often utilized in cases where the cauliflower ear has progressed further and the swelling and blood collection are more pronounced. Regardless of the chosen treatment, a five-day course of antibiotics is crucial to prevent post-surgical infections.

Drainage

Cauliflower ear can be treated through drainage, but it should always be performed by a doctor, even in emergencies. The goal is to completely evacuate the subperichondrial hematoma and reposition the perichondrium. Needle aspiration is not recommended. Instead, the ear is cleansed with an antiseptic solution, anesthetized, and then an incision is made along the auricle's curvature using a scalpel for proper drainage. Afterward, the ear is wrapped with elastic support or gauze bandages to promote healing.

Surgery

In most cases, otohematoma surgery, also known as califlower ear surgery, can be performed as an outpatient procedure, sparing patients the need for hospitalization. The treatment focuses on addressing the condition affecting the ear, specifically the area between the antelice (outer ear) and the hollow region. During the procedure, a skilled surgeon will carefully remove the trapped blood or fluid, providing relief to the affected ear and alleviating the discomfort experienced by the patient. Additionally, precise reconstruction of the cartilage in the affected area is conducted to ensure the proper alignment and shape of the ear is restored. Following the surgery, a light compressive bandage is gently applied to the treated ear. This bandage aids in minimising swelling and facilitating the healing process.

Risks and possible issues

In cases of complications like severe infections or necroses, healthcare professionals will take necessary action by removing necrotic areas to foster the healing of healthy tissues. Addressing underlying issues in and timely and accurate manner is vital for a smooth recovery.

How to prevent cauliflower ear

To prevent cauliflower ear effectively, it is essential to avoid trauma and injury by wearing proper protection during contact sports. In the event of an injury, seeking immediate medical attention can also help prevent cauliflower ear from developing.

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