Cauliflower ear and otohematoma

What is cauliflower ear?

Cauliflower ear, also known as perichondrial hematoma or wrestler's ear, is an ear deformity caused by trauma that leads to a collection of blood (like fibrosis) between the perichondrium of the auricle and the cartilage.

What does cauliflower ear look like?

The affected ear has an abnormal swollen shape and it is usually folded back on itself. Some of the irregular curves are also visible that resemble the appearance of cauliflower, hence the name of the disorder.

What are the causes of cauliflower ear?

Cauliflower ear is caused by a strong blow or by repeated trauma to the ear, which leads to the damage of vasculature and the detachment of the auricle from the perichondrium.

Cauliflower ear in rugby, wrestling and MMA

This is the main reason why it is very common in sports such as rugby, wrestling and mixed martial arts and mostly affects men. According to some studies, up to 84% of male wrestlers have reported this deformity.

Cauliflower ear and piercings

Although the most common cause of cauliflower ear is blunt trauma to the ear, it is sometimes possible that a badly executed or infected piercing can cause this disorder. Commonly, these complications are minor and the tissue damage heals in a short time. It is always important to wait until there is no swelling and the ear is back to normal before getting any type of piercing.

Cauliflower ear treatment

Cauliflower ear can be treated by removing the clot with an incision and then placing sutures, this small surgery is called otoplasty or it can be treated by draining accumulating blood using Penrose drainage with a compression dressing. All these treatments are followed by antibiotic therapy that lasts about 5 days to prevent an infection.

Should you drain cauliflower ear?

Cauliflower ear can be treated through drainage. However, drainage should always be done by a doctor, even in cases considered to be an emergency. The goal of drainage is the complete evacuation of the subperichondrial hematoma and the repositioning of the perichondrium.

It is not recommended to perform the drainage by aspirating with the needle and the correct method to do that is by cleaning the auricle with an antiseptic solution, anesthetizing the ear and cutting the skin with a scalpel, along the curvature of the auricle. The ear will then be drained and wrapped with elastic support or gauze bandages.

Cauliflower ear and otohematoma surgery

Otohematoma surgery does not require hospitalization but in special cases it can be done as an outpatient. It consists of the evacuation and reconstruction of the cartilage in the area between the antelice and the hollow, and after then applying a light compressive bandage.

Possible complications and risks

Only in the case of complications, such as a severe infection or the presence of necroses, the removal of necrotic areas is necessary that can allow healthy tissues to heal.

Cauliflower ear protection and prevention

The best way to prevent cauliflower ear is to avoid trauma and injury by wearing adequate protection during contact sports. In the event of an injury, cauliflower ear can be prevented by seeking immediate medical attention.

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