An auricular hematoma is a condition in which there is swelling and redness of the outer ear because of accumulation of blood between the cartilage and the tissue surrounding it (called perichondrium).
This occurs on account of trauma to the ear, which is why the patient may also notice some amount of bleeding and external injury at the same time. Auricular hematoma, if neglected, results in deformities of the outer ear the deformed ear is called cauliflower ear.
If an auricular hematoma is not treated promptly, it can result in permanent damage to the ear cartilage and, scarring and disfigurement are permanent. When the condition is allowed to progress this far, it is a lot harder to treat and the damage will very often be irreversible.
The most effective way to deal with this problem is by attending to it immediately and by preventing any disfiguration in the first place.
What are the causes of Auricular Hematoma?
The outer ear is mainly comprised of cartilage that lends the ear its distinctive contours. It also gives it some amount of flexibility and movement. As blood vessels do not supply blood to the cartilage, the cartilage must receive necessary nutrients from the surrounding tissue called the perichondrium.
“Blunt force trauma” to the ear can result in accumulation of blood between the cartilage and the perichondrium, disturbing blood flow to the cartilage and resulting in localized swelling.
The presence of a hematoma may stimulate the growth and formation of new cartilage and fibrous tissue, but the new cartilage is often asymmetric.
Auricular hematomas may also develop on account of repeated and frequent friction during wrestling when the ears may be compressed or pressed against the floor or mat. In this case, the perichondrium may be separated from the cartilage causing bleeding between them.
What are the signs and symptoms of an Auricular hematoma?
The symptoms of auricular hematoma are not hard to recognize, but they may vary slightly depending on the severity of the trauma that the ear is subjected to. Some of the common symptoms include:
- Swelling and bruising of the ear
- Ear pain that may be mild to severe
- Abnormality or changes in the normal curvature of the ear
- Facial swelling
In severe cases, the facial trauma may also cause other accompanying symptoms like:
How is Auricular hematoma diagnosed?
An auricular hematoma is almost always diagnosed through physical examination and patient history as it is fairly easy to recognize. There will almost always be swelling and the ear will appear disfigured.
If there is any uncertainty about the diagnosis, the doctor will probably withdraw some of the fluid from the swollen area with a needle to establish if it is filled with blood or pus due to abscess formation.
Make it a point to inform the doctor of all the symptoms the patient has experienced and any other medical conditions that they suffer from or are receiving treatment for.
In addition to standard tests and physical examination, doctors may also recommend imaging tests like x-rays or CT scans to rule out any facial and skull base injuries.
How does anyone treat Auricular hematoma?
Auricular hematoma can be easily prevented if treatment is provided as soon as the symptoms of auricular hematoma start to surface. The greater the delay in treatment, the more difficult it becomes to manage the problem. This is because if there is no intervention, blood supply to the cartilage can be greatly reduced, increasing the risk of cauliflower ear deformity.
The first step of treatment is to drain the blood that is trapped and to provide treatment in case of any infection. The hematoma is drained via an incision that is made in the ear. Smaller hematomas can be aspirated with a needle in very early stages.
Anti-inflammatory medications are also prescribed to reduce inflammation. A compressive dressing is usually applied to compress the wound. If this is done promptly, there is little to no chance of any deformity developing. Doctors often prescribe antibiotics to minimize the risk of infection as this would greatly complicate the problem.
Depending on the severity of the trauma responsible for the patient’s condition, there may even be a need for stitches to reconnect the tissues. The compressive or pressure dressing that is used will generally need to remain for a few days or a week at least.
Make sure that the patient follows the advice of his doctor and go back for regular check-ups as needed. This is extremely important as the ear will need to be monitored in case of any infection or if a change in treatment is required.
In cases with a worsening superimposed infection, the patient may actually need to be admitted so that intravenous antibiotics can be administered. Exploration and washout under general anesthesia may also be necessary.