Cauliflower ear is the result of auricular hematoma when blood gets into the outer part of the ear (auricle) following blunt trauma. This is most commonly seen in sports where there is shearing force on the ear which causes an injury and bleeding; most commonly in wrestling and rugby, but it can happen in any sport where collisions occur without protective head gear.
If not promptly treated, the auricular hematoma can lead to a chronic accumulation of tissue which is known as cauliflower ear. Cauliflower ear is the permanent deformity caused by fibrocartilage overgrowth which occurs when an auricular hematoma is not fully drained, recurs, or is left untreated.
How can cauliflower ear be prevented?
Prompt treatment is the key to preventing cauliflower ear. Having an experienced health care provider drain the hematoma within 48-72 hours is important to prevent fibrous tissue from developing. The hematoma is recognizable because it will be painful, swollen, tense and, at times, red after a match or game. Cauliflower ear will be more firm, swollen and chronic in appearance.
How is cauliflower ear treated?
The area around the ear is sterilized and then a numbing medicine is used to do a regional block where lidocaine is used to numb the ear. The lidocaine is injected around the base of the ear in order to numb the whole ear. Once numb, and depending on the size of the hematoma, the outer part of the ear is either drained by using a needle and aspirating the blood or by making an incision and draining the blood. A pressure dressing is applied after the drainage in order to prevent re-accumulation of blood.
Young athletes can return to play after the ear has healed and all sutures or pressure dressings have been removed – anywhere form seven days to three weeks. All athletes are encouraged to wear head gear that protects the ears in order to prevent a repeat injury.
For more information on Nationwide Children’s Hospital’s Sports Medicine services, click here.
Dr. Reno Ravindran is a board-certified family medicine physician and recently completed his sports medicine fellowship at Nationwide Children’s Hospital. He completed his residency at The Ohio State University.
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