From the Guidelines
Cauliflower ear should be treated promptly with drainage of the hematoma followed by compression to prevent permanent deformity. The treatment of cauliflower ear is crucial to prevent long-term morbidity and mortality, and to improve the quality of life for patients. When treating cauliflower ear, it is essential to prioritize prompt drainage of the hematoma, followed by compression to prevent reaccumulation of fluid and allow the cartilage to reattach to the perichondrium 1. Some key points to consider when treating cauliflower ear include:
- Seeking medical attention within 24-48 hours if swelling or fluid collection is noticed in the ear after trauma
- Using a sterile needle to aspirate the blood collection, then applying a compression dressing using dental rolls, cotton bolsters, or specialized ear dressings secured with sutures or clips to maintain pressure for 3-7 days
- Managing discomfort with over-the-counter pain medications like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours)
- Preventing infection with antibiotics such as cephalexin (500mg four times daily for 5-7 days) if necessary
- Considering surgical correction for established cauliflower ear (after 7-10 days) It is also important to note that prevention is crucial for those participating in wrestling, boxing, or other contact sports, and properly fitted headgear should always be worn during these activities. In the context of real-life clinical medicine, it is essential to prioritize the treatment of cauliflower ear to prevent long-term complications and improve patient outcomes.
From the Research
Treatment Options for Cauliflower Ear
- Fine needle aspiration with pressure bandages is a common treatment for cauliflower ear, but it may not always be effective 2
- Open incision, drainage, and debridement may be necessary for recurrent or recalcitrant auricular hematomas 2
- Surgical reconstruction using costal cartilage framework can be used to treat severe cauliflower ear deformities 3
- Evacuation of the hematoma via needle aspiration or incision and drainage, followed by bolster compression dressing, can help prevent reaccumulation of blood and promote healing 4, 5
- Antibiotics may be recommended to mitigate the risk of perichondritis, with coverage for Pseudomonas aeruginosa 4
- Excision of deformed cartilage and reshaping of the auricle may be necessary for management of cauliflower ear 6
Management of Auricular Hematoma
- Prompt management of auricular hematoma is crucial to prevent complications such as perichondritis, infection, and necrosis 4, 6
- Analgesia using an auricular block should be performed prior to evacuation of the hematoma 4
- Patients should be reevaluated at 24-48 hours and abstain from contact sports for at least 2 weeks 4
- A refined technique for aspiration and drainage of auricular hematoma using an 18-gauge catheter and compression dressing has been described as a simple and cost-effective alternative to current methods 5