From the Guidelines
Cauliflower ear, also known as auricular hematoma or perichondritis, is a serious condition that requires prompt treatment within 48-72 hours of injury to prevent permanent deformity and should be managed with needle aspiration or incision and drainage, followed by compression to prevent reaccumulation of fluid. The condition typically occurs after blunt force injuries, common in contact sports such as wrestling, boxing, rugby, and martial arts, where the ear is struck, causing blood to collect between the cartilage and skin, separating them and cutting off blood supply to the cartilage 1. Some key points to consider in the management of cauliflower ear include:
- Prompt treatment is essential to prevent permanent deformity and should be done within 48-72 hours of injury
- Treatment involves draining the hematoma through needle aspiration or incision, followed by compression to prevent reaccumulation of fluid
- A healthcare provider will typically clean the area, use local anesthesia, drain the blood with a sterile needle or small incision, and then apply a compression dressing that must remain in place for 3-7 days
- Prevention includes wearing proper protective headgear during high-risk activities
- Once the deformity has developed, only surgical reconstruction can address the appearance, though this is often challenging and may not fully restore the ear's original shape
- It is also important to note that auricular perichondritis and perichondrial abscess can occur as a complication of ear piercing, and can be managed with fluoroquinolone antibiotic treatment, such as ciprofloxacin or levofloxacin, and in some cases, surgical incision and drainage may be necessary 1.
From the Research
Definition and Causes of Cauliflower Ear
- Cauliflower ear is an auricular deformity characterized by thickened soft tissue and cartilage, resulting from a subperichondrial hematoma or fluid collection 2.
- The condition occurs when the ear cartilage becomes ischemic due to being cut off from the perichondrium blood supply, leading to the development of scar tissue, fibrous tissue, new cartilage overgrowth, or necrosis beneath the skin 2.
- Acute auricular hematoma is a common cause of cauliflower ear, often resulting from blunt trauma to the side of the head 3.
Management and Treatment of Cauliflower Ear
- Prompt management of hematoma includes drainage and prevention of reaccumulation to prevent complications such as perichondritis, infection, and necrosis 3.
- Management of cauliflower ear involves excision of deformed cartilage and reshaping of the auricle 3.
- Simple and complex techniques have been developed to treat cauliflower ears, including replacement with an auricular prosthesis or implant or autogenous costal cartilage framework 2.
Perception of Cauliflower Ear
- Cauliflower ear is typically viewed as a deformity, but it has been observed that combat sport athletes view it as a respected aesthetic trait 4.
- A study found that combat sport athletes rated subjects with cauliflower ear more favorably than the general population in terms of perceived success, attractiveness, approachability, and affect display 4.
- The term "cauliflower ear" is of relatively recent origin, coined in the first decade of the 20th century, and has been adopted by both the popular press and the medical profession 5.