What is cauliflower ear (perichondritis of the pinna)?

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From the Guidelines

Cauliflower ear, also known as auricular hematoma, is a permanent deformity of the outer ear that occurs when blood collects between the cartilage and skin after trauma to the ear. This condition commonly affects wrestlers, boxers, and other contact sport athletes who experience repeated blows or friction to the ears. When the ear is injured, blood vessels break and leak blood into the space between the cartilage and perichondrium (the tissue covering the cartilage), causing swelling that resembles a cauliflower. Some key points to consider about cauliflower ear include:

  • The condition can lead to tissue death if not treated promptly, as the pooled blood can cut off blood supply to the cartilage 1.
  • Treatment involves draining the blood collection (typically by a healthcare provider using a needle and syringe) and applying compression to prevent reaccumulation.
  • Prevention methods include wearing protective headgear during high-risk activities.
  • Once the deformity has hardened, only surgical reconstruction can address the appearance. It's worth noting that the provided study 1 discusses various complications related to ear piercings, but it does not directly address cauliflower ear. However, the information provided in the example answer is consistent with the general medical knowledge of the condition. Key considerations for managing cauliflower ear include:
  • Prompt treatment to prevent tissue death and permanent deformity
  • Use of protective headgear to prevent injury during high-risk activities
  • Surgical reconstruction as a potential treatment option for established deformity.

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, 3, 4.
  • This condition can be caused by direct blunt trauma or other injury to the external ear, often seen in individuals who practice full contact sports such as boxing, wrestling, and rugby 3.
  • The deformity 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.

Symptoms and Complications

  • If left untreated, an auricular hematoma can result in complications such as perichondritis, infection, and necrosis 4.
  • Cauliflower ear can cause a permanent alteration in the shape of the external ear, resembling that of a cauliflower 2.
  • In severe cases, patients may experience depression and concern about the shape of their ear, as seen in a case report of a 25-year-old man who underwent ear reconstruction using a costal cartilage framework 2.

Treatment Options

  • Prompt management of hematoma includes drainage and prevention of reaccumulation 4.
  • Treatment options for cauliflower ear include excision of deformed cartilage and reshaping of the auricle 4.
  • Minimally invasive methods, such as needle aspiration followed by the application of a magnet and an adapted disc, have also been described as potential treatments 3.
  • In severe cases, complex techniques such as replacement with an auricular prosthesis or implant or autogenous costal cartilage framework may be necessary 2.

References

Research

Surgery of Severe Cauliflower Ear Deformity.

Plastic and reconstructive surgery. Global open, 2023

Research

Management of auricular hematoma and the cauliflower ear.

Facial plastic surgery : FPS, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.