Auricular hematoma

Background

• Leads to "cauliflower ear"
• Separation of perichondrium from underlying cartilage tears the adjoining blood vessels
  • Subperichondrial blood collection -> increased cartilage growth -> cauliflower ear

Clinical Features

Auricular hematoma

Differential Diagnosis

Ear Diagnoses

External

• Auricular hematoma
• Auricular perichondritis
• Cholesteatoma
• Contact dermatitis
• Ear foreign body
• Herpes zoster oticus (Ramsay Hunt syndrome)
• Malignant otitis externa
• Otitis externa
• Otomycosis
• Tympanic membrane rupture
  • Otic barotrauma

Internal

• Acute otitis media
  • Bullous myringitis
• Chronic otitis media
• Mastoiditis

Inner/vestibular

• Labyrinthitis, vestibular neuritis
• Meniere's disease
• Sudden sensorineural hearing loss

Maxillofacial Trauma

• Ears
  • Auricular hematoma
• Nose
  • Nasal fracture
  • Nasal septal hematoma
• Oral
  • Dental trauma
  • Lip laceration
  • Tongue laceration
• Other face
  • Le Fort fractures
  • Mandible fracture
• Zygomatic arch fracture
• Zygomaticomaxillary (tripod) fracture
• Related
  • Head trauma (main)
    • Skull fracture
    • Skull fracture (peds)
    • Basilar skull fracture
  • Orbital trauma
    • Eyelid laceration
  • Scalp laceration

Diagnosis

• Clinical diagnosis

Treatment

1. Evacuate the clot
   • Make semi-circle incision inside the inner curvature of the helix or antihelix
   • Remove hematoma by gentle suction or curettage
2. Prevent re-bleeding
   • Pack the helix w/ petroleum jelly-impregnated gauze
   • Place regular gauze both in front of and behind the ear
   • Circle the head with a compressive wrap
3. Antibiotics
   • Only indicated for immunocompromised patients
   • Cover pseudomonas and S. aureus

Disposition

• Discharge

See Also

• Maxillofacial Trauma