Cauliflower Ear

Have you ever wondered why wrestlers and boxers wear a headgear?

Headgears ensure protection to their ears. Blunt trauma to ears can give rise to a clinical condition known as ‘Cauliflower Ear’

What is Cauliflower ear and its cause?

Auricular hematoma also known as ‘cauliflower ear’occurs subsequent to any physical trauma to the auricle or the external ear. As a result of the direct injury, there is hematoma formation or accumulation of blood between the perichondrium (tissue surrounding bone or cartilage) and the cartilage. Clinically there is prominent redness and swelling which if left untreated, leads to the formation of a fibrocartilagenous mass with a characteristic appearance known as ‘Cauliflower Ear’. This disfigurement of the ear can be irreversible if not attended or managed immediately. 

What are the causes and complication of the cauliflower ear? 

Cauliflower ear is a consequence of a closed blunt trauma or any direct hit to the auricle leading to the hematoma formation. Although it is frequently witnessed in sports persons, one can suffer from it, following any injury or infection to the ear.  Due to the  accumulated blood (hematoma), the nutrient and the blood flow to the healthy surrounding tissue gets compromised, if not cured, gets the skin separated from the cartilage which disfigure into a shrived up structure or mass or deformity referred as cauliflower ear. 

Ultimately, there is necrosis or death of the cartilage, which further increases the susceptibility to infection.Some studies have also reported that subperichondrial hematoma can stimulate the formation of new asymmetrical cartilages. 

What are the symptoms of cauliflower ear? 

The symptoms largely depend on the extent or the severity of the injury. Most common findings are pain, bruising, swelling, and a deformity in the curvature of the ear.  Severe cases may present with findings such as facial swelling, uncomplicated rupture of the ear drum, loss of hearing and facial palsy or paralysis of the facial muscles. 

How is cauliflower ear treated? 

Although this deformity is permanent or irreversible in nature, immediate management can prevent the injury advancing into the cauliflower ear. The goal of treatment is to ease the blockage so that blood can again flow normally into the injured tissues. The treatment strategy is to reduce the inflammation, drain blood from hematoma, minimize infection and re-establish the lost connection between the skin and the cartilage.

What to do for an immediate Management? 

Quickly following any ear injury, applying ice to the affected area reduces the chances of swelling. Seeking medical management at earliest reduces the chance of deformity or the cauliflower ear. 

Medical Management

Medical management is accompanied by both surgical and pharmacological approach. The hematoma drainage is performed by making a small incision into the mass. Stiches are applied to reconnect the tissue with the cartilage and a pressure dressing is applied. The site is monitored to eliminate chances of infection and any further complication.  Antibiotics are prescribed to rule out chances of infection and facilitate healing.

How to avoid or protect oneself from cauliflower ear? 

For wrestlers and sportsperson wearing protective headgear and helmets are imperative to avoid this clinical condition. For common people wearing a helmet can keep them protected from any direct injury which can attribute to auricular damage or head injury.  

In case one witnesses any minor or major injury to the ears, visiting the specialist at the earliest for definite care can avoid such clinical scenario.