Synonyms
Ring ear, box ear, cauliflower ear, blood ear (in animals, especially domestic dogs) auricular hematoma, othematoma
Definition
The medical term “haematoma” simply means bruise. The prefix “Ot-” indicates that it’s around the ear. An othatom or seroma is therefore an accumulation of blood or serous fluid between the cartilage of the auricle and the cartilage skin (bruise on the ear). This may also be of interest to you: How to treat a bruise?
Causes
The cause of an othaematoma (bruise on the ear) is considered to be shearing force and sharp bending of the auricle. This also includes blunt blows to the ear, which are possible in some contact sports, such as wrestling, boxing, judo, rugby, wrestling, MMA, water polo or even with bag carriers. The bursting of blood vessels can cause a bruise.
If the injury remains closed, blood or serous fluid can accumulate between the cartilage and the cartilage skin. The resorption tendency of this accumulation of fluid is poor. A swelling develops that remains for some time.
The haematoma, in turn, can lead to an interruption of the cartilage‘s nutrition by the cartilage skin. This can cause the cartilage to die off. It is typical of the elastic cartilage of the auricle that it cannot regenerate. This means that if an othaematoma is repeatedly caused by blows or violent impact, the bruise is remodeled into connective tissue and a permanent disfigurement of the auricle is the result. Colloquially one speaks then of a “boxer’s or cauliflower ear”.
Symptoms
Even though the trauma is typically painful, the othaematoma is usually painless (bruising on the ear) and only presents as a reddish swelling. This may be accompanied by a hearing deterioration due to massive swelling.
Diagnosis
The diagnosis is made on the clinical picture (bruise on the ear). It impresses with an enormous swelling at the front of the auricle, which is well palpable as a protrusion and in severe cases also visible. In this case, the natural folding in the area of the auricle is no longer visible.
During a medical examination, various concomitant injuries must be excluded. For this purpose, the doctor additionally performs a hearing test with the help of a tuning fork or determines the frequency range still perceptible by the patient by recording an audiogram. If an additional petrous bone fracture is suspected, a computer tomogram is also recorded, which can identify possible damage to the petrous bone, as well as the temporal bone, the auditory canal, the middle ear or the temporomandibular joint.
The treatment of the othaematoma (bruise on the ear) is in most cases conservative. Small swellings are treated with a pressure bandage or punctured. A sterile puncture needle is inserted into the bruise at the highest point of the bulge and the blood or fluid is drained.
A pressure bandage is then applied. In severe cases an operation is necessary. By surgically cutting out a small window (cartilage windowing), the congested blood of the effusion can drain off.
This restores the supply of nutrients to the cartilage. A modelling bandage (e.g. made of oil wadding) is then applied here too. In the case of recurring othaematomas, which can also occur after surgical treatment, it is possible to remove a piece of cartilage from the back of the auricle.
The wound is closed with a suture and can prevent the cartilage skin from reattaching and thus a renewed accumulation of fluid. Prophylactic antibiotics are often recommended during therapy to prevent a complication of this disease: cartilage skin inflammation (perichondritis). This is because the subsequent immigration of germs and bacteria (e.g. Staphylococcus aureus) into the wound or puncture site can cause severe inflammation. For this reason, the treating physician should always ensure a sterile working environment in order not to provoke an infection. Due to the poor absorption in this area, this can lead to permanent changes in the shape of the cartilage and the image of the “cauliflower ear” (bruise on the ear), which can no longer be reproduced, can develop.
