Cauliflower ear is an irreversible condition that occurs when the external portion of the ear is hit and develops a blood clot or other collection of fluid under the perichondrium. This separates the cartilage from the overlying perichondrium that supplies its nutrients, causing it to die and resulting in the formation of fibrous tissue in the overlying skin. As a result, the outer ear becomes permanently swollen and deformed, resembling a cauliflower, hence the name.

The condition is common in wrestling, boxing, and kickboxing, in martial arts such as Brazilian jiu-jitsu, judo, sumo, and mixed martial arts, and in full-contact sports such as rugby union and rugby league.

Presentation

People presenting with possible auricular hematoma often have additional injuries (for example, head/neck lacerations) due to the frequently traumatic causes of auricular hematoma. The ear itself is often tense, fluctuant, and tender with throbbing pain. However, because of potentially more remarkable injuries often associated with auricular hematoma, it can easily be overlooked without directed attention.

Diagnosis

Perichondral hematoma and consequently cauliflower ear are diagnosed clinically. This means that the medical provider will make the diagnosis by using elements of the history of the injury (examples: participation in contact sports, trauma to the ear, previous similar episodes) and combine this with findings on physical exam (examples: tenderness to the area, bruising, deformation of the ear contours) to confirm the diagnosis and decide on the appropriate treatment for the patient.

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|+Classification of cauliflower ear Joints, eyes, audiovestibular system, cardiovascular system, and respiratory tract can also be involved. The outer ear skin is tightly adherent to the perichondrium because there is almost no subcutaneous fat on the anterior of the ear.

Treatment

thumb|A mild auricular hematoma after drainage

There are many types of treatment for the perichondral hematoma that can lead to cauliflower ear, but the current body of research is unable to identify a single best treatment or protocol. There is definitive evidence that the drainage of this hematoma is better for the prevention of cauliflower deformity when compared to conservative treatment, but the use of bandages and/or splinting after drainage requires more research. There are many described techniques for the drainage of blood in the acute stage to prevent hematoma, including aspiration and drainage, incision and drainage, use of continuous suction devices and placing a wick. can also be used to ensure adequate pressure is applied to the damaged area Without medical intervention the ear can sustain serious damage. Disruption of the ear canal is possible. The outer ear may wrinkle and can become slightly pale due to reduced blood flow; hence the common term "cauliflower ear". Cosmetic procedures are available that can possibly improve the appearance of the ear.

History

thumb|Depiction of cauliflower ear in the [[Boxer at Rest|Boxer of Quirinal, circa 100–50 BC]]

The presentation of cauliflower ear was recorded in ancient Greece.

In 19th-century Hong Kong opium dens, opium users would develop cauliflower ear from long periods sleeping on hard wooden pillows.

References

  • Cauliflower ear, Cleveland Clinic
  • Cauliflower ear, medical illustration, eMedicineHealth
  • Medicinenet.com