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Auricular Hematoma

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Other Names





An auricular hematoma
  • Caused by direct blow or frictional forces to the auricle
  • Hematoma forms between the skin and auricular cartilage
  • Hematoma causes pressure necrosis and scarring of the cartilage causing deformity ("cauliflower ear")

Risk Factors

  • Failure to wear headgear while participating in sports that can cause ear trauma

Differential Diagnosis

  • Auricular Hematoma<
  • Ear Laceration
  • Cellulitis
  • Perichondritis

Clinical Features

  • Hematoma of Auricle on physical exam
  • Tenderness over hematoma
  • Asymmetry compared to opposite auricle


  • Diagnosis made on physical exam and history of trauma to ear; No labs or imaging useful in diagnosis
  • Evaluate for clinical signs of Auricular Hematoma on physical exam
  • Assess patient's hearing and evaluate tympanic membranes as may rupture with trauma to ear
  • Assess for signs and symptoms of concussion


  • N/A


  • Provide local anesthesia with lidocaine without epinephrine
  • Aspirate with 18 to 22 gauge needle
  • Apply compression dressing to avoid reaccumulation of hematoma (keep in place until healed)
  • Consider preventive antibiotics covering gram-positive skin bacteria (Cephalexin x 7 days)
  • Avoid NSAIDs and Aspirin to minimize hematoma recurrence

Return to Play

  • Auricular Hematoma should be fully healed prior to return to play
  • Patient should be referred to ENT for close follow-up
  • Returning prior to being fully healed increases risk of poor outcomes
  • Headgear should always be worn


  • Scarring and cosmetic deformity
  • Chondritis and Perichondritis

See Also


Created by:
John Kiel on 12 June 2019 16:17:35
Last edited:
6 July 2021 22:31:31
Trauma | HEENT | Acute