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Auricular Hematoma
From WikiSM
Contents
Other Names
Background
History
Epidemiology
Pathophysiology
- 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
Evaluation
- 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
Classification
- N/A
Management
- 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
Complications
- Scarring and cosmetic deformity
- Chondritis and Perichondritis