Auricular Hematoma and Cauliflower Deformation of the Ear

Abstract

Auricular hematoma and cauliflower deformation of the ear are unique in several respects. Knowledge about it began, in antiquity, through artists, particularly Greek and Roman, and then Japanese in the 18th century with their representation of cauliflower deformation of the ear on sculptures and paintings of pugilists and wrestlers. It is only in the 19th century that physicians began to make substantive progress in understanding this abnormality. It was first thought to be associated with mental disease, but by the beginning of the 20th century, its etiology was recognized as being caused by trauma and was then named auricular hematoma. The second step in the understanding of this affliction was the observation that auricular hematoma progresses toward cauliflower deformation of the ear, which was named cauliflower ear. Recognition of this evolution led to the development of therapies. During the second half of the 20th century, different treatments were developed. They included various hematoma drainage techniques with special bandages to prevent hematoma recurrence and ensuing progression to cauliflower ear. In summary, cauliflower deformation of the ear is an old artistic affliction that has only recently received medical attention.

Oxygen Mask Related Nasal Integument and Osteocartilagenous Disorders in F-16 Fighter Pilots

“…[9] The resulting pathophysiology of excessive fibrocartilage formation is similar to that of a cauliflower ear arising from a subperichondrial hematoma after stretching of, or direct trauma to, cartilagenous structures. [10] Finally, the pathophysiology of new bone formation induced by pressure has previously been illustrated in animal studies. Cyclic fatigue loading was shown to cause microdamage of bones with subsequent new bone formation.…”

Pathology of ear hematomas in swine

“…1,6,11 A subperichondral location appears to be the rule for hematoma auris in humans but this issue has been challenged and has not been resolved. 9 Examination of the acute cases in our study indicates that the formation of the hematoma in pigs takes place in both subperichondral and intrachondral locations. Considering these 2 locations, it is likely that the hemorrhages resulted from torn vascular branches at the points where they enter, pass through, or emerge from the foramina of the cartilage rather than from the larger blood vessels from which they derive and that run over the convex surface of the ear.…”

Clinical Implications of Intralesional Steroid Injections in the Management of Otohematoma

“…The subperichondrial hematoma then acts as a mechanical barrier between the cartilage and its perichondrial blood supply, stimulating fibrosis, granulation, and neocartilage formation. [2][3][4] If it is not managed promptly, otohematoma can result in complications such as perichondritis, perichondrium thickening, and "cauliflower ear." 5 At present, although evidence to identify the most effective treatment for otohematoma is limited, incision and drainage methods in combination with the application of compression, especially when the otohematoma is large in diameter (>2 cm), are recommended due to their satisfactory results.…”