[20] Auricular Haematoma Flashcards
What is an auricular haematoma?
A complication resulting from direct trauma to the anterior auricle
What arteries form the blood supply to the auricle?
- Posterior auricular artery
- Anterior auricular branch of the superficial temporal artery
- Occipital artery
What happens in auricular haematoma?
There is tearing of the perichondral blood vessels in the auricle
What cause tearing of the perichondral blood vessels in the auricle?
Shearing forces on the auricle leading to separation of the anterior auricular perichondrium from the underlying, tightly adherent cartilage
What can happen as a result of perichondral blood vessels tearing and haematoma formation?
Compromise of the avascular underlying cartilage
What can result if an auricular haematoma is left untreated or is treated inadequately?
Cauliflower ear
What are the most common causes of auricular haematoma?
- Sports injuries
- Earring placement
- RTA
What sports commonly cause auricular haematoma?
- Rugby
- Wrestling
- Boxing
What is often present in the history of a patient with auricular haematoma?
Trauma
What are some typical symptoms of auricular haematoma?
- Pain
- Paraesthesia
- Ecchymosis
What symptoms make a diagnosis of auricular haematoma less likely?
- Erythema
- Warmth
- External auditory canal swelling
- Hearing loss
What examination findings are typical of auricular haematoma?
- Contour irregularity
- Swelling and fluctuant area overlying the ear’s cartilaginous portion
What investigations may be useful in auricular haematoma?
- USS
- CT or MRI
Does auricular haematoma require investigations?
Not usually
Why may USS be useful in auricular haematoma?
To evaluate the swelling and rule out auricular abscess
When might a CT or MRI be used in auricular haematoma?
If significant trauma has occurred and there is concern for a foreign body or abscess and middle or inner ear need assessing
What are the differentials for auricular haematoma?
- Perichondritis
- Auricular abscess
- Cellulitis
- Temporomandibular disorder
- Laceration
- Normal anatomical variance
- Skin cancer
When is drainage of auricular haematoma appropriate?
If it occurred within 7 days
How can an auricular haematoma be drained?
- Incision and drainage
- Needle aspiration
What sort of dressing should be applied after drainage of auricular haematoma?
Compression dressing
What are the complications of auricular haematoma drainage?
- Reaccumulation
- Site infection
- Chondritis
- Scar formation
What may complicate drainage of auricular haematoma after 7 days?
Formation of granulation tissue
What must patients be informed about when refusing treatment for auricular haematoma?
Risk of permanent cosmetic outcomes
What is the main complication of auricular haematoma?
Cauliflower ear
What is the typical appearance of cauliflower ear?
Mis-folded ear with several soft tissue humps abnormally located in the ear
