396:
153:
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32:
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276:, and the cartilage. The outer ear skin is tightly adherent to the perichondrium because there is almost no subcutaneous fat on the anterior of the ear. This leaves the perichondrium relatively exposed to damage from direct trauma and shear forces, created by a force pushing across the ear like a punch, and increasing the risk of hematoma formation. In an auricular
307:. Importantly, an auricular hematoma can also occur on the posterior ear surface, or even both surfaces. Risk of necrotic tissue is greatest when both posterior and anterior surfaces are involved, although posterior surface involvement is less likely given its increased quantity of impact-dampening subcutaneous tissue.
288:. The hematoma mechanically obstructs blood flow from the perichondrium to the avascular cartilage. This lack of perfusion puts the cartilage at risk for becoming necrotic and/or infected. If left untreated, disorganized fibrosis and cartilage formation will occur around the aforementioned cartilaginous components.
368:
can lead to cauliflower ear, prompt evacuation of the blood can prevent permanent deformity. 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
291:
Consequently, the concave pinna fills with disorganized connective tissue. The cartilage then deforms and kinks, resulting in the distinctive appearance somewhat resembling a cauliflower. Rapid evacuation of the hematoma restores close contact between the cartilage and perichondrium, thereby reducing
382:
are usually prescribed. Pressure can be applied by bandaging which helps the skin and the cartilage to reconnect. Clothes pegs, magnets, and custom molded ear splints can also be used to ensure adequate pressure is applied to the damaged area
Without medical intervention the ear can sustain serious
377:
sutures. The use of simple drainage becomes less useful after six hours from the injury and when there is recurrent trauma. In these cases it has been suggested that open surgical treatment is more effective in returning the cosmetic appearance and prevention of recurrence. The outer ear is prone to
148:
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
360:
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
136:
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
369:
wick. After the blood has been drained, the prevention of re-accumulation becomes the most pressing issue. This has been achieved with many techniques including: direct pressure dressings, in and out mattress sutures, buttons placed on sutures,
76:
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
160:
To assist with settling on the best form of treatment for cauliflower ear, Yotsuyanagi et al. created a classification system for deciding when surgery is needed and as a guide as to what the best approach would be.
263:
disorder in which recurrent episodes of inflammation result in destruction of cartilage of the ears and nose. Joints, eyes, audiovestibular system, cardiovascular system, and respiratory tract can also be involved.
343:
can also be made to keep the ear compressed, so that the damaged ear is unable to fill thus preventing cauliflower ear. For some athletes, however, a cauliflower ear is considered a badge of courage or experience.
252:. The skin that covers this cartilage is extremely thin with virtually no subcutaneous fat while also strongly attached to the perichondrium, which is richly vascularized to supply the avascular cartilage.
395:
1080:
576:
Yotsuyanagi, Takatoshi; Yamashita, Ken; Urushidate, Satoshi; Yokoi, Katsunori; Sawada, Yukimasa; Miyazaki, Souichiro (July 2002). "Surgical correction of cauliflower ear".
383:
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".
149:
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.
1459:
666:
303:(scapha) and extends anteriorly into the fossa triangularis. Less frequently, the hematoma may form in the concha or the area in and around the external auditory
236:
is a typical source of such trauma. The structure of the ear is supported by a cartilaginous scaffold consisting of the following distinct components: the helix,
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to the ear leading to a hematoma which, if left untreated, eventually heals to give the distinct appearance of cauliflower ear. Participating in
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deformity when compared to conservative treatment, but the use of bandages and/or splinting after drainage requires more research.
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Cauliflower ear can also present in the setting of nontraumatic inflammatory injury of auricular connective tissue such as in
932:
339:
or ear guard in wrestling and other martial arts, that protects the ears is worn to help prevent this condition. A specialty
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Brickman, Kris; Adams, Daniel Z.; Akpunonu, Peter; Adams, Samuel S.; Zohn, Stephen F.; Guinness, Michael (July 2013).
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418:, opium users would develop cauliflower ear from long periods sleeping on hard wooden pillows.
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Auricular hematoma most often occurs in the potential space between the helix and the
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780:"Acute management of auricular hematoma: a novel approach and retrospective review"
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hematoma, auricular hematoma can easily be overlooked without directed attention.
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The components of the ear involved in cauliflower ear are the outer skin, the
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Type 1: Minimal deformity with no or slight changes to the outline of the ear
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522:(2010-11-17). "Management of Auricular Hematoma and the Cauliflower Ear".
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are available that can possibly improve the appearance of the ear.
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Deformity that extends from the antihelix to the helix of the ear
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Vogelin, E; Grobbelaar, AO; Chana, JS; Gault, DT (1998).
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Type 2: Substantial deformity of the outline of the ear
16:
Permanent deformity caused by physical trauma to the ear
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that would otherwise result from a remaining hematoma.
825:
Keating, Thomas M.; Mason, John (October 27, 1992).
460:
Ingvaldsen, Christoffer A.; Tønseth, Kim A. (2017).
407:
The presentation of cauliflower ear was recorded in
896:
Nationwide
Children's Hospital: Sports Med Articles
690:Jones, Stephen EM; Mahendran, Suresh (2004-04-19).
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924:The Safe and Sane Guide to Teenage Plastic Surgery
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60:is an irreversible condition that occurs when the
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181:Deformity is restricted to the concha of the ear
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209:Deformity that extends throughout the outer ear
1460:Skin conditions resulting from physical factors
428:
689:
292:the likelihood of deformity by minimizing the
187:The structural integrity of the ear is intact
1074:
692:"Interventions for acute auricular haematoma"
997:"Surgical correction of the cauliflower ear"
824:
746:
224:The most common cause of cauliflower ear is
622:Rapini (2006). "Relapsing polychondritis".
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1067:
980:: CS1 maint: location missing publisher (
867:"Cauliflower ear – How to avoid and treat"
132:People presenting with possible auricular
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477:
659:"For Wrestlers a Swelled Sense of Pride"
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394:
356:A mild auricular hematoma after drainage
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314:
151:
1450:Diseases of the ear and mastoid process
1048:, medical illustration, eMedicineHealth
696:Cochrane Database of Systematic Reviews
466:Tidsskrift for den Norske Laegeforening
373:, sutured cotton balls, and absorbable
68:or other collection of fluid under the
1442:
920:
759:from the original on September 6, 2011
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1062:
947:
518:Greywoode, Jewel; Pribitkin, Edmund;
201:Poor structural integrity of the ear
116:, and in full-contact sports such as
927:. BenBella Books, Inc. p. 103.
921:Lukash, Frederick (21 August 2013).
827:"A Simple Splint for Wrestler's Ear"
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399:Depiction of cauliflower ear in the
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1001:British Journal of Plastic Surgery
902:from the original on 6 August 2012
784:Clinical Journal of Sport Medicine
636:10.1016/j.clindermatol.2006.07.018
578:British Journal of Plastic Surgery
165:Classification of cauliflower ear
14:
1496:
1234:Slipped capital femoral epiphysis
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156:Cauliflower ear in an MMA fighter
657:Williams, Preston (2008-03-06).
280:, blood accumulates between the
30:
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873:from the original on 2019-01-30
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669:from the original on 2012-11-10
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708:10.1002/14651858.cd004166.pub2
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310:
1:
749:"Auricular Hematoma Drainage"
747:Inna Leybell (May 10, 2018).
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323:player wearing a tiger-print
1300:Patellofemoral pain syndrome
831:Journal of Athletic Training
796:10.1097/JSM.0b013e31825c4623
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140:
7:
84:The condition is common in
62:external portion of the ear
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414:In 19th-century Hong Kong
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892:"Cauliflower Ear Article"
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1480:Rugby league terminology
948:Smith, R. R. R. (1991).
257:relapsing polychondritis
1485:Rugby union terminology
1275:Chondromalacia patellae
479:10.4045/tidsskr.15.1279
1252:Angular limb deformity
1014:10.1054/bjps.1997.0033
590:10.1054/bjps.2002.3854
536:10.1055/s-0030-1267719
524:Facial Plastic Surgery
404:
357:
335:" in rugby, or simply
328:
157:
64:is hit and develops a
1173:Boutonniere deformity
952:Hellenistic Sculpture
462:"Auricular haematoma"
398:
371:thermoplastic splints
355:
318:
155:
146:Perichondral hematoma
72:. This separates the
1470:Martial arts culture
1409:Abnormal angulation
1333:Bunion/hallux valgus
1127:Subacromial bursitis
1229:Protrusio acetabuli
1183:Swan neck deformity
1117:Adhesive capsulitis
956:. London. pp.
663:The Washington Post
385:Cosmetic procedures
331:Headgear called a "
166:
90:Brazilian jiu-jitsu
50:Otorhinolaryngology
1405:Ligamentous laxity
1257:Unequal leg length
1042:, Cleveland Clinic
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114:mixed martial arts
81:, hence the name.
1475:Wrestling culture
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1122:Rotator cuff tear
934:978-1-935618-63-8
403:, circa 100–50 BC
401:Boxer of Quirinal
364:Because an acute
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19:Medical condition
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1285:Luxating patella
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702:(2): CD004166.
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665:. p. 14.
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1290:Patella alta
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1379:Torticollis
1093:deformities
906:23 December
763:October 26,
380:antibiotics
321:rugby union
311:Preventions
122:rugby union
79:cauliflower
1444:Categories
1348:Hammer toe
1219:Coxa valga
1202:Lower limb
1188:Wrist drop
1100:Upper limb
877:2019-01-29
673:2008-04-02
422:References
416:opium dens
341:ear splint
337:"headgear"
250:antitragus
102:kickboxing
66:blood clot
1328:Foot drop
1323:Flat feet
1318:Club foot
1224:Coxa vara
1089:Acquired
976:cite book
804:1536-3724
716:1465-1858
598:0007-1226
560:260133952
544:0736-6825
348:Treatment
333:scrum cap
325:scrum cap
301:antihelix
286:cartilage
268:Mechanism
238:antihelix
141:Diagnosis
94:wrestling
74:cartilage
45:Specialty
1109:shoulder
900:Archived
871:Archived
853:16558175
812:22695406
757:Archived
753:Medscape
734:15106240
667:Archived
644:17113965
606:12372365
552:21086231
488:28127072
375:mattress
366:hematoma
294:ischemia
278:hematoma
206:Type 1C
198:Type 2B
192:Type 1B
184:Type 2A
178:Type 1A
134:hematoma
88:such as
1023:9771361
844:1317260
725:8078643
391:History
1021:
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305:meatus
248:, and
246:tragus
242:concha
220:Causes
98:boxing
1142:elbow
958:54–55
556:S2CID
112:, or
1366:neck
1364:and
1362:Head
1310:foot
1267:knee
1165:hand
1019:PMID
982:link
962:ISBN
929:ISBN
908:2011
849:PMID
808:PMID
800:ISSN
765:2011
730:PMID
712:ISSN
700:2004
640:PMID
602:PMID
594:ISSN
548:PMID
540:ISSN
484:PMID
284:and
232:and
110:sumo
106:judo
1455:Ear
1244:leg
1211:hip
1009:doi
839:PMC
792:doi
720:PMC
704:doi
632:doi
586:doi
532:doi
474:doi
470:137
120:or
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