Auricular Hematoma Research Articles

Current concepts in the surgical management of traumatic auricular hematoma.

There has been considerable confusion in the literature regarding the proper treatment of auricular hematoma. This has stemmed from an inadequate understanding of the mechanisms involved in the formation and propagation of this condition. This article reviews the literature and give suggestions as to the proper surgical management of this problem.

Wrestler's ear: pathophysiology and treatment.

Management of auricular hematomas has always been a challenge for physicians. This injury is very common among wrestlers since early olympic competition times. Initial treatment usually involves simple aspiration and a compression bandage. Most of these hematomas recur; then it must be decided how to manage this recurrent problem and the eventual "cauliflower ear." A treatment is proposed that directs attention to the pathophysiology of the injury and involves total excision of the newly formed fibroneocartilaginous layer. Unless this layer is successfully removed the hematoma will persist and a thickened ear will result. This treatment can be performed on an outpatient basis under local anesthesia and allows immediate resumption of wrestling competition.

A semirigid stent for use after auricular cartilage graft harvest

Use of auricular cartilage as an interpositional graft after temporomandibular joint (TMJ) discectomy has gained attention in recent years.lM7 However, formation of a hematoma after procurement of an auricular cartilage graft has been associated with several deleterious effects, most notably cauliflower deformity of the pinna.6 Because the cartilaginous auricular dome acts as a framework for the overlying soft tissues, stenting is generally performed postoperatively to prevent hematoma formation. Stenting after auricular cartilage procurement is commonly performed by sandwiching the soft tissues of the pinna between several cotton bolsters.’ While pressure is effectively applied in this manner, precise support for soft-tissue anatomy is not provided. Converse has used dental compound material and molded it for use as a pressure dressing in the treatment of auricular hematoma.* However, a search of the literature did not disclose any previous report of the use of elastic impression material in the fabrication of auricular stents. We have developed a technique for auricular stenting that involves the fabrication of a semirigid splint from common dental impression materials and a cotton roll. The technique has the advantages of ease of fabrication, with ready availability of materials, and good patient acceptance. In addition, because the stent duplicates the preoperative appearance and form of the helix, it functions as a mold for the healing soft tissues. Preoperative appearance is thus precisely duplicated.

Treating Auricular Hematoma

In brief When an athlete sustains an auricular hematoma, the traditional collodion-cotton cast can be reinforced with a swimmer's nose clip to exert continuous pressure. This treatment prevents hematoma reaccumulation, and when the athlete also wears protective headgear, there is no disruption in the athlete's practice or competition schedule.

How i do it: Otology and neurotology: A specific issue and its solution: Absorbable mattress sutures in the management of auricular hematoma

The LaryngoscopeVolume 101, Issue 10 p. 1124-1126 Article How i do it: Otology and neurotology: A specific issue and its solution: Absorbable mattress sutures in the management of auricular hematoma H. D. Vuyk MD, Corresponding Author H. D. Vuyk MD Departments of Otolaryngology (H.D.V.) and Dermatology (E.J.M.B.), Gooi-Noord Hospital, Rykstraatweg, Blaricum, HollandDepartment of Otolaryngology, Gooi-Noord Hospital, Rykstraatweg 1/1261 AN, Blaricum, HollandSearch for more papers by this authorE. J. M. Bakkers MD, E. J. M. Bakkers MD Departments of Otolaryngology (H.D.V.) and Dermatology (E.J.M.B.), Gooi-Noord Hospital, Rykstraatweg, Blaricum, HollandSearch for more papers by this author H. D. Vuyk MD, Corresponding Author H. D. Vuyk MD Departments of Otolaryngology (H.D.V.) and Dermatology (E.J.M.B.), Gooi-Noord Hospital, Rykstraatweg, Blaricum, HollandDepartment of Otolaryngology, Gooi-Noord Hospital, Rykstraatweg 1/1261 AN, Blaricum, HollandSearch for more papers by this authorE. J. M. Bakkers MD, E. J. M. Bakkers MD Departments of Otolaryngology (H.D.V.) and Dermatology (E.J.M.B.), Gooi-Noord Hospital, Rykstraatweg, Blaricum, HollandSearch for more papers by this author First published: October 1991 https://doi.org/10.1288/00005537-199110000-00015Citations: 12AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume101, Issue10October 1991Pages 1124-1126 RelatedInformation

Otolaryngologic manifestations of child abuse

The number of reported cases of child abuse has increased dramatically over the past several years. Maltreatment of children can take several forms including neglect, sexual abuse, physical assault and psychological trauma. Five cases of child abuse presenting initially to the Otolaryngology Service are outlined: bilateral auricular hematomas, recurrent tympanic membrane lacerations, a pharyngeal laceration with retropharyngeal abscess and medical neglect of a patient with a parotid malignancy and one with laryngeal papillomatosis. Characteristic presentations and risk factors in family background are discussed toward the goal of early recognition and appropriate intervention.

A Technique to Treat Wrestler's Auricular Hematoma

To the Editor .—Having read with interest the article by Schuller et al 1 concerning the treatment of wrestler's auricular hematoma, we would like to briefly report our experience with this pathologic condition of the pinna. Our series consisted mainly of alcoholics, alienated people living in hospice, or patients with an occasional auricular hematoma. Most of these patients are uncooperative and conventional pressure dressings applied over the auricle are usually impractical. In our experience, auricular hematoma decompression by needle aspiration or by simple incision, with or without curettage, is frequently ineffective, resulting in hematomal reoccurrence. Consequently, with increasing experience, we developed the following technique, which is now our therapy of choice for auricular hematoma drainage: (1) Anesthetize the skin overlying the hematoma, generally the lateral auricular surface. (2) Make a triangular incision, 1 × 1 × 0.5 cm, directly over the hematoma. Excise and discard the resulting cutaneoperichondrial triangle. (3)

耳血腫について 耳血腫破裂症例の報告および文献的考察

Auricular hematoma is not rare condition and its prognosis has been considered to be good in Japanese textbooks. Recurrence of the hematoma, however, frequently occurs by use of simple aspiration or incision, and a pressure dressing. In this paper, we report a case of ruptured othematoma and review the biliographies concerning the pathology and treatment of othematomas. A 37-year-old man sustained a fist blow to his left ear at the beginning of May, 1989. He was first seen with auricular hematoma on July 4, but refused a surgical treatment. The laceration of the skin overlying the hematoma occurred by once more fist blow on July 26, with the upper auricle divided into anterior and posterior parts. The auricular cartilage was broken into several pieces, some of which attached to the anterior side and the others to the posteriors side. Under general anesthesia, fibrin glue was applied to the dead space after irrigation, minimal debridement, and removal of the clots. Four horizontal mattress sutures were put through the entire pinna after the anterior skin was protected by fluffed gauze with antibiotic ointment and the posterior skin by buttons. The dressing was allowed to remain in place ten days and was then removed. Nine months after the operation the pinna appeared almost normal. In recent reports, the othematoma is considered to occur between the perichondrium and the cartilage, or within the cartilage. Various techniques have been applied to treat the othematoma, which are classified into three types: incision and drainage, pressure dressing with splinting mold, or with mattress suture. Treatment of choice is discussed, with reviewing the advantages and disadvantages of each method.

Treatment of auricular haematoma by silicone rubber splints.

A modification of existing techniques for the treatment of auricular haematoma is described. This method employs incision, drainage and the application of silicone rubber splints (Silastic). Existing methods of treatment are reviewed and discussed. A retrospective review of 16 cases using this technique showed a satisfactory cosmetic result in all cases.

Management of Auricular Hematomas with Suction Assisted Lipectomy Apparatus

A rugby player with a large 5-day-old auricular hematoma was successfully treated with aspiration, using the suction-assisted lipectomy apparatus and tie-over bolstering.

Alternative Treatment for Wrestlers' Hematoma-Reply

In Reply .—This letter is in response to letters you have received from Drs Jaffee and Koopmann. The technique described by Dr Jaffee certainly is interesting. It has run the test of time with his extended personal experience of 25 years. The problem it creates for the high school or collegiate wrestler, who is currently competing, is that is does not permit physical contact for 48 to 72 hours. Our motivation for using the approach described in our article reflects the reluctance on the part of the wrestlers to delay competing for any period of time. I would be somewhat skeptical that the fine-mesh gauze and collodion would represent enough protection for the auricle that will be stressed with competition. It obviously represents a very effective way of treating auricular hematoma for a nonathlete. With respect to Dr Koopmann's letter, I can only offer my apologies. I also apologize to Dr Tom

Auricular Injury and the Use of Headgear in Wrestlers

Questionnaires designed to assess attitudes and use of headgear were completed by 537 Division I collegiate wrestlers. Only 35.2% of the wrestlers wore headgear all of the time during practice as opposed to 92.4% during competition, which was a statistically significant difference. The most common reason for not wearing headgear was discomfort (35%). There were 482 participating in nonschool team events, and 203 (42%) described headgear use as "seldom or never." However, there was a statistically significant difference of developing auricular hematoma while wearing headgear (26%) vs not wearing headgear (52%). There were 208 (39%) who reported a permanent auricular deformity resulting from an injury that occurred with (10.6%) or without (26.6%) headgear. These results suggest that headgear provides only partial protection and that nonuse is widespread, causing a surprisingly high frequency of permanent auricular deformities.

A technique to treat wrestlers' auricular hematoma without interrupting training or competition.

Auricular hematoma is a common injury occurring among high school and collegiate wrestlers. Conventional pressure dressings applied over the auricle make it impossible for the athlete to continue to train and to compete, resulting in a high degree of noncompliance. We describe a technique that permits treatment of the hematoma while the athlete continues to train. It involves an incision and drainage followed by the immediate application of a pressure dressing sutured to the auricle. This approach was used to treat 24 auricular hematomas in 19 wrestlers. The analysis demonstrates a low complication rate and documents a rapid return to competition.

A Technique to Treat Auricular Hematoma While Continuing to Wrestle

At the American Academy of Facial Plastic and Reconstructive Surgery spring meeting in Palm Beach, Fla, Dr David Schuller, Columbus, Ohio, described the results of a study Dr Steven Dankle, Milwaukee, and he conducted using a technique to treat auricular hematoma. The technique, which permits continued wrestling after an injury, can be performed in an athletic training room. Treatment consists of infiltrating the lateral and medial surfaces of the auricle with a local anesthetic with epinephrine, incising the lateral skin over the hematoma, and compressing the hematoma site between dental rolls held in place with through-and-through sutures of 3-0 nylon. Dr Schuller recommends using a mastoid dressing for 24 hours. He then has the patient coat the dental rolls with ointment until he removes them at 14 days. Dr Schuller reviewed the results of this technique in 24 auricular hematomas in 19 prep and collegiate wrestlers. Thirteen of the hematomas

AURICULAR HAEMATOMA—TREATMENT OPTIONS

The acute auricular haematoma following a blow to the external ear presents a number of treatment options. If a satisfactory final cosmetic result is to be obtained a minor surgical procedure of one sort or another must be performed to prevent a 'cauliflower ear'. Simple needle aspiration is often insufficient to prevent this complication. Different procedures are reviewed and a simple, reliable technique for treating the acute auricular haematoma is described.

The wrestler's ear (acute auricular hematoma).

The wrestler's ear (acute auricular hematoma) is a common problem for physicians treating facial trauma. One method of treatment involves open drainage of the serum and excision of the newly formed fibroneocartilage. This technique provides an outstanding cosmetic result and allows the athlete continued wrestling competition.

Treatment of auricular hematoma using button technique.

10 male patients suffering from auricular hematoma were treated by evacuation of the hematoma followed by suturing two buttons to the ear using through-and-through staying silk sutures, leaving them attached for 1 week. Not a single case of recurrence has been encountered as this technique eliminates the dead space and does not allow reaccumulation of the hematoma.

Surgeon's workshop. Treatment of auricular haematoma by suction drainage.

The various techniques available for the management of auricular haematoma are reviewed and discussed. A modification of existing methods of treatment employing vacuum drainage is described. This method used in six cases resulted in a satisfactory cosmetic appearance.

Continuous portable vacuum drainage of auricular hematomas

A simple, fast, effective method of managing auricular hematoma is presented. It is based on continuous vacuum drainage after complete aseptic evacuation of the hematoma and blood clots. Pressure dressings are unnecessary.

Intrachondral rupture and hematoma formation in the external ear of dogs.

Biopsies from auricular hematomas in 36 dogs and the whole ears from 4 dogs with recent untreated or old healed unilateral hematomas were studied microscopically. A predominantly intrachondral location of the hematomas was demonstrated. They apparently arise as sequelae to primary, traumatically induced, intrachondral ruptures with subsequent cleavage of the cartilage plate. Occasionally, in some areas, separation occurs between the perichondrium and the corium. The hemorrhage presumably results from rupture of small blood vessels where these pass through the foramina in the cartilage. No difference in histological appearance was found between auricular cartilage from affected dogs and normal dogs in the same age range. No breed predisposition was demonstrable.