John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Cauliflower ear (boxer's ear, wrestler's ear) is an acquired deformity of the outer ear. It is usually due to blunt trauma to the ear. When the cartilage of the ear is injured by trauma or inflammation, the blood supply from the skin is disrupted. It often forms a large pocket of blood, called a hematoma. As the injury to the ear heals it can shrivel up and fold in on itself and appear pale, giving it a cauliflower-like appearance, hence the term cauliflower ear. Wrestlers, boxers, and martial artists in particular are susceptible to this type of injury.
The ear is vulnerable to blunt trauma. When the ear is struck and a blood clot develops under the skin, or the skin is sheared from the cartilage, the connection of the skin to the cartilage is disrupted, causing cauliflower ear.
The cartilage of the ear has no other blood supply except that supplied by the overlying skin. When the skin is pulled from the cartilage, and/or separated from the cartilage by blood (as with accumulated blood from injury or inflammation) or infection, the cartilage is deprived of important nutrients. Ultimately, the cartilage dies and the risk of infection is increased.
Untreated, the ear cartilage begins to contract on itself forming a shriveled up outer ear, known as the cauliflower ear deformity. Once there is cartilage death and scarring (fibrosis), the resulting deformity is generally permanent. The ear may also appear pale, due to loss of blood supply. In some cases, cosmetic procedures may improve the appearance of the ear.
Cartilage damage may also result from piercing the upper ear in the cartilage. Piercing can lead to a type of ear cartilage infection called auricular perichondritis, which can result in cauliflower ear. An even more rare cause of cauliflower ear is from the inflammation of cartilage in relapsing polychondritis.
Medical Author: Benjamin C. Wedro, MD,
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
The anatomy of the ear can be a little confusing, especially since the ear is
responsible not only for hearing, but also for balance.
There are three components to the ear: the outer ear, the middle ear and the
inner ear. All three are involved in hearing but only the inner ear is
responsible for balance.
The outer ear is composed of the pinna, or ear lobe, and the external
auditory canal. Both structures funnel sound waves towards the ear drum or
tympanic membrane allowing it to vibrate. The pinna is also responsible for
protecting the ear drum from damage. Modified sweat glands in the ear canal form ear wax.
The middle ear is an air filled space located in the temporal bone of the
skull. Air pressure is equalized in this space via the Eustachian tube which
drains into the nasopharynx or the back of the throat and nose. There are three
small bones, or ossicles, that are located adjacent to the tympanic membrane.
The malleus, incus, and stapes are attached like a chain to the tympanic membrane
and convert sound waves that vibrate the membrane into mechanical vibrations of
the three bones. The stapes fills the oval window which is the connection to the