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February 9, 2010
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Cauliflower Ear

Medical Author: John P. Cunha, DO
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

What is cauliflower ear?

Cauliflower ear (boxer's ear, wrestler's ear) is an acquired deformity of the outer ear. In this injury, the ear 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. 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.

The ear is vulnerable to blunt trauma. 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, localized blood from injury, called a hematoma) 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 classically known as the cauliflower ear deformity. Once there is cartilage death and scarring (fibrosis), the resulting deformity is very difficult to reconstruct. The ear may also appear pale, due to loss of blood supply. In some cases, cosmetic procedures may be able to improve appearance of the ear, but often the victim can be left with a permanent deformity.

Because the ear is vulnerable to infection, it's important to treat these hematomas, even if the patient is not concerned with the cosmetic appearance of the ear. If the ear drum is also injured (ruptured), the wound may be treated with stitches. However, significant hearing loss may still occur.



Next: How is cauliflower ear treated? »

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Cauliflower Ear

What is a hematoma?

By definition, a hematoma is a collection of blood outside of a blood vessel. It occurs because the wall of a blood vessel wall, artery, vein or capillary, has been damaged and blood has leaked into tissues where it does not belong. The hematoma may be tiny, with just a dot of blood or it can be large and cause significant swelling.

The blood vessels in the body are under constant repair. Minor injuries occur routinely and the body is usually able to repair the damaged vessel wall by activating the blood clotting cascade and forming fibrin patches. Sometimes the repair fails if the damage is extensive and the large defect allows for continued bleeding. As well, if there is great pressure within the blood vessel, for example a major artery, the blood will continue to leak and the hematoma will expand.

Blood that escapes from the blood stream is very irritating and may cause symptoms of inflammation including pain, ...

Read the Hematoma article »




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