Auricular Hematoma

Excerpt

An auricular hematoma is a blood collection underneath the ear's skin that typically occurs due to blunt trauma (see Image. Auricular Hematoma). If hematoma treatment is delayed or inadequate, cauliflower ear deformity may arise as a complication (see Image. Severe Cauliflower Ear Deformity). Combat sports like wrestling and boxing are the usual causes of auricular hematomas. Diagnostic testing is often unnecessary unless other clinical indications are present, such as hearing loss and neurologic deficits.

Prompt hematoma removal prevents complications such as infection and cauliflower ear deformity. To avoid recurrence, it is recommended to maintain pressure on the treated site for 5 to 7 days. A pinna injury specialist, such as an otolaryngologist or plastic surgeon, may provide recommendations regarding diagnosis, management, and follow-up care.

Outer Ear Histology

The auricle, or external ear pinna, consists of elastic cartilage enveloped by a dense, fiber-filled perichondrium and skin. The pinna's fibrocartilaginous structure contributes to its mechanical support and 3-dimensional shape, forming the helix, antihelix, scapha, concha, triangular fossa, tragus, and antitragus. The lobule is an exception, as it is composed chiefly of fibrofatty tissue (see Image. Auricle Surface Anatomy).

The perichondrium serves crucial functions, providing structural support to maintain the ear's shape and integrity. The poorly vascularized cartilage relies on the perichondrium's blood supply for oxygen and nutrients. This fibrous layer also facilitates cartilage repair and growth, containing cartilage progenitor cells in its inner stratum, and serves as an attachment site for the overlying skin.

Auricular skin contains sparse hairs, sebaceous glands, eccrine sweat glands, and keratinized stratified squamous epithelium. The anterolateral surface lacks subcutaneous tissue and tightly adheres to the underlying perichondrium. The posteromedial part features subcutaneous fat and skeletal muscle. This disparity makes the anterolateral pinna more vulnerable to injury than the posteromedial aspect.