Aural Hematomas

We’ve all seen it – the misshapen lump that makes you wonder why on earth anyone would pack his ear with silly putty. That putty, however, is actually a condition known as cauliflower ear and it is common among mixed martial artists, amateur wrestlers, and to a lesser degree, boxers.

“It can often come from, not so much punches to the ear but, rubbing on the ear, compressing the ear. That kind of thing really results in a cauliflower more than just an actual blow to the ear,” says Dr. Margaret Goodman, the former chair of the Medical Advisory Board of the Nevada State Athletic Commission.

According to Dr. Goodman, stresses to the outer ear can create a hematoma, or a pooling of blood underneath the skin. The collecting blood separates the overlying tissue (perichondrium) from the cartilage beneath, depriving the cartilage of much needed oxygen and nutrients. If the condition is left untreated, the cartilage eventually begins to die. Thereupon the cartilage contracts in on itself, resulting in the all too familiar otological lump.

“In order to treat a cauliflower ear appropriately,” advises Dr. Goodman, “you want to get it while the hematoma can be evacuated.” The recommended course of treatment requires a visit to a nearby emergency room where the blood can be drained from the ear. Otherwise, the blood can begin to coagulate, making the hematoma difficult to treat.

Once properly drained, a compressive dressing is applied to the ear, which keeps the cartilage in contact with the surrounding tissue, and prevents further collection of blood.

Longtime risks associated with cauliflower ear are minimal, with the deformity of the ear likely to be the only lasting impact. Generally the condition does not pose a threat to one’s hearing, except in the most extreme cases, where the resulting scar tissue grows large enough to obstruct the ear canal.

Dr. Goodman does warn that, “the outer ear is really prone to infection. So anytime you’ve got something that doesn’t belong, [like a hematoma], you’re setting yourself up for infection.” Antibiotics may be prescribed to prevent an infection from taking hold.

While most fi ght fans know what cauliflower ear looks like, few know how it feels. The word hematoma certainly doesn’t sound too good, but does it hurt?

“Yes it would be very painful,” says Dr. Goodman. “It would be kind of like a really, really bad toothache from an infected tooth. You know that bad, throbbing, pounding pressure.”

However, adrenaline may temporarily limit the amount of pain a fighter experiences immediately after a fight. Dr. Goodman speculates that may be the reason many fighters choose not to have the hematoma treated, thereby making cauliflower ear so characteristic of the sport of MMA.

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