Cauliflower ear (also known as an auricular hematoma) is an injury to the ear that causes bleeding and inflammation - essentially, the top swells. It can be caused by exposure to heavy airflow, excessive friction from rubbing, or repeated minor trauma to the ear. It is a rather frequent disorder among those who practice wrestling, mixed martial arts, rugby and water polo. Treatments mainly focus on reducing swelling and draining the blood, which must be done within about 48 hours, to avoid permanent deformities. A doctor should always take care of the drainage with the use of a syringe and needle, unless you are in an emergency situation.
Steps
Method 1 of 3: Initiate Immediate Treatment
Step 1. Apply ice
Immediately after suffering the swelling injury, you should stop the activity you were doing and put on ice (or something cold) to reduce the inflammation and numb the area to soothe the pain. Ice decreases blood flow to the area between the skin and the cartilage of the upper ear. During the first 3-4 hours after the injury, apply a cold pack for about 15 minutes at a time, every hour or so.
- Wrap ice cubes, crushed ice, or cold gel pack in a thin towel before placing it against your ear to avoid the risk of cold burns or skin irritation.
- Alternatively, you can use a bag of frozen vegetables or fruits, which performs the same function of decreasing ear swelling.
Step 2. Use a hair band to compress the injured ear
In addition to applying ice, you should protect your ear by wrapping your head with an elastic band or bandage to cover the ear and apply some pressure. The combination of cold and compression therapy is the most effective way to combat the swelling of virtually all musculoskeletal injuries. The pressure stops internal bleeding faster, thus reducing the severity of the deformation due to the ear hematoma.
- You can use a long strip of gauze or an elastic exercise band to press the ice against your ear.
- To increase pressure, consider inserting gauze wedges in front of and behind the pinna.
- Do not over tighten the bandage to the point of causing headache or dizziness. You must prevent the bandage from interfering with vision or impairing the hearing of the affected ear.
Step 3. Take anti-inflammatories
Another way to soothe the swelling and pain of the cauliflower ear is to take inflammation medications, such as ibuprofen (Brufen), aspirin, or naproxen (Momendol). Take them as soon as possible, right after the injury, if you want to start benefiting soon. Combine medication intake with cold therapy and compression.
- Pain relievers, such as acetaminophen (Tachipirina), obviously help with pain, but remember that they do not reduce swelling.
- Aspirin and ibuprofen can increase and aggravate internal bleeding, so you need to ask your doctor if these drugs are suitable for you.
- Do not take anti-inflammatories for more than two weeks to avoid or limit side effects, such as stomach or kidney irritation. For this specific ailment, taking them for a couple of days is more than enough.
Method 2 of 3: Drain the Cauliflower Ear at Home
Step 1. Know the risks
While it is possible in mild cases to drain the ear without the need for medical intervention, especially if you have had some training to do so, be aware that you could significantly increase the risk of future infections and complications. You should only perform this procedure if you are unable to see a doctor within 2 to 3 days.
- Also, you should only do drainage if the trauma is mild, i.e. when the ear is only moderately swollen and the skin is not torn.
- If you have a cell phone, call emergency services for advice and support.
Step 2. Wash your hands thoroughly and / or wear gloves
Before starting the procedure, you need to make sure your hands are sanitized by washing them with warm soapy water for about 30 seconds, then dry them with paper towels. If you have surgical-grade latex gloves, put them on after washing your hands, but it's not strictly necessary. If your hands are clean or protected, you greatly reduce the risk of spreading bacteria in the injured ear, which could lead to an infection.
- If you don't have soap and water available, you can clean your hands with an alcohol-based hand sanitizer.
- Alcohol or baby wet wipes can also be useful for washing your hands when you are in an emergency situation.
Step 3. Disinfect and prepare the injured ear
Before you start draining it, you need to make sure you disinfect it thoroughly. Wet a sterile cotton ball with rubbing alcohol or tea tree oil and apply it to the upper half of the ear where the edema is greatest. This is the place on the ear that you will need to prick, so you need to make sure it is completely sterilized.
- Tea tree oil is a natural antibacterial cleanser, but be careful it doesn't get into your eyes, or you may experience burning.
- Use a generous amount of alcohol or tea tree oil to cover all the depressions and reliefs typical of the auricle, both inside and out.
- You can also disinfect the ear with swabs already soaked in alcohol or with an alcoholic sanitizer that you can apply with a cotton swab.
- Put ice on for about 10-15 minutes just before you prick the ear to numb it and reduce pain. ice acts a bit like a natural anesthetic.
Step 4. Pierce the hematoma with a syringe needle
If you don't have one available at home or where you are, buy a 2.5cm long needle with 20 gauge, with a syringe of at least 3ml; in this way, you can drain the large pouch filled with blood. The 20-gauge needle is not the thinnest available, but it is the best choice for aspirating the thick, coagulated blood from inside the injured ear.
- The 3ml capacity of the syringe is enough to hold all the liquid you will aspirate, while the 2.5cm long needle avoids puncturing the ear too deeply and potentially damaging the cartilage.
- Just puncture the swollen part of the upper-middle area of the ear, deep enough to allow the tip of the needle to penetrate. Do not push the needle too far to avoid further damage.
Step 5. Drain the blood and other fluids
Once the needle tip has pierced the skin, slowly and steadily pull the syringe plunger to draw out the blood, pus, and other inflammatory secretions. Continue draining fluids until the plunger can no longer be pulled or the injured area is completely emptied and deflated.
- During the procedure, gently squeeze the injured part of the ear to make it easier for blood and other fluids to escape through the needle. finally, extract the latter from the skin.
- The secretions may appear a slightly milky red when there is pus or a bright red if the trauma is recent (a few hours).
- When you pull out the needle, be careful to move it slowly and with a steady hand, so that the needle hole remains small. If you move the needle too much into the skin, it could tear it a little, so be cautious.
Step 6. Disinfect the area once more
After gently squeezing any remaining liquid to drain it from your ear, use a cotton ball, cotton ball, or soft tissue to disinfect the needle hole with more denatured alcohol, tea tree oil, or an alcohol-based sanitizer. When there is an open wound, the ear is more prone to infection at this stage of treatment, so take your time to do a thorough disinfection job.
- Keep in mind that the skin will still appear a little wrinkled afterwards, but it typically heals over time and returns to normal size once the ear is fully drained.
- Let the needle hole ooze for a few minutes if necessary; this means that a small amount of blood may still leak out.
Step 7. Apply pressure to stop bleeding
Depending on the type of injury and how carefully you drained your ear, the small bleeding may stop after a few minutes or the tissues may just ooze slightly. However, if blood continues to come out or drip from your ear, you need to apply some pressure for a few minutes, placing a clean piece of gauze or tissue on it to stop bleeding and help blood clot.
- After some time has elapsed, you can put on a small patch to cover the hole and protect it from infection.
- Make sure you change the patch every day or whenever it gets wet.
Method 3 of 3: Get Professional Care
Step 1. Undergo drainage and compression treatment
Although needle drainage is still a method used by many doctors, it is no longer recommended by many professionals, as the hematoma often re-forms somehow. Regardless of this, the physician may still prefer this aspiration procedure and perform an operation similar to how previously described. When finished, the doctor will apply a special compression bandage to the site to prevent additional blood from accumulating in the injured area.
- In addition to the increased experience, the main difference between the drainage performed by you and that by the doctor is that he will use a topical anesthetic to make the procedure less painful.
- The compression bandage, in addition to putting pressure on the ear, also helps the torn skin to re-adhere to the underlying cartilage.
- The doctor will also apply the gauze both above and below the ear before wrapping the ear with a sterile bandage.
Step 2. Learn about drainage and immobilization
This is quite similar to the drainage and compression technique with the use of a needle and syringe, but instead of applying a tight bandage to the ear, the doctor puts a special internal splint to ensure constant pressure on the lesion and completely drain the ear. 'ear.
- This sort of "splint" for the ear can also consist of sutures, which are applied all over the ear, in order to hold the special gauze well in place.
- Alternatively, the splint can be made of silicone and molded to the shape of your ear.
- If you are put on this device, your doctor will need to check your ear again after a week. The sutures should stay in place for two weeks unless the area starts to become red or sore. If the splint is custom molded, it can be held for a longer period.
Step 3. Get an incision to drain the cauliflower ear
This is the method most often recommended by doctors and is performed with the use of a scalpel. The incision allows the blood to come out completely and reduce the possibility that the hematoma can reform again, a problem that instead tends to recur with the needle technique. In addition, with the incision, it is also easier to extract thick and coagulated blood from the ear.
- This type of procedure is performed by a plastic surgeon or a licensed otolaryngologist (the nose, ear and throat specialist).
- With the incision technique, the doctor will close the wound with resorbable sutures or sutures that will need to be removed after about a week.
- The suture allows the skin that had detached to recover the correct adherence with the underlying cartilage.
Advice
- In addition to swelling, the classic symptoms of cauliflower ear are: pain, redness, hematoma and deformity of the curvature of the auricle.
- Keep the ear dry during the first day following the drainage procedure.
- Do not bathe or swim for the first 24 hours after drainage.
- Keep the compression bandage on for at least 24 hours (if not a few more days) to promote healing.
- Once you get home after your fluid wiping procedure, apply an antibacterial ointment to the hole or incision to avoid infection.
- Wait at least a couple of days before resuming your sport. Wear proper head protection to avoid other similar injuries. Always use an approved helmet and make sure it fits perfectly.
- Your doctor may prescribe a topical or oral antibiotic to prevent infections, especially if you've had an incision or if your skin has tears from the initial trauma.
Warnings
- It is highly recommended that you see a doctor for the drainage procedure rather than doing it yourself. It is definitely safer and better performed when it is handled by a licensed professional.
- The ear should be treated within the first 24-48 hours. In the early stages of trauma, the cauliflower ear is still soft and filled with fluid. It is essential to drain the blood and secretions at this juncture, as the edema will be harder later on. Once the tissues have hardened, you will need to undergo plastic surgery to correct the deformity.
- Tell your doctor immediately if you suspect an infection has developed; severe ones must be treated by a surgeon with intravenous curettage and antibiotics. Symptoms that indicate the presence of infection are headache, fever, painful touch, redness, purulent discharge, swelling, increased pain or hearing changes.
