A 38-year-old female with no past medical history presented with left ear pain and swelling, that started 4 days prior as a small pimple and progressed over the course of 4 days to the point that patient is unable to lay on her left site due to pain and swelling. No history of trauma to that area. Patient denied any systemic symptoms, hearing loss, tinnitus, ear drainage. Patient never had similar symptoms before. Patient does not take any medications and is not allergic to any medications. Review of system is negative except left ear pain and swelling. On physical exam, patient appears uncomfortable due to pain. There is an obvious left auricular swelling, sparing the lobe, tender to palpation.

No mastoid tenderness. External canal is normal. Middle ear exam is normal as well. No lymphadenopathy is noted. Right ear is normal. The rest of exam is unremarkable.

The images depict an auricular hematoma that resulted from a minor trauma such as rubbing a cartilaginous auricle, in this case an initial pimple that was itching. The resulting shearing forces caused a separation of underlying perichondrium from the cartilage itself, thus forming an auricular hematoma.

A needle aspiration of the swelling was performed and 10 ml of serosanguinous fluid was drained. A compressive dressing was applied. Patient was instructed to follow up with ENT the following day.

Teaching points:

This case illustrates that often even a minor trauma, not necessarily an obvious blunt injury, may be enough to cause the separation of perichondrium from the cartilage and form an auricular hematoma. It is very important to take a detailed history in cases of such obvious auricular hematomas without obvious traumatic history, as asking the right questions will inevitably reveal that the trauma, albeit minor, did take place.

• Auricular hematomas are always traumatic, but the trauma may be subtle and inapparent to the patient
• Early identification, drainage, compressive dressing to prevent cauliflower ear and close follow up is a must

Courtesy of Karima Sajadi, MD

The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.

The images being used are for illustrative purposes only; any person depicted is a model.

 
 Back to Top