ENT
CAULIFLOWER EAR/AURICULAR HAEMATOMA
Auricle = Pinna = part of the ear outside the head
Prompt
ResponseAuricular haematoma to R ear
Small associated skin tear
Overlying skin appears well perfused
No apparent involvement of the tragus/external auditory meatus/canal
Management:
Analgesia
Field block of the pinna
Incision and drainage of the haematoma
Compression bolster/Pressure dressing post drainage to prevent reaccumulation
Assessment for other injuries including in the external canal and medial aspect of the pinna
Tetanus prophylaxis as appropriate to immunisation status
Close follow up
Small associated skin tear
Overlying skin appears well perfused
No apparent involvement of the tragus/external auditory meatus/canal
Management:
Analgesia
Field block of the pinna
Incision and drainage of the haematoma
Compression bolster/Pressure dressing post drainage to prevent reaccumulation
Assessment for other injuries including in the external canal and medial aspect of the pinna
Tetanus prophylaxis as appropriate to immunisation status
Close follow up
PromptIndications for referral of auricular haematoma
ResponseLarge overlying skin avulsion (>5mm)
Severe crush injuries
Complete or near complet avulsion or amputation
Large cartilage defects (>5mm)
Obvious devitalisation
Large auricular haematoma
Wounds that require removal of more than 5mm of tissue
Significant involvement of the auditory canal
Severe crush injuries
Complete or near complet avulsion or amputation
Large cartilage defects (>5mm)
Obvious devitalisation
Large auricular haematoma
Wounds that require removal of more than 5mm of tissue
Significant involvement of the auditory canal
PromptContraindication to drainage in ED
ResponseHaematoma >7 days old
Recurrent/chronic haematoma
(requires surgery because haematoma/granulation can be within cartilage instead of sub-perichondrial space)
Recurrent/chronic haematoma
(requires surgery because haematoma/granulation can be within cartilage instead of sub-perichondrial space)