Formation of the ‘cauliflower ear’ deformity:

Trauma to the ear causes bleeding and a haematoma to form between the avascular cartilage cells and the perichondrium, disrupting the diffusion of nutrients and oxygen from the blood vessels in the perichondrium to the cartilage. The cartilage cells undergo necrosis, and limited regeneration means that it is replaced by fibrous scar tissue leading to this obvious deformity.

Auricular haematomas are common in rugby players and wrestlers. Prompt treatment is important to avoid the formation of 'cauliflower ear'.

Management

• auricular haematomas need same-day assessment by ENT
• incision and drainage has been shown to be superior to needle aspiration