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Preventing Cauliflower Ear

By motion-is-medicine | May 27, 2021 | General Sports Medicine | Tagged: combat sports, ear pain, sports medicine, ear trauma, auricular hematoma, cauliflower ear, procedure, wrestling, jujitsu, mma, ufc, mixed martial arts | 0 Comments

Last month we wrapped up the USA Wrestling Olympic Trials. Along with this, we wrapped up severalears as well! Auricular hematoma, bleeding between thecartilage layers of the ear, is a very common occurrence in combat athletes such as wrestling, jujitsu, judo, and mixed martial arts (MMA), to name a few. If left untreated this results in the condition known as “cauliflower ear.” The initial treatment for the auricular hematoma is to drain the bloody fluid from the ear. This is typically done by cleaning the area and using a large needle attached to a syringe to aspirate the fluid out of the pocket the hematoma formed.

If available, I often find that having ultrasound available to scan the ear both before and after drainage is valuable as well. This ensures the entire hematoma is fully evacuated and can also see if the hematoma septates into separate sections which each require aspiration and drainage.

After the fluid has been fully aspirated out, it is imperative that this portion of the ear is compressed from each side so no further blood reaccumulates between the layers. This is where “the art” of treating this injury/condition comes in. There are numerous ways to pack/compress the ear after it has been drained. Some are more successful than others, and some have increased risks (ie: infection) associated with them. Some of the common packing/compressing methods include:

• EarSplintz
• Simple Wrap
• Dental Caulking
• Thermoplastic splint
• Sew a button/gause plug
• Collodian casts
• Hard gause plug without sewing through it

After working at numerous USA Wrestling events I have found there are effective “in-season” and “out-of-season” approaches to this. Sewing a button is a great way to maintain compression and still allow the athlete to compete while the head is wrapped. The downside of this is there is a greater risk of infection of the ear. The dental caulking method and Ear Splintz device is a safe and effective way of compressing the ear cartilage and reducing the chance of a recurrence of the hematoma and resultant “cauliflower ear” formation.

When treated correctly there should be no concerns for cauliflower ear, so those ear modeling days aren’t over quite yet!