DEFINITION:
This is a distorted pinna post healing after trauma and it is regarded as a badge of honour for rugby players.
ANATOMY:
The pinna is made up of cartilage covered with perichondrium and skin. The blood vessels pass through the perichondrium to the cartilage. The cartilage has no blood vessels of its own.
PATHAPHYSIOLOGY:
Shearing forces separates the anterior cartilage from its lining resulting in a haemorrhage (haematoma). Over time, if not adequately treated or there is a repeated insult, this results in damage and new growth of the cartilage and a subsequent cauliflower ear. There is also thickening of the overlying skin.
MANAGEMENT:
The management goal in the acute phase (less then 7 days) is to evacuate the clot and prevent reaccumulation. Once established and scarring has taken place, little can be done surgically.
SURGERY:
Simple aspiration with a needle is not recommended as the haematoma tends to reaccumulate. Incision and drainage with obliteration of the space is the treatment of choice. The Surgeon can use a pressure dressing, quilting sutures, splints and buttons, a drain and antibiotics may also be used.