The othematoma is an effusion between the cartilaginous auricle and the cartilage skin. Because it’s usually caused by a shearing force such as a sideways blow to the ear, it’s also known as boxer’s ear. The othematoma should always be treated promptly, since if left untreated it can lead to complications such as permanent changes in the shape of the auricle and infections, which are much more difficult to treat.
What is an othematoma?
The accumulation of bloody or protein-rich (serous) fluid between the cartilage and the cartilage skin (perichondrium) of the auricle is called an othematoma. The auricle consists of a cartilaginous framework that gives the ear its characteristic shape. The cartilage is covered by a cartilage skin, which in turn is attached to the outer skin. this is rich in blood vessels and nerves. See theinternetfaqs for Medulloblastoma Basics.
The cartilage skin is normally so close to the cartilage that there is no space between the two structures. The outer skin also adheres firmly to the perichondrium from the other side. As a result of trauma, however, it can happen that the cartilage membrane separates from the cartilage, creating a space that does not exist naturally, but in which fluid can now collect. The result is the development of an othematoma.
In most cases, an othematoma is caused by external violence. As a rule, shearing and tangential forces acting on the auricle are the cause of the development of the disease. A lateral blow to the auricle during a boxing match is probably the most common cause of the development of the othematoma.
For this reason, the disease is called boxer’s ear. Furthermore, lying on the bent ear for a long time can be the cause of the effusion. This is especially typical in people who sleep in a sideways position and very quietly.
Symptoms, Ailments & Signs
The othematoma appears as a pink, firm, elastic swelling on the front of the auricle. Much like a blister from burns, it bulges convexly under the skin and can cause a strong feeling of pressure. Those affected usually do not complain of pain. The ear is often only slightly red and usually not overheated.
In many cases, however, the effusion can be displaced when pressure is applied from above or from the side. If an infection with bacteria occurs, severe local pain, redness, swelling and overheating can occur. In addition, there may be a discharge of pus-containing fluid from the sore spot. Slight bleeding is also possible in this case. If an othematoma is not treated, the effusion will grow together with connective tissue.
The hematoma becomes firm, grows together with the surrounding cartilage and causes the auricle to appear deformed like a cauliflower. This occurs especially with recurring effusions that have either not been properly treated or are due to renewed force. This complication can be easily averted with early diagnosis and treatment.
Diagnosis & course of disease
The othematoma is usually a visual diagnosis made by the ENT doctor. Appropriate events in the recent past, such as a blow to the affected ear or the onset of symptoms immediately after waking up, support the diagnosis. Imaging procedures such as an ultrasound examination or X- ray are usually not required.
The diagnosis of an acute othematoma always requires therapeutic intervention, since the disease does not heal on its own. Although the connective tissue remodeling of the chronic hematoma is not dangerous, it can have an unaesthetic effect. Treatment of the disease at this stage is far more complex and less successful.
If an othematoma is not treated, the swelling can become inflamed and cause severe pain. In addition, fluid can leak from the sore and cause serious infections. As the disease progresses, connective tissue grows over the effusion, which is associated with visual changes and chronic pain, among other things. This complication occurs primarily with recurrent hematomas that are inadequately treated.
In severe cases, an othematoma can be associated with damage to the eardrum and total or partial hearing loss. Martial artists in particular are affected by this. In addition, a hematoma can severely damage the surrounding tissue structures. If muscles and nerves are damaged, this can lead to so-called compartment syndrome with permanent sensory disturbances and symptoms of paralysis in the affected part of the body.
Finally, an othematoma can cause severe pain and permanent damage to muscles with recurrent trauma. The treatment of an hematoma can promote severe adhesions, bleeding and infection (in the case of drainage) as well as bleeding, secondary bleeding and the formation of scars (in the case of surgical interventions). Drug treatment can cause side effects and interactions. Inadequate follow-up care can result in renewed trauma.
When should you go to the doctor?
If bleeding or dizziness occurs after an accident or a blow to the ear, an othematoma may be present. A doctor should be consulted if the symptoms have not subsided after a few hours or if they become worse within a short period of time. After a serious accident or fall, the emergency services must be called. Depending on the severity of the injury, first responders may need to provide first aid and place the casualty in the recovery position to allow blood to drain from the ear. Those who repeatedly subject their ears to physical shock – such as boxers and other martial artists – risk permanent disfigurement of the auricle.
Since this optical flaw can also represent a psychological burden, a family doctor and therapist must be consulted. The deformity can possibly be corrected surgically. The othematoma itself is treated by a sports medicine doctor, audiologist or general practitioner. In the case of severe injuries, the wound must be surgically closed and the blood stasis removed. In the first few weeks after a surgical procedure, the audiologist must monitor the healing of the wound and, if necessary, prescribe painkillers and anti-inflammatory drugs. The hematoma always requires medical treatment and aftercare. Failure to do so can lead to serious complications, which in the worst case can result in hearing loss.
Treatment & Therapy
Since the accumulation of fluid between the cartilage and cartilage membrane organizes and solidifies over time and can thus lead to a deformity of the auricle, the hematoma must always be treated promptly. As a rule, a small skin incision is made on the front of the auricle (incision) through which the fluid can be drained (drainage).
A pressure bandage should then be applied to the ear so that the space between the cartilage and cartilage skin cannot fill with fluid again. The pressure bandage supports the adhesion between the two tissues and ensures that the unnatural space closes sufficiently.
A small cartilage window can be created on the back of the auricle, especially in the case of recurring effusions in the same place. The changed cartilage is cut out, which very well prevents the development of a new hematoma at this point.
Infected othematomas should be treated with medication. This may require solutions containing antibiotics. It is also important to have the wound cleaned regularly and thoroughly by an experienced doctor and to avoid renewed trauma.
Outlook & Forecast
With immediate treatment, the prognosis of the othematoma is usually favorable. For most of those affected, recovery is achieved through the use of various therapy methods. Fluids that have formed are transported away, so that an optical change in the auricle can regress within a few weeks. A pressure bandage is necessary so that no pathogens can get into the organism during the healing process.
In some patients, if the course is unfavorable, surgical intervention must be carried out, as otherwise secondary diseases can develop. The procedure is described as simple and only rarely leads to unwanted health developments. If, contrary to expectations, complications arise from the operation, a delay in the healing process must be expected. Long-term faults are usually not documented.
If the use of medical care is avoided, the risk of subsequent disorders or long-term impairments is significantly increased. In these cases, the prognosis worsens to a significant extent. Deformations of the ear can occur, which can no longer be adequately corrected later in life. In addition, the repeated occurrence of infections is often observed. Overall, this leads to a weakening of the sense of health and thus of the organism. This process can be particularly difficult for high-risk patients.
The best way to prevent an hematoma is to avoid martial arts. Boxers should pay attention to sufficient head protection and not aim at their opponent’s ears. Susceptible people can tape their ear pieces to their heads at night to avoid buckling.
Falling asleep on your back can also help prevent the development of an othematoma. If, despite precautionary measures, a hematoma develops, immediate treatment can achieve complete healing and avoid chronification.
In the case of an othematoma, the options for aftercare are in most cases relatively severely limited or are not even available to those affected. First and foremost, this disease must be diagnosed quickly and early so that the symptoms do not worsen further or complications occur.
Therefore, those affected should consult a doctor as soon as the first symptoms and signs of the disease appear. As a rule, the symptoms can be alleviated relatively well with a minor surgical intervention, so that there are no further complications. After the procedure, those affected should rest and take it easy, with the sensitive area being particularly well protected.
A pressure bandage should also be worn for several days to prevent infection or inflammation. Regular checks and examinations are also necessary after the procedure in order to check the condition of the othematoma. Other measures and options for aftercare are usually not available to those affected by this disease and are usually not necessary. The othematoma has no negative impact on life expectancy.
You can do that yourself
A hematoma should be treated by a doctor as soon as possible. After puncturing the swelling that causes the hematoma to decongest, the wound must be well cared for and kept away from dust, dirt and aggressive care products.
The swelling should have completely subsided after a week at the latest. During this period, the affected ear must not be burdened with earmuffs and the like. However, should complications arise, it is best to consult a doctor. Inflammation or bleeding should not be treated independently, as improper treatment can lead to infection and skin damage. A recurrent othematoma requires close monitoring by a physician. In addition, the patient should carry out the measures described after each procedure. In the case of recurring complaints, there are often unknown causes that must be identified and eliminated. The patient should look for possible triggers both at work and in private life and check the connection to the recurrent effusion.
The healing of an othematoma can be supported by various natural remedies. For example, devil’s claw, aloe vera and various essential oils promote blood circulation and support wound healing.