Indications for Cauliflower Ear Treatment
Cauliflower ear results from bleeding into the cartilage of the ear, usually from trauma.
Surgical Details of Procedure
1. The ear surface is swabbed with a non-chlorhexidine antiseptic.
2. A medium gauge needle (e.g., #18) on a 5-10 cc syringe is inserted into the hematoma while the surgeon aspirates.
3. An antibiotic impregnated dressing is placed over the area of aspiration and secured with tape of collodion soaked gauze.
4. Close observation is made to insure hematoma does not reaccumulate
5. A second aspiration may be attempted in the face of a recurring hematoma.
6. If the hematoma again reaccumulates, one or two mattress sutures with pledgits can be placed through the scapha to allow chronic drainage.
7. If the hematoma is not adequately drained or ignored, fibrous deposits will appear in the ear cartilage requiring a surgical procedure.
8. An curvilinear incision is made with a No. 15 scalpel along the medial and/or lateral border of the antihelix depending on where the fibrous deposits are located.
9. Skin flaps are raised using sharp dissection with care taken not to lacerate or tear the skin.
10. The No. 10 blade is used to shave the fibrous deposits until all excess tissue has been removed.
11. Meticulous attention to hemostasis (i.e., stopping the bleeding) is required to prevent another hematoma (clot) from forming.
12. If needed a small drain can be placed under the skin flaps.
13. The skin is then reapproximated with interrrupted 6-0 nylon sutures.