Overview
Auricular dilatation, often resulting from trauma, involves hematoma formation within the subperichondrial space of the ear, posing risks such as perichondritis and cauliflower ear if not promptly managed. 1Diagnosis
Clinical Presentation: Shearing or blunt trauma leading to fluctuant hematoma within 7 days post-injury. 1
Physical Examination: Identification of swelling, deformity, and fluctuance in the auricle. 1Management
Early Intervention: Evacuation of hematoma via needle aspiration or incision and drainage within 7 days of injury. 1
Analgesia: Auricular block for pain management prior to procedure. 1
Post-Procedure Care: Application of bolster compression dressing to prevent reaccumulation of blood. 1
Duration of Dressing: Typically 7-10 days post-evacuation. 1Special Populations
Newborns with Malformations: Early identification and intervention by trained hearing screen technicians can expedite necessary ENT consultations and treatments. 2Key Recommendations
Evacuate Fluctuant Hematoma Promptly: Perform evacuation within 7 days of injury to prevent complications like perichondritis and cauliflower ear. (Evidence: Strong 1)
Use Analgesia Before Procedure: Administer auricular block for pain relief before hematoma evacuation. (Evidence: Strong 1)
Apply Bolster Compression Dressing: Post-evacuation, use a bolster dressing for 7-10 days to prevent reaccumulation of hematoma. (Evidence: Moderate 1)
Implement Early Screening Protocols: For newborns, integrate trained technicians to screen and promptly refer cases of auricular malformations. (Evidence: Moderate 2)References
1 Long B, Mason J, Bridwell RE, Gottlieb M. Managing Auricular Hematoma: An Emergency Medicine Narrative Review. The Journal of emergency medicine 2025. link
2 Liu YC, Kini S, Barton G, Pham T, Marcet-Gonzalez J, Novak B. Implementation of auricular malformation screenings in the newborn population. International journal of pediatric otorhinolaryngology 2020. link
3 Mudry A. Contribution of Ambroise Paré (1510-1590) to otology. The American journal of otology 1999. link
4 Kaminsky A. Repair of the partial loss of the helix. Aesthetic plastic surgery 1997. link