What are cauliflower ears

Cauliflower ear is a condition that results when the external portion of the ear suffers trauma that causes fluid or blood to collect under the perichondrium, a layer of connective tissue that covers the cartilage. The external ear becomes permanently misshapen and swollen, resembling a cauliflower.

Causes

Normally ear cartilage is covered by a thin adherent layer of connective tissue called the perichondrium, which makes cartilage. Traumatic shearing forces, when one part of the body is pushed in one direction while another is pushed in the opposite direction, can cause the perichondrium to separate from the underlying cartilage. This results in bleeding (hematoma) or the formation of a chronic fluid pocket (seroma).

If the perichondrium remains separated, abnormal cartilage will begin to form on top of the normal cartilage. This cartilage buildup results in bulky, misshapen ears.

Cauliflower ear often occurs in contact activities such as boxing, wrestling, mixed martial arts, or rugby.

Treatment

If the underlying bleeding and pockets of fluid are noticed right away, they should be drained immediately and compressed with a pressure dressing. This helps the perichondrium to re-adhere to the cartilage. Antibiotics may also be prescribed to reduce risk of infection.

Old cauliflower ear deformities that aren’t treated early require surgery to remove the abnormal cartilage. Postoperative compression, drain placement, and/or quilting sutures can improve the results.

Cauliflower ear is commonly seen in wrestlers. To avoid the need for additional surgeries in the future, your doctor may recommend postponing surgery until your child's wrestling season or wrestling career is over.