Auricular haematoma is a collection of blood between the perichondrium and cartilage of the pinna after shearing or blunt trauma, and without prompt drainage it can leave a permanent cauliflower ear.
It is common in wrestling, judo, mixed martial arts, boxing, water polo and rugby, especially in front-row forwards. The priorities are early recognition, drainage, a compression dressing to stop it refilling, and checking for an associated head injury.
The pinna is a folded plate of elastic cartilage covered on both sides by tightly adherent perichondrium. The cartilage has no blood supply of its own and depends on diffusion from the perichondrium.
Shearing or blunt force tears small perichondrial vessels, and blood collects beneath the perichondrium, lifting it off the cartilage. The cartilage loses its nutrition, and an undrained collection leads to fibrocartilaginous overgrowth: the thickened, irregular cauliflower ear, which is permanent without surgical reconstruction.
Haematomas usually form on the lateral surface, over the scapha and triangular fossa. Recurrence at the same site is common, which is why compression after drainage matters.
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