An athlete presents with swelling of the external ear after blunt traumatic impact. Which is the most appropriate management?

An athlete presents with swelling of the external ear after blunt traumatic impact. Which is the most appropriate management?

• A. Evacuation
• B. Evacuation followed by antibiotics
• C. Ice and compression
• D. Evacuation with subsequent antibiotics and splinting

Answer: (D)

An auricular hematoma from blunt trauma is the main issue here. Blood collects between the cartilage and the perichondrium, and if it’s not removed quickly the cartilage loses its blood supply and a fibrous scar forms, leading to cauliflower ear. The best management combines three actions: evacuating the hematoma to reestablish contact between the perichondrium and cartilage, applying compression or splinting to prevent reaccumulation and mold the ear as it heals, and giving antibiotics to reduce the risk of infection that can jeopardize cartilage healing. Ice and compression alone don’t address the need to drain, and drainage without subsequent compression and antibiotics leaves a high risk of reaccumulation and infection. So evacuating the hematoma with antibiotics and splinting provides definitive protection against deformity while minimizing infection risk.

An auricular hematoma from blunt trauma is the main issue here. Blood collects between the cartilage and the perichondrium, and if it’s not removed quickly the cartilage loses its blood supply and a fibrous scar forms, leading to cauliflower ear. The best management combines three actions: evacuating the hematoma to reestablish contact between the perichondrium and cartilage, applying compression or splinting to prevent reaccumulation and mold the ear as it heals, and giving antibiotics to reduce the risk of infection that can jeopardize cartilage healing. Ice and compression alone don’t address the need to drain, and drainage without subsequent compression and antibiotics leaves a high risk of reaccumulation and infection. So evacuating the hematoma with antibiotics and splinting provides definitive protection against deformity while minimizing infection risk.