Cauliflower ear

Last revised by Candace Makeda Moore on 15 May 2023

Cauliflower ear, also known as perichondrial hematoma or wrestler's ear, is a deformity of the outer ear that occurs as a result of repeated blunt trauma or injury. It is most commonly seen in participants in contact sports such as wrestling, boxing, rugby, and martial arts.

The diagnosis of cauliflower ear is clinical and does not require imaging 1, however head trauma or some differential diagnoses might.

A cauliflower ear typically presents as a swollen, misshapen, and lumpy ear that resembles a cauliflower.

This pathology develops when blood accumulates between the cartilage and perichondrial soft tissue, disrupting the blood supply to the cartilage and leading to calcifications and fibrosis 1.

Auricular hematomas, if treated with proper dressing and in some cases drainage, soon after the pathogenic trauma, should not progress to cauliflower ear. Once a cauliflower ear has formed, surgery may be required to repair the damaged cartilage, for calcification extraction, and to restore the ear's normal appearance2.

Differential diagnoses may include of external ear calcification and auricular perichondritis or even relapsing polychondritis depending on the stage and presentation of the pathology.

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