Interventions for acute auricular haematoma

Acute auricular haematoma is a condition where a collection of blood forms in the pinna (external ear), often following blunt trauma. If untreated it will result in the 'cauliflower ear' or 'wrestler's ear' deformity.

We searched for trials in adults or children who had sustained a haematoma. Treatments could be simple aspiration of the haematoma, incision and drainage and any post-drainage procedures (such as splinting or bandaging) to prevent re-accumulation of the haematoma. We found no trials of good quality to demonstrate that any one technique to remove the haematoma and prevent its recurrence gives the best cosmetic outcome. The literature, however, generally suggests that treatment is better than leaving a haematoma untreated. Well-designed studies are required.

Authors' conclusions: 

There is no clearly defined best treatment for acute auricular haematoma. There are no good quality data to determine either the optimal management strategy or even whether post-drainage intervention (such as splinting or bandaging) is necessary. Further research is required before any specific treatment may be recommended.

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Background: 

This is an update of a Cochrane Review first published in The Cochrane Library in Issue 2, 2004 and previously updated in 2005 and 2008.

Acute haematoma of the pinna is a condition where a collection of blood forms beneath the perichondrial layer of the pinna. It is usually caused by blunt trauma and if untreated will ultimately result in a deformity commonly known as 'cauliflower ear' or 'wrestler's ear'. Various treatments are employed to relieve the haematoma but no clear consensus exists on the best way to do so in order to produce the best cosmetic result with the least permanent deformity.

Objectives: 

To assess the effectiveness of treatment options in acute auricular haematoma.

Search strategy: 

We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 13 January 2011.

Selection criteria: 

Randomised controlled trials, case controlled trials and cohort studies including children and adults undergoing any intervention for acute auricular haematoma.

Data collection and analysis: 

No studies are included in the review. We identified 59 references from the original searches; we retrieved and assessed 48 for eligibility. None met the inclusion criteria. No studies which met the inclusion criteria were identified when the search was updated in November 2005 (from 16 references), November 2008 (6) or January 2011 (10).

Main results: 

Due to the lack of data from trials fulfilling selection criteria no results could be presented.

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