Aural Hematoma

Associated Terms:

Auricular Hematoma, Boxer Ear

The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery. Only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called specialists in veterinary surgery.

Your ACVS board-certified veterinary surgeon completed a three-year residency program, met specific training and caseload requirements, performed research and had research published. This process was supervised by ACVS Diplomates, ensuring consistency in training and adherence to high standards. After completing the residency program, the individual passed a rigorous examination. Only then did your veterinary surgeon earn the title of ACVS Diplomate.

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Overview:

An aural hematoma is a collection of blood within the cartilage of the ear and the skin. This is most commonly the result of external physical trauma to the pinna (the “flap” of the ear) or self-inflicted injury from your pet’s scratching and head shaking secondary to infection of the external ear canal. The condition is common in dogs with chronic otitis externa and less common in cats. Hematoma formation has also been associated with increased capillary fragility (e.g., as seen with Cushing's disease).

Sources of irritation to the ear linked to the development of an aural hematoma include:

inflammation
immune mediated diseases
allergies
parasites
foreign bodies
trauma (bite wound or blunt trauma)

Most animals usually have an associated infection. Recurrence of the condition is common if the underlying condition is not resolved.

Signs and Symptoms:

Figure 1

Swelling associated with an aural hematoma is most apparent on the concave inner surface of the pinna (Figure 1). The swelling is soft, fluid-like and warm in the early stages. With time, scar tissue will thicken and deform the ear, resulting in a cauliflower contracture.

Diagnostics:

A few simple tests may be performed to make sure there is not an underlying reason for the ear being irritated or hard to heal from the bleed.

fine needle aspirate and cytology
systemic testing for underlying causes may include
- allergy testing
- ear swabs
- endocrine testing

Treatment:

Pet owners should contact an ACVS board-certified surgeon for advice early in the disease process before chronic changes occur in order to achieve the best results. Treatment options include needle aspiration and bandages, tube drainage systems, incisional drainage and/or tacking sutures to eliminate the space that fluid can accumulate. The goals of surgery are to remove the hematoma, prevent recurrence and retain the natural appearance of the ears. Surgery typically includes making an incision on the underside of the ear flap to drain the fluid and followed by placing several sutures to prevent fluid from building back up. A bandage is typically placed after surgery for days to weeks to help decrease swelling, discharge, and trauma.

Aftercare and Outcome:

Deformity of the ear can occur if the condition is left untreated. This typically will leave the animal with a “cauliflower” ear. Potential complications include:

cosmetic alteration of the ear
recurrence of the hematoma
necrosis (death) of the pinna

A bandage should be placed to protect the ear from infection and self-inflicted trauma. Infection can occur in the surgical site if surgical wound is not managed appropriately with bandages.

Aural hematomas seldom recur if they are properly treated and the underlying disease is appropriately addressed. This condition can be prevented by providing prompt attention to conditions that result in irritation of the ears.

Content Theme:

Animal Owners

Also known as:

Aural Hematoma

Auricular Hematoma

Boxer Ear

This Animal Health Topic was written by and reviewed by Diplomates of the American College of Veterinary Surgeons. Any opinions stated in this article are not necessarily the official position of the American College of Veterinary Surgeons.

The American College of Veterinary Surgeons recommends contacting an ACVS board-certified veterinary surgeon or your general veterinarian for more information about this topic.

To find an ACVS Diplomate, visit www.acvs.org/find-a-surgeon.

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