What is Aural Hematoma?

An aural hematoma is a collection of blood within the cartilage of the ear and the skin. It most commonly occurs due to 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. While more common in dogs with chronic otitis externa, it can also occur in cats. Hematoma formation has been associated with increased capillary fragility, such as in Cushing’s disease.

Signs & Symptoms:

• Swelling: The swelling associated with an aural hematoma is most apparent on the concave inner surface of the pinna.
• Texture: The swelling is soft, fluid-like, and warm in the early stages.
• Scar Tissue: Over time, scar tissue thickens and deforms the ear, resulting in a cauliflower-like appearance.

Diagnostics:

• A few simple tests may be performed to ensure there is no underlying reason for the ear being irritated or slow to heal from the bleed.
• These tests may include fine needle aspirate and cytology, systemic testing for underlying causes (such as allergy testing or endocrine testing), and ear swabs.

Treatment Options:

Pet owners should seek advice from an ACVS board-certified surgeon early in the disease process to achieve the best results. Treatment options include:

1. Needle Aspiration and Bandages:

   • Draining the hematoma using a needle.
   • Applying bandages to prevent fluid accumulation.

2. Tube Drainage Systems:

   • Inserting a tube to allow continuous drainage.
   • Effective for larger hematomas.

3. Incisional Drainage and/or Tacking Sutures:

   • Making an incision on the underside of the ear flap to drain the fluid.
   • Placing sutures to prevent fluid from re-accumulating.

Aftercare and Outcome:

• Deformity: If left untreated, deformity of the ear (a “cauliflower” ear) can occur.
• Complications:
  • Cosmetic alteration of the ear.
  • Recurrence of the hematoma.
  • Necrosis (death) of the pinna.
• Prevention: Prompt attention to conditions that result in ear irritation can prevent aural hematomas.

 

Remember, always consult a veterinarian for personalized advice tailored to your pet’s specific needs.