Opening of a hematoma of the auricle. Provoking factors of hematoma, causes and treatment

Morphologically, an otohematoma is an accumulation of blood and lymph between the skin and the perichondrium or between the perichondrium and the cartilage of the auricle. It is formed as a result of violation of the integrity of regional vessels during mechanical separation of the above structures. The border capsule, as a rule, is not formed.

In case of violation of the blood coagulation system, significant traumatic damage to the ear may be absent. Otohematoma always occurs on the lateral (outer) side of the auricle, due to the higher elasticity of the connection between the skin and the perichondrium on the medial surface. Feature this pathology is a recurrent course, which is caused by weakness smooth muscle vascular walls this localization, local bleeding disorder and complex mechanism lymph drainage.

Causes of ear hematoma

Traumatic injuries of the ears occur due to the following influences:

Mechanical. Ear injury from a blow, bite, injury, during unsuccessful deletion foreign objects from the ear.
Thermal. High or low temperatures can cause burns or frostbite.
Chemical. Under the influence of substances, which include acids and alkalis.
Acoustic. At sudden appearance loud sound.

The development of a hematoma of the outer ear is more often due to damage blood vessels. Pathology can occur not only after being hit with a blunt object, but also from simple pressing. There are two reasons:

Traumatic, which occurs most often. A hematoma is formed after a blow to the auricle. Ear injury can be obtained in domestic, industrial conditions, in sports. This pathology observed also in athletes who are engaged in wrestling, boxing. In older people, it occurs after prolonged squeezing of the ear, for example, during sleep.
Spontaneous, which is formed after a simple pressure. Patients suffering from hemophilia, antiphospholipid syndrome, hemorrhagic diathesis, thrombocytopenia, beriberi, etc. are susceptible to such a pathology.

Possible causes of middle ear injury ear cartilage, can be reduced to the following:

random hits;
falling from a height;
sports injuries;
bruises in a fight;
bites of animals and insects;
thermal and chemical negative impacts;
too loud sound effect.

Even kick in lower jaw can damage the temporal bone and hurt ear canal.

Children are exposed to ear bruises no less than adults due to the fact that they are more active, inquisitive and often find themselves in various unforeseen situations.

The appearance of an hematoma should be considered as a consequence of a hemorrhage, which, in turn, occurred due to a bruise, or strong pressure on the ear canal. As a rule, this is the main mechanism for the appearance of a hematoma.

If timely medical care is not carried out, in this case, the likelihood of suppuration increases. The area where the bruise was inflicted does not receive proper nutrition, the ear cartilage gradually softens, losing its frame properties.

There are cases of spontaneous hematoma, when it occurs at the slightest pressure. This can happen when:

hemophilia;
beriberi;
leukemia;
any trophic disorders;
certain infectious diseases;

in an accompanying bleeding disorder.

In most cases, this diagnosis is observed in sports - boxing, some types of martial arts, wrestling without rules.

The main cause of hemorrhage is damage to the blood and lymphatic vessels auricle. The disease can be caused by both local effects on the outer ear and systemic pathologies. In this regard, 2 etiopathogenetic forms of otohematoma are distinguished:

Traumatic. The most common variant of the disease. A hematoma is formed as a result of tangential blows to the auricle or when it is broken. The causes are household, industrial and sports ear injuries. This pathology is most often found in athletes involved in boxing or other martial arts. In older people, an otohematoma can occur against the background of prolonged compression, for example, when squeezing the ear in a dream.
Spontaneous. Occurs as a result of a slight impact on the auricle in the presence of concomitant pathological conditions. Most often it is a bleeding disorder in hemophilia, antiphospholipid syndrome , oncohematological diseases, hemorrhagic diathesis, thrombocytopenic conditions. Also, the risk of hemorrhage increases beriberi, alimentary dystrophy , infectious diseases (hemorrhagic fevers – Ebola, Lassa, Marburg, Congo-Crimea), degenerative changes cartilage, prolonged exposure cold.

Characteristic features

There is a gradual or lightning-fast formation of a tumor inside the auricle. When a large swelling forms, it fills the entire cavity of the outer ear. On examination, it is revealed:

swelling of a round or oval shape;
hyperemia of the ear with a bluish tint;
soreness.

With a mild hematoma, the patient does not feel pain during touching. A bruise may appear after damage to the blood vessels, but if the lymphatic component predominates, then the skin of the auricle remains unchanged.

Severe pain syndrome can occur with perichondritis or after hematoma suppuration

Symptoms of a hematoma of the auricle

An ear bruise is a fairly common mechanical injury that can be obtained even with a relatively mild bruise. With a slight hit, you can get slight bruise outer shell, and strong impact can damage the medium and even inner ear.

An ear bruise is often accompanied by such complications as an otohematoma, which appears as a result of hemorrhage of damaged vessels. In this case, a bluish swelling appears in the ear area.

How can you get hurt?

If you have an ear bruise, everyone should know what to do, but first let's figure out how people usually get it. Injury can occur when falling or hitting, and all parts of the ear are damaged. Swipe into the lower jaw can lead to a fracture of the temporal bone located near the external auditory meatus.

When a bruise breaks the skin or ruptures the pinna, it is important to prevent the entry of pathogens and subsequent infection.

Ear injury symptoms

Quite often, a bruised ear cartilage is accompanied by the occurrence of severe hematomas, and with more serious injuries, a transverse or longitudinal fracture of the pyramid can occur. In the latter case, such dangerous consequences as:

membrane rupture;
frequent liquorrhea;
bleeding from the ear canal.

An ear bruise with a longitudinal fracture of the pyramid leads to hearing loss, and with a transverse fracture, the labyrinth is damaged and facial nerve. As for the auditory and vestibular functions, they disappear, but the eardrum may not be affected. For exact definition the degree of damage, doctors conduct an x-ray examination.

Injury (bruise) of the outer ear can have symptoms:

redness;
the presence of a hematoma, bruise;
bleeding from the outer ear;
pain when touched, a feeling of pulsation at the site of injury;
headache, weakness;
swelling of the injured area.

If the damage also affected the middle and / or inner ear, then the following signs may be added:

bleeding occurs from inner ear;
complete or partial hearing loss;
congestion, noise in the ear;
lack of coordination;
sharp pain inside the ear;
nausea;
loss of consciousness.

These symptoms are often characteristic of a disease of the membrane and auditory ossicles.

As a rule, the hematoma is located in the upper part of the auricle. It is a swelling of a red-blue hue, covered normal skin. During palpation, a person does not feel pain. Pain is felt if the cartilage and perichondrium are injured.

Inside is a liquid from the blood and lymph, the latter prevails to a greater extent. Therefore, the color of the liquid is light yellow. In the case of a long absence of treatment, or infection, suppuration of the hematoma itself is observed.

It should be noted that the hematoma of the auricle is dangerous by secondary infection. Here, skin hyperemia with inherent inflammation can be observed, which can spread beyond the hematoma with fever and pain in the auricle.

The first signs of the disease are the gradual or rapid formation of swelling in the upper part of the auricle. Typical localization is between the curl and the shuttle. Small hemorrhages can be visualized in the area of the triangular or navicular fossa. Large otohematomas sometimes fill the entire cavity of the auricle - from the helix to the tragus or antitragus.

Outwardly, such a swelling is a round or oval fluctuating protrusion. The skin covering the otohematoma is usually hyperemic, with a bluish tint, but with a predominance of the lymphatic component, it can retain a normal flesh color. The auricle itself, with the exception of the lobe, thickens, and its contours are smoothed out.

With large volumes of hemorrhage, the ear takes the form of a "shapeless cake". Otohematomas of traumatic etiology are almost always accompanied by some soreness, a feeling of fullness and heaviness. Spontaneous and mild hematomas are painless when touched and are not accompanied by subjective sensations.

Diagnosis and treatment

Any individual injury requires detailed diagnosis and individual approach in treatment.

How to treat an ear injury? In the treatment of damage to the external ear, it is usually limited to treating the wound and taking antibacterial agents in order to prevent infection of the tissues. But the most common is the defeat of the middle ear. Injuries internal departments of the ear organ require careful diagnosis, which may include:

examination by an otolaryngologist;
otoscopy;
radiography;
MRI, etc.

With serious ear injuries, a transverse/longitudinal fracture of the temporal bone can occur. If the injury was accompanied by damage eardrum and for 2 months the hearing has not fully recovered, so it goes inflammatory process. An antibiotic is required. Damage to the auditory ossicles, as well as intracranial complications and incessant bleeding from the inside require surgical intervention.

In case of severe crush and rupture of cartilage, doctors perform surgical treatment, fix the edges of each wound with sutures and apply a bandage. Additionally carry out antibiotic therapy and physiotherapy: UHF currents, ultraviolet and other procedures. Warming up the bruised area will help improve blood circulation.

It is better not to treat a child’s bruised ear at home, but immediately contact an otolaryngologist to avoid negative consequences with the hearing organ in the future.

As a result of the injury, a blue ear often occurs. Rather, ointments from bruises will help to remove the hematoma. Also in such cases, you can use folk ways. For example, apply badyagi powder diluted with water, chilled cabbage leaf or aloe. If the hematoma is large, it may be necessary to open and remove its contents.

How long does an ear injury last? Usually, the tissues of the ears regenerate quickly and, with the right help, hearing quickly returns. Cleaning and washing the auditory passages are contraindicated. During treatment, it is necessary to periodically change dressing, treat a healing wound, observe proper nutrition and rest. Additionally, sulfonamides and tetanus vaccine are prescribed.

Diagnosis of otohematoma is not difficult. The main goal of an otolaryngologist in making a diagnosis is to determine the likely etiological factor and conduct differential diagnosis with other similar nosologies. The complete examination program includes:

Collection of anamnesis and complaints. The information obtained during communication with the patient plays one of the leading roles in the diagnosis. The presence of an otohematoma is indicated by recent traumatic injuries ear, concomitant decrease in blood clotting, professional boxing or martial arts.
Physical examination. In favor of an otohematoma, the presence of a symptom of fluctuation against the background of the absence or mild pain indicates. With the development of inflammatory complications during palpation, there is a sharp pain, local boost temperature and severe hyperemia of almost the entire surface of the auricle.
Laboratory tests. Their conduction is most informative in case of suspected spontaneous otohematomas, since there are no changes in the CBC in case of traumatic etiology of the disease. At comorbidities hemostasis in general analysis blood thrombocytopenia, pancytopenia, blast cells may be present. With hemophilia, a slowdown in the Lee-White blood clotting time and violations of the autocoagulation test (ACT) are determined. With suppuration of hematomas in the KLA, there are non-specific signs inflammation: leukocytosis with shift leukocyte formula to the left, an increase in ESR.
diagnostic puncture. As a rule, it is used for differential diagnosis. With traumatic hemorrhages, a mixture of lymphatic fluid and blood is obtained as a result of puncture. Spontaneous forms of otohematomas, as a rule, are filled only with non-clotting blood. Recurrent forms are characterized by the presence a large number lymph is a light yellow liquid that does not clot.

Differential diagnosis of otohematoma is carried out with primary perichondritis, erysipelas of the auricle, benign and malignant formations. Primary perichondritis is characterized by a diffuse lesion of the auricle, the initial absence of a symptom of fluctuation, often the presence of diseases of the outer and middle ear in history.

At erysipelas V pathological process the earlobe is retracted, there are vesicles with serous contents and a demarcation shaft, and from the first days of the disease there is a pronounced intoxication syndrome. Tumors are characterized by slow development, negative symptom fluctuations, lack of hyperemia skin and contents at a diagnostic puncture.

Treatment of bruises and ear injuries

After that, the ear must be bandaged very tightly to the head. After a couple of days, the bandage can be removed. If the treatment of the hematoma of the auricle has not been successful, the animal must be operated on. The hematoma of the auricle is opened, all blood clots are removed from it, the cavity is washed with a solution of novocaine with an antibiotic, and a ligature is applied to the vessel to improve the outflow of blood. After that, the surgical wound is sutured and protected with a special adhesive bandage.

Complications: if the hematoma of the auricle is not detected in time and treatment is not started, it can provoke the formation of cysts, as well as neoplasia.

Predictions: in almost all cases, the hematoma of the auricle is removed and successfully cured without all sorts of complications and consequences.

For bruises and ear injuries of varying severity Doctors carry out a number of activities:

For minor injuries treat the wound hydrogen peroxide or brilliant green and apply a bandage.
For dangerous damage when blood is released, antibiotics are prescribed to prevent the inflammatory process.
When a hematoma occurs the damaged area is opened and cleaned to prevent infectious inflammation. After that, a gauze bandage is applied to the wound.
When there is a rupture or deformation of the auricle performing reconstructive surgery.
When the tympanic membrane is ruptured the ear canal is treated with antiseptics using a cotton swab and drug treatment with antibiotics is prescribed.

At first, supervision is necessary medical specialist And proper care for damage, which includes changing the dressing material, treating the wound, observing proper nutrition and rest regime.

How to treat an ear bruise at home?

Two days after receiving a bruise, you can use the following methods of treatment at home:

Warm compress relieves pain helps to restore blood circulation.
Light massaging the affected area helps with mild pain.
Treatment of bruises with bruises contributes to its speedy healing.

Folk remedies for pain relief

The following means traditional medicine help reduce pain and help eliminate hematomas:

Ear injury symptoms

Therapy depends on the extent of the injury. But to open the hematoma and carry out preventive actions to prevent the development of complications will have with any method. For this apply:

Pressure bandage. It is necessary for minor hematomas to stimulate spontaneous resorption. For a greater effect, it is recommended to pre-treat the affected area with iodine, and fix several gauze rollers over the formation. First aid is that immediately after the injury, you need to apply cold to the affected ear. Massage of the auricles should be carried out on the 4th day of treatment.
Puncture aspiration. Manipulation is carried out with the development of swelling large sizes and late visits to the doctor. The procedure consists in the fact that the specialist pumps out the liquid from the hematoma with a syringe, and injects one drop of iodine inside. An alcoholic solution of iodine helps to accelerate the development of a cicatricial septum between the walls. After the procedure is completed, a sterile dressing is applied to the ear area.
Hematoma opening surgically. Surgery indicated when the aspiration method fails positive result. The surgeon makes an incision along the edge of the formation and carefully removes its contents. The cavity is further treated with antiseptic solutions, sutures are applied and a drainage system is installed. A few hours after the completion of the operation, the doctor fixes pressure bandage. Dressing should be done daily.
Antibacterial therapy. Antibiotics are prescribed for any method of treatment to prevent the occurrence of secondary infection. Sulfonamides, 3-4 generation cephalosporins, aminoglycosides are widely used.

Sliced potatoes, honey with aloe, honey ointment with the addition of wormwood will help to dissolve the formation.

Treatment lumbar sciatica at home

The prognosis of the disease is quite favorable, the person recovers completely within two weeks. Occurrence cosmetic defect depends entirely on timely assistance.

If the swelling is small, a tight pressure bandage is applied. Before applying a bandage, the skin around the hematoma is treated alcohol solution iodine. For greater efficiency, the pressure is fixed with a band-aid. Cold is also used. After 2-3 days, a special massage is possible.

With a large hematoma, the contents are aspirated with a syringe and a thick needle. Everything is done under strictly sterile conditions. Then a small amount of an alcoholic solution of iodine is introduced into the cavity so that the walls of the cavity are more likely to heal. Next, a pressure bandage is applied. In case of suppuration, an extensive autopsy is performed, followed by the removal of dead tissues.

The prognosis of recovery directly depends on the timing of seeking help from an ENT specialist.

Therapeutic tactics depends on the size of the hemorrhage in the auricle. The essence of the treatment is the emptying of the otohematoma cavity and the prevention of development bacterial complications. For this purpose, the following are used:

Pressure bandage. It is the method of choice for small otohematomas. Due to this, spontaneous resorption of the hemorrhage is stimulated. To increase efficiency, before applying a bandage, the skin is treated with an alcoholic solution of iodine, and 2-3 gauze rollers are fixed over the formation. Additionally, in the first few hours from the onset of a hematoma, cold is used, and after 2-4 days - massage.
Puncture aspiration. It is carried out with large accumulations of lymph and blood that occurred less than 3 days ago. Under aseptic conditions, with the help of a syringe and a needle, the entire contents of the hematoma are evacuated. Further, 1-2 drops of an alcohol solution of iodine are introduced into the resulting cavity in order to accelerate the formation of a scar between the walls. After this manipulation, a bandage is also applied.
Opening of a hematoma of the auricle. Surgical intervention is necessary if it is impossible to empty the hematoma by aspiration. During the operation, an arcuate incision is made along the edge of the hematoma, after which all its contents are removed. Next, the formed cavity is treated with antiseptic preparations, sutures are placed on the wound or a drainage system is installed. Some time after the operation, a pressure bandage is also applied, the bark is changed every day.
Antibiotic therapy. It is prescribed for any treatment option in order to prevent secondary infectious complications, abscess formation or secondary perichondritis. Antibiotics are the drugs of choice a wide range actions from the groups of sulfonamides, III-IV generation cephalosporins, aminoglycosides and others.

First aid for ear hematoma

Injury without injury skin tissue you can apply a cold object to the sore spot. This will help relieve swelling and reduce hematoma. Ice wrapped in a clean cloth is a good remedy. You can also use a cold water bottle, milk carton, etc. You need to keep a cold object for no more than 20 minutes, since prolonged freezing can lead to necrosis of the skin.

In case of minor injuries in the form of a bite, scratches, it is necessary to treat the damaged area with brilliant green, iodine or hydrogen peroxide. Then you need to protect the wound from dirt and dust, using a gauze bandage or adhesive tape.

For more serious types of wounds (cuts or tears), you need to press the wound with your fingers to stop the bleeding.

Clear damage cotton swab moistened with hydrogen peroxide, and treat the area near the wound with iodine or brilliant green.

Apply a gauze bandage, secure with a bandage.

In the event that part of the ear is torn off or cut off, it must be preserved. To do this, you need to put it in clean polyethylene, lower it into a container with cold water and deliver it along with the victim to the hospital. Within 10 hours it is possible to sew on the torn part.

If the eardrum is damaged, it is necessary to put a cotton pad on the ear, strengthen it with a bandage and urgently deliver the patient to a medical facility.

In case of injury and bruising of the ear, in no case should you do:

Insert cotton wool or a napkin into the ear canal. This will prevent blood and fluid from escaping from the wound.
Independently rinse and cleanse the body.
If you get a burn or frostbite, warm up, rub or cool the damage. This can damage hearing and change the shape and appearance of the pinna.
Independently remove foreign objects from the ear. This can lead to their penetration deep into the body and significantly aggravate the situation.

If a person has been injured in the ear area, care should be taken to ensure that the bruise does not develop into a painful hematoma. Cold is applied to the site of injury for 20 minutes. Take care to prevent tissue frostbite by placing the ice in a plastic bag and wrapping it in a towel. After the time has elapsed, take a short break, for 10-15 minutes and repeat the procedure.

If the hematoma of the auricle is still formed, you should not hesitate to solve the problem. At the first sign of blue skin of the ear, you need to act immediately, even if you do not feel severe discomfort. Contacting a competent ENT doctor will give you a complete picture of the condition of the bruise.

Performing this procedure at home and without a special tool will not be easy. This procedure is quite painful and requires anesthesia. Yes, and the lack of certain skills can cause great harm to your health.

Traumatic ear hematoma

How is the procedure for the treatment of ear hematoma

Having made local anesthesia, blood clots are removed by means of a vacuum medical pump or syringe.
The ear cartilage is examined to determine if there is any damage. Cartilage fractures can form outgrowths and, in the future, spoil appearance person.
The hematoma is opened with a scalpel. This is done in order to carry out proper disinfection and make the healing process faster.
If the operation to open the tumor is carried out no later than 5 hours after the formation, then there is absolutely nothing to fear. The patient is prescribed a course of antibiotics, which speed up healing, help restore the whole body and fight infections. Electrophoresis procedures may also be prescribed.

How long do bruises go under the eye

At home, you can use lotions from medicinal herbs. Before the doctors arrive, apply a cold compress to your ear. The use of funds for the treatment of bruises is also allowed. If the hematoma hurts very much, use an anesthetic ointment. Creams with extracts of leeches and shark oil well remove the tumor and accelerate the healing of the bruise.

An onion compress will help soothe the pain. To eliminate itching, you can use lotions from heated glycerin. It will not only reduce the desire to comb the bruise, but also reduce the size of the hematoma. You can relieve the heat with a green tea compress. The iodine mesh will warm up the hematoma of the auricle well.

Levomekol ointment for hematoma resorption

In the case of only external damage, treatment may be limited to first aid. If the auricle is damaged and there is slight bleeding, it is necessary to treat the damaged area with hydrogen peroxide, chlorhexidine bigluconate or any other antiseptic.

In case of more significant injuries, the victim must be provided not only with first aid, but also brought to the clinic, trauma center or ENT department of the hospital as soon as possible. If blood has flowed from the ear canal, it is necessary to introduce a shallow sterile cotton wool (tampons) inside and then apply a bandage. This will help stop the bleeding and get to the doctor sooner.

It is better for the victim to ensure peace and in no case should you independently wash, clean the ear canal after an ear bruise.

After a bruise, the ear swells, what to do in this situation? Often there is a bluish swelling at the site of injury due to hemorrhage of affected vessels. Due to swelling of the tissues in the area of the passage, hearing difficulties may appear, and accumulated air and fluid may also come out of the ear. Cold compresses will help relieve swelling and reduce hematoma (cold exposure can be carried out for no longer than 20 minutes in one procedure).

With a severe injury to the auditory organ, you need to get to the doctor as soon as possible in order to get professional help, including the speedy stitching of the auricle. There are cases when there is a complete detachment of part of the ear.

In this case, it is important to create a sterile cold environment for this part (ice pack or wetted cloth) and transport it together with the victim as soon as possible to the hospital. If everything is done correctly and within 10 hours after the incident, an operation is performed to reattach the torn ear, then the hearing organ will most likely be completely restored.

Complications and consequences

Pulmonary fibrosis: treatment with breathing exercises, nutrition and folk remedies

hyperemia and inflammation that go beyond the boundaries of hemorrhage;
severe pain that radiates to nearby tissues;
increase in body temperature.

If you do not receive treatment at this stage of the disease, the abscess is replaced by perichondritis - the disappearance of the contour of the auricle due to purulent fusion of cartilage. Also, the infection can penetrate into the middle ear, after which laryngitis, otitis media, etc. can occur.

If happened serious injury ear, and timely proper medical care was not provided, then the victim may face disability or even death in the most unfavorable situation.

In the event of any ear injury, it is very important to prevent the development of infection: treat the wound and take antibacterial agents treatment.

If you ignore the symptoms of damage to the middle ear and untimely assistance, complications may subsequently arise: chronic otitis media, mastoiditis. Also possible Negative consequences in the form of hearing disorders, vestibular disorders.

Preventive measures will help to avoid the above: avoid noise, clean your ears properly, wear a protective helmet when riding a motorcycle / bicycle, active sports, observe traffic rules and others.

Most common complication- transformation into an abscess of the auricle. This occurs as a result of secondary infection in time not removed contents of the hematoma. Clinically, abscess formation is accompanied by hyperemia of the skin of the ear, which extends beyond the hemorrhage, a significant increase pain syndrome, the occurrence of irradiation of pain in adjacent structures.

Forecast and prevention

In order to prevent ear injuries, you need to follow preventive measures. It is necessary to carry out proper cleaning ears, avoid loud noises, wear a safety helmet when cycling, follow the rules traffic and speed while driving.

Getting to work with increased level noise, you need to pass the test for the degree of ear fatigue. At long recovery hearing after passing the test, it is not recommended to get a job like this. If you have successfully passed the test, you should always use personal protective equipment against noise and observe safety precautions during work.

In the event of an ear injury, it is necessary to provide the victim with first aid, and then deliver him to a trauma facility. Treatment of injuries and bruises at home, as well as application folk remedies should be agreed with the attending physician.

The prognosis for recovery from otohematoma is favorable. Depending on the method of treatment, recovery occurs within 3 days to 2 weeks. With regard to a cosmetic defect, the prognosis is doubtful - the development of an irreversible deformation of the auricle depends on the modernity and usefulness of medical care.

specific preventive measures for this disease has not been developed. TO nonspecific prevention include avoiding injury or compression of the outer ear, careful antiseptic treatment and hemostasis of the resulting injuries, correction of blood clotting disorders, treatment of other concomitant diseases.

Hematoma of the auricle (or otohematoma) is a disease of the ears, which, as a rule, has a traumatic nature. We can assume that this is just a bruise. Actually, almost every person with a bruise thinks so and does not seek medical help. But almost a quarter of cases lead to suppuration, and sometimes to sepsis and necrosis, which develops on the third day after the injury, and all due to the fact that a person with a hematoma did not turn to an otorhinolaryngologist in time.

So what is the difference between hematoma and a simple bruise? With hematomas, hemorrhage occurs due to damaged blood vessels, as a result of which an accumulation of wound exudate and blood clots occurs under the skin. This is a kind of tumor that forms on the auricle. It is localized in the upper part of the ear and has a round or oval shape. The color of the formation is usually red-blue. If you press on it, you can feel how the liquid flows inside. The affected auricle hurts, itches. and "burning". Sometimes noise and ringing in the ears may occur. IN rare cases, the pathology may be accompanied by dizziness. A bruise also occurs due to bruises, but superficial tissues are injured. The injured area of the skin turns blue, but after a few days it restores its color.

A hematoma can develop for several reasons:

household bruises;
sports injuries (the disease is often called "wrestler's ear");
blood diseases;
diseases of the blood vessels;
infectious diseases (for example, scarlet fever);
fulfillment medical manipulations(for example, during plastic surgery).

medical service	price, rub.
Opening of a hematoma (including festering) of the auricle (on one side)	5000
Initial appointment with an ENT doctor	2000
Repeated appointment with an ENT doctor	1500
Initial consultation with the head of the clinic	4000
Repeated consultation of the head of the clinic	2000
Additional consultation during the procedures	500
Adaptation of the child to the ENT office	2000
Adaptation of the child to the ENT office by the head of the clinic	4000

The treatment of the ear shell must be taken very seriously! In the absence of proper and timely treatment of a person from a hematoma, complications such as: otitis media, purulent abscess, sepsis, perichondritis, ear deformity and even tissue necrosis..

Application ear drops and testing the advice of traditional medicine on yourself will not lead to recovery! It is necessary to treat an ear injury on time and strictly under the supervision of an otorhinolaryngologist.

Hematoma treatment

The first stage in the treatment of otohematoma, like any other disease, is diagnosis. As a rule, ENT is enough for a doctor visual inspection to determine the presence of an otohematoma. If there is a suspicion of crushing and deformation of the cartilage, the patient is sent for an X-ray examination. If there is a high risk of joining purulent infection an ENT doctor prescribes a smear to determine the pathogen.

In cases where the tumor is large or suppuration has occurred, the otorhinolaryngologist prescribes an autopsy of the otohemotoma. Before opening, the affected area is treated antiseptic solution, and is carried out local anesthesia. The tumor is opened with a scalpel. With the help of a syringe or vacuum suction, purulent masses and blood clots are removed. After the procedure, the patient is prescribed a course of antibiotic therapy.

If the hematoma is small, instead of opening, a pressure bandage is applied, which contributes to the gradual "resorption" and restoration of the shape of the ear.

If the hematoma arose a few days ago and the formation is small, the ENT doctor treats it with an antiseptic, makes a puncture with a syringe and pumps the contents out.

Which method of treatment to choose in a particular case, is determined by the doctor - otorhinolaryngologist.

Carrying out the procedure in Moscow

Opening of hematomas is carried out by many medical institutions Moscow, where an ENT doctor takes them: these can be large multidisciplinary medical centers, and there may be highly specialized private clinics. Price policy each medical institution has its own, so the price for the same procedure in different clinics will be different.

Ear hematoma - dangerous formation, because pus can accumulate inside it, so you should pay attention Special attention for her treatment.

How to distinguish a bruise from a hematoma

In order for the treatment to be effective and not harm your health, you need to know how to distinguish a hematoma in a person's ear from a simple bruise.

A bruise on the ear is a bruise that occurs due to mechanical influences - bruises. It can appear even with minor blows and is characterized by a blue discoloration of the injured area, which is explained by hemorrhage into the superficial tissues. Often the bruise resolves after a few days, so it does not pose a big threat.

A hematoma (otohematoma) is similar to a bruise in nature of its origin, but is a much more dangerous manifestation of mechanical impact. The cause of the appearance can be both sports injuries, and just a blow to the ear. It is also worth noting that otohematoma also manifests itself, for example, when cosmetic procedures(ear piercing) or with a disease of the vessels or the circulatory system.

It is a kind of tumor on the surface of the ear and is an accumulation of a blood clot under the skin, between the cartilage and the perichondrium, which has come out of damaged tissues. Such skin has a red or bluish color. The hematoma is localized in the upper part of the auricle, looks like a round or oval formation. It is characterized by fluctuation - if you press on the affected area with gentle movements, you feel a wave-like movement of fluid in the hematoma.

Treatment Method

The main task of treatment is to extract fluid from the hematoma and provide preventive measures preventing complications. At the first manifestations of a hematoma, it is worth applying cold.

If the tumor is small, it is necessary to apply a pressure tight bandage. This action will lead to a gradual release of fluid from the hematoma. You can wipe it with an alcohol solution of iodine - this will speed up the healing process, the formation will resolve within 3 days.

But there are situations when the hematoma lasts more than 3 days, increases in size and hurts. In this case, you should definitely consult a doctor. Doctors can solve this problem in various ways, depending on the nature of the hematoma itself.

If there is no threat of complications, the hematoma is pierced with a syringe and the contents are sucked out. After that, a pressure bandage is applied for an average of 2-3 days.

If there is a threat of infectious inflammation, the formation is opened. The affected area is also treated with antiseptics, then an incision is made along the formation and cleaned out. After that, the wound is sutured along the edges, leaving the middle intact. This is necessary for further drainage - the introduction of one edge of the rubber strip into the wound (the second is brought out), along which the remnants of the contents will come out.

During treatment, doctors prescribe antibiotics and pain medications. After therapy, you will need to come back for a follow-up appointment.

Ear hematoma can cause:

purulent perichondritis - pus accumulates under the skin, contributes to the melting of the ear cartilage and leads to ear deformity;
otitis media - inflammation of the ear from the outside;
abscess - an abscess formed as a result of an inflammatory process.

Therefore, it is necessary to immediately respond to the consequences of bruises, and it is best to carry out disease prevention, which includes providing the necessary equipment when playing sports, avoiding injuries at home and at work, medical examinations for the detection of diseases associated with circulatory system and vessels.

In contact with

Hematoma of the auricle - hemorrhage under the skin of the ear shell due to mechanical injuries. As a rule, such hematomas occur much more often in dogs and cats than in humans.

Treatment of hematoma of the auricle

In order to really clarify the diagnosis for the purpose of treatment, the skin in the area of \u200b\u200bthe hematoma is pierced and all the contents are sucked out with a syringe. Then, to treat a hematoma, a solution of novocaine and mezaton, or novocaine with adrenaline, must be injected into the damaged area on the auricle. A solution of novocaine is used in half a percent. After that, the ear must be bandaged very tightly to the head. After a couple of days, the bandage can be removed. If the treatment of the hematoma of the auricle has not been successful, the animal must be operated on. The hematoma of the auricle is opened, all blood clots are removed from it, the cavity is washed with a solution of novocaine with an antibiotic, and a ligature is applied to the vessel to improve the outflow of blood. After that, the surgical wound is sutured and protected with a special adhesive bandage.

Complications: if the hematoma of the auricle is not detected in time and treatment is not started, it can provoke the formation of cysts, as well as neoplasia.

Predictions: in almost all cases, the hematoma of the auricle is removed and successfully cured without all sorts of complications and consequences.

Causes of ear hematoma

The causes of the formation of a hematoma of the auricle are injuries. The blood that has poured out under the skin of the ear shell causes very painful sensations and itching, and this very often provokes scratching and further injuries. After some time, the part of the ear where the hematoma was formed becomes overgrown with connective tissue, as a result, the ear can be significantly deformed. If the capillaries have increased permeability, this can also cause a hematoma of the auricle. In some cases, a hematoma of the auricle can generally form without any visible reasons.

Symptoms of a hematoma of the auricle

Sharply and completely suddenly, a round and hot, fluctuating swelling appears on the ear shell, which greatly disturbs the animal with itching and painful sensations. Basically, this lesion is unilateral, but, in some cases, a hematoma can form on two ears at once. It is likely that the hematoma can grow and become much thicker. Such a hematoma of the auricle may be accompanied by otitis externa. If the animal is not provided on time medical care, the development of this disease will progress significantly.

Ear hematoma. Diagnosis, treatment and prevention.

veterinarian

Hematoma of the auricle (Othaematoma) is an acute surgical disease characterized by the release of blood outside the vessels of the auricle (hemorrhage) and its accumulation between the cartilage and the perichondrium or between the cartilage and the skin of the auricle.

Hematoma of the auricle occurs when subcutaneous damage to a vein or artery of the auricle with bruises, scratching, bites or squeezing.

More often, hematomas are found on the inner surface of the auricle, where they form as a result of injury to the anterior artery of the ear, located on inside ear cartilage. Less commonly, hematomas occur on outside ear as a result of damage to the internal auricular artery located on outer surface ear cartilage.

Hematoma of the auricle can reach a considerable size. It is usually formed very quickly in the form of a limited hemisphere on the inner or outer surface of the auricle.

As a rule, the owners pay attention to the thickening of the auricle or to the “swelling” on the ear. At the same time, in animals with erect ears, wringing and sagging of the ear is observed.

A fresh hematoma is a hot, painful lump in the thickness of the auricle, in which fluctuation can be detected. On unpigmented areas of the skin, redness with a cyanotic (cyanotic) tint can be noted. The animal is usually anxious, shakes its head, tries to reach the affected ear with its paws, tilts its head to the affected side.

On 2-3 days, crepitus is noted during palpation, soreness increases, inflammation of the base of the auricle develops.

In the absence of adequate treatment, small hematomas can organize themselves - degenerate into dense formations consisting of fibrin and connective tissue. Soreness and redness are usually

at the same time disappear, however the animal continues to feel discomfort.

Large hematomas often become infected, resulting in their suppuration. In this case, the adjacent tissues are melted by pus, which leads to spontaneous opening of the purulent pocket. This is often accompanied by necrosis of the cartilage of the auricle.

It should be noted that in both cases of arbitrary resolution of the hematoma of the auricle, as a rule, the shape and position of the ears are disturbed.

Hematoma of the auricle is usually diagnosed by clinical signs, and, in addition, to confirm the diagnosis, a puncture and aspiration of the contents of the seal are performed. To do this, the field for processing the puncture site is pierced with a sterile needle and a small amount of the contents is sucked out with a syringe. With a hematoma of the auricle, the punctate is usually liquid or moderately viscous, has a pink or red color, does not have bad smell. It should be noted that on the first day after the formation of a hematoma, the punctate is more viscous and has a more intense red color. Purulent character contents and a specific unpleasant odor, as a rule, indicate the development of an abscess of the auricle. If it is impossible to aspirate from the fluid compaction, we can talk about an organized hematoma or an abscess or a neoplasm.

Hematoma of the auricle, as a rule, requires surgical treatment. Even with very limited hemorrhages, cases of arbitrary resorption are extremely rare. Especially if a hematoma has formed on the anterior surface of the auricle as a result of damage to the deep auricular artery, when blood accumulates between the cartilage and the perichondrium, tightly adherent to the skin, which, unfortunately, is the most common. In this area, there are practically no absorption pathways. In addition, due to the deposition of fibrin on the walls of the cavity, resorption is even more difficult. In this case, the animal avoids head movements and keeps it tilted towards the damaged ear.

Manipulations for the treatment of hematoma of the auricle can be carried out as under general anesthesia and without anesthesia, which depends on the temperament of the animal. In any case, it is necessary to organize reliable fixation of the head and convenient access to the surgical field, as well as take into account what is most painful procedure is ear cartilage piercing.

In preparation for the operation, it is necessary to remove from operating field hairline and protect the ear canal from getting the contents of the hematoma.

et al. recommend opening a hematoma 4–5 days after its formation. This is probably due to the fact that, according to the authors, during this period, the damaged vessel of the auricle becomes thrombosed, which makes it possible to avoid additional bleeding.

Shakalov et al. consider the complete aspiration of the contents of the hematoma with a sterile needle and syringe, followed by suturing the skin of the auricle to the cartilage, as an alternative to opening the hematoma.

and others recommend that in the first hours after an injury, a pressure bandage be applied to the hematoma, and on days 3-4, open the hematoma and remove blood clots from the cavity. To prevent re-bleeding from a damaged vessel, it is tied up with a suture ligature. Further, having powdered the hematoma cavity with antiseptic powder, sutures and a protective bandage are applied to the wound. The sutures are removed on the 7th - 8th day.

The disadvantages of the above described methods, in our opinion, include the fact that in the first two, additional ligation of damaged vessels is not recommended at all, and when ligating a vessel according to the method of Belov and others, it is extremely difficult to correctly localize the damaged vessel and, therefore, conduct reliable hemostasis.

In his clinical practice we recommend opening a hematoma immediately after its appearance, since it is not uncommon for an unopened hematoma of the auricle to significantly increase in size after 4–5 days of waiting, which in turn increases the volume of surgical intervention.

After opening the hematoma and removing the liquid contents from the cavity, it is necessary to remove the fibrin lump adhering to the walls by scarification. Next, the straightened auricle is stitched with double threads, taking into account the uniform closing of the walls of the cavity throughout, laying gauze rollers along the length. The incision is not sutured. When bandaging, the ears are thrown back to the back of the head, and it is recommended to apply a cleansing ointment directly to the incision or apply a napkin moistened with an antibiotic or antiseptic emulsion. Rollers are removed for 5 - 8 days.

In our opinion, the advantages this method be:

1. reliable hemostasis due to the use of sutures with rollers, which helps prevent re-bleeding

2. outflow of exudate from the open cavity and hematoma; the possibility of using cleansing and disinfectants for the prevention of its suppuration.

With cartilage necrosis, extensive suppuration or the formation of a large organized seal at the site of the hematoma of the auricle, as well as with frequent relapses removal of the auricle is indicated.

Since the hematoma of the auricle is, as a rule, a consequence of injuries of the vessels of the ear, the main necessary condition Prevention is to avoid injury.

It is important to take into account the fact that often hematomas occur in animals suffering from various diseases of the outer and inner ear, causing anxiety and itching. Animals can injure the vessels of the auricle by combing their ears with their paws or on environmental objects. In lop-eared dogs, hematomas often form due to the fact that a dog that is experiencing discomfort in the ear area for some reason shakes its head and breaks blood vessels and hits the ears on the skull.

Most often, itching and anxiety in the neck area in animals cause internal and external otitis, different kinds acariform (scabies) mites, foreign bodies in the ear canal, ingress of water and other liquids into the ear canal.

It should be noted that purulent otitis media complicate the course of the hematoma of the auricle, since the close proximity of the focus of infection leads both to infection of the hematoma cavity, and can also cause suppuration of postoperative sutures.

Auricular hematoma is a common ear disease in dogs and cats. It requires immediate surgical treatment and further careful postoperative care. To prevent the disease, it is necessary to prevent injuries to the ear area of animals, as well as in case of animal anxiety in the ear area, carry out timely diagnosis and elimination of its causes.

Literature:

1. Private veterinary surgery /, etc.; Ed. .-L.: Kolos., 1981.

2. Diseases of dogs /, etc. - M .: Kolos, 1995.

3. Private veterinary surgery /, .-K .: Vyscha school, 1991.

Illustration: Diseases of dogs and cats /, etc.-K.: Vishcha school, 1984. – “Hematoma of the ear” p. 128. (and there is no scanner J)