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ENT · Otology: auricular haematoma
Sample itemA wrestler has a tense, purple swelling of the upper pinna after a blow, and the contours of the ear are lost. What is the correct management and what is the risk if it is left?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Prompt drainage of the haematoma with a pressure dressing, to prevent cauliflower ear from cartilage necrosis and fibrosis
A subperichondrial haematoma separates the cartilage from its perichondrial blood supply. If it is left, the cartilage becomes ischaemic and is replaced by fibrous tissue, giving a permanent cauliflower deformity. Treatment is early aspiration or incision and drainage with a compressive dressing or bolsters to prevent reaccumulation, with antibiotics if needed.
Option by option
A. Reassurance, since it will resolve within days
Delay leads to permanent deformity.
B. Ice packs alone
Ice reduces swelling but does not evacuate the clot.
C. Oral antibiotics alone
Antibiotics do not remove the collection.
D. Prompt drainage of the haematoma with a pressure dressing, to prevent cauliflower ear from cartilage necrosis and fibrosis (correct)
Correct. Drainage and compression prevent cartilage necrosis and cauliflower ear.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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