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Perichondrial Hematoma: Treatment For Cauliflower Ear

Perichondrial Hematoma: Treatment For Cauliflower Ear

Cauliflower Ear – Perichondrial hematoma

Perichondrial hematoma, more commonly known as cauliflower ear, is a deformity of the outer ear usually seen after experiencing blunt trauma to the ear, causing damage and bleeding. The injury can cause the ear to have a lumpy appearance which bears some semblance to a cauliflower head, hence the name. When left untreated, the blood supply to the outer ear can be disrupted, which may cause permanent damage. Fortunately, cauliflower ear can be easily prevented with protective equipment and treated by draining the blood or otoplasty surgery.


 In most cases, perichondrial hematoma/cauliflower ear is a complication from blunt trauma to the ear. The blood vessels in the outer ear rupture and eventually cause clots that disrupt blood supply (hematoma). Eventually, the cartilage supporting the structure of the outer ear can die, which can cause the soft tissue to fold in on itself, and form lumpy scar tissue, together giving the “cauliflower” look. Occasionally, cauliflower ear can also be a result of infection from disease or wounds from ear piercing. In any case, the result is similar: Blood clots or swollen tissue disrupt the blood supply to the ear cartilage, causing them to die and deform eventually.

Signs and symptoms

The most common signs and symptoms of perichondrial hematoma/cauliflower ear include

  • A recent history of either:
    • Blunt trauma to the outer ear
    • Disease/ailment affecting the ear, including inflammation and infection
  • Redness, bruising and/or swelling of the outer ear
  • Pain or tenderness
  • A deformity in the curvature of the ear

In the most severe cases:

  • Severe, conspicuous lumps and swelling of the outer ear, sometimes completely deforming it and possibly blocking the ear canal.
  • Impairment or complete loss of hearing
  • Tinnitus (ear ringing)
  • Frequent headaches

Even though cauliflower ear has very recognisable symptoms in the later stages, it is much harder to detect in the earlier stages when there is less blood pooling. Hence, you should always seek medical attention if your ear is swelling/bruising following a blunt blow or any other reason.


As opposed to treatment, it is much easier to prevent cauliflower ear from happening as it can be completely avoided with simple precautions.

  • When necessary, always wear protective gear to protect your ears, especially individuals who are at higher risk of having trauma to the ears (Example: Martial artists, wrestlers etc)
  • Avoid piercing in the upper ears as much as possible
  • Seek medical advice ASAP if your ears begin to swell, bleed, bruise or experience pain following a blunt impact, after a piercing or for any other reason.


Cauliflower ear should be treated as early as possible, not because it is particularly serious, but because the later stages can be easily prevented.

Once a doctor detects that there is blood pooling or clotting in the outer, they can easily remove them via a small incision or a syringe. The ear is usually carefully stitched to close any gaps that may accumulate blood and wrapped in a pressure bandage to reduce future bleeding. In most cases, the ear will recover relatively well.

If your ear is already deformed, then you will likely need to undergo otoplasty (plastic surgery of the ear). The surgeon will carefully remove any blood clots, dead cartilage and excessive scar tissue from the outer ear. If needed, some cartilage will be grafted from other parts of the body to give structure. The ear is then carefully sculpted and stitched connect the tissue to the cartilage.

The later cauliflower ear is addressed, the more complex the otoplasty will be, and the less likely that it will not relapse. Hence, it is important to seek medical advice as early as possible if you believe you are at risk and take the necessary precautions to prevent injury to your ear.

If you suffer from this condition and wish to undergo surgery to address it, contact us to arrange a consultation with our experienced plastic surgeon and learn more about our cauliflower ear treatment in Singapore.