OTOHEMATOMA CRÓNICO

Abstract

INTRODUCTION The otohematoma is an accumulation of blood and / or serous fluid under the perichondral lamina of the auricle. It is frequent and is due, in most cases, to a blunt trauma. If left untreated, the fluid content is gradually replaced by scar tissue, causing a deformity of the auricle, known as "cauliflower ear" or "wrestler's ear", so it is essential to diagnose it early and perform a correct treatment. MATERIAL AND METHODS We present the clinical characteristics, treatment and evolution of 8 patients with chronic otohematoma, who were followed in our service for about 10 years. We describe the surgical technique used, illustrating one of the cases with a video. RESULTS Of the 8 registered patients, there was only one woman. The age ranged between 10 and 59 years. Except in one case, the affected ear pavilion was the left one. We intervened 3 patients surgically exposing the affected areas of the pavilion, removing the neoformed cartilage and applying on the skin a maintained understanding with points, for 2-3 weeks, which improved the deformity, allowing a patient to permeabilize the secondary stenosis of the duct auditory. In the rest, puncture and drainage was sufficient, with subsequent compression for 2 weeks. The repeated trauma of the pavilion, in the context of a cognitive deterioration, was the main reason for the chronicity of the otohematoma. In some cases, the cause was an incomplete and prolonged treatment over time. DISCUSSION The cartilage of the ear does not have a blood supply of its own, depending on the perichondrium to be nourished. The hematoma breaks this contact and deprives the cartilage of its nutrients, which can result in necrosis or infection. Necrosis and loss of cartilage, fibrosis secondary to infection or incomplete evacuation of the clot, they stimulate the perichondrium, which responds with the production of new cartilage, the main consequence of which is the disfigurement of the auricular pinna. The purpose of the treatment will be to prevent permanent deformity, taking into account the following basic principles: early evacuation of the hematoma, immediate restoration of contact between the perichondrium and the underlying cartilage to avoid necrosis and prevention of recurrences and infection.