Cauliflower ear
Encyclopedia
Cauliflower ear is a condition that occurs when the external portion of the ear suffers a blow, blood clot
Thrombus
A thrombus , or blood clot, is the final product of the blood coagulation step in hemostasis. It is achieved via the aggregation of platelets that form a platelet plug, and the activation of the humoral coagulation system...

 or other collection of fluid under the perichondrium
Perichondrium
The perichondrium is a layer of dense irregular connective tissue which surrounds the cartilage of developing bone. It consists of two separate layers: an outer fibrous layer and inner chondrogenic layer. The fibrous layer contains fibroblasts, which produce collagenous fibers. The chondrogenic...

. This separates the cartilage
Cartilage
Cartilage is a flexible connective tissue found in many areas in the bodies of humans and other animals, including the joints between bones, the rib cage, the ear, the nose, the elbow, the knee, the ankle, the bronchial tubes and the intervertebral discs...

 from the overlying perichondrium that supplies its nutrients, causing it to die and resulting in the formation of fibrous tissue in the overlying skin. As a result, the outer ear becomes permanently swollen and deformed, resembling a cauliflower
Cauliflower
Cauliflower is one of several vegetables in the species Brassica oleracea, in the family Brassicaceae. It is an annual plant that reproduces by seed...

.

The condition is most common among wrestlers
Wrestling
Wrestling is a form of grappling type techniques such as clinch fighting, throws and takedowns, joint locks, pins and other grappling holds. A wrestling bout is a physical competition, between two competitors or sparring partners, who attempt to gain and maintain a superior position...

, mixed martial artists and forwards in rugby union
Rugby union
Rugby union, often simply referred to as rugby, is a full contact team sport which originated in England in the early 19th century. One of the two codes of rugby football, it is based on running with the ball in hand...

.

Headgear (called a "scrum cap
Scrum cap
The Scrum cap is a form of headgear used by rugby players to protect the ears in the scrum, which can otherwise suffer injuries leading to the condition commonly known as cauliflower ears....

" in rugby, or simply "headgear"
Headgear (martial arts)
Headgear is padded helmet worn during sparring in the martial arts.-Boxing:Headgear is a padded helmet, worn on the head by contestants in Amateur and Olympic boxing. It effectively protects against cuts, scrapes, and swelling, but does not protect very well against concussions. It will not protect...

 in wrestling and other martial arts) that protects the ears is worn in wrestling and rugby, many martial arts, and other contact sports to help prevent this condition. For some athletes, however, a cauliflower ear is considered a badge of courage or experience.

Treatment

Because an acute hematoma can lead to cauliflower ear, prompt evacuation of the blood is needed to prevent permanent deformity. The outer ear is prone to infections, so antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...

s are usually prescribed. If the pressure is left alone without medical intervention, the ear can suffer serious damage. Pressure can build up and eventually rupture the ear drum. When this occurs, the ear may further wrinkle, and can become slightly pale; hence the common term "cauliflower ear". Cosmetic procedures are available which can possibly improve the appearance of the ear.

History

An extensive literature and serious science on this condition developed between the 1860s and the turn of the century. It was defined as "An effusion of blood or of bloody serum between the cartilage of the ear and its perichondrium, occurring in certain forms of insanity and sometimes among the sane". Alienists (psychiatrists) argued ardently that it was a symptom of insanity and had nothing to do with mechanical causes. Some thought it was involved in all types of insanity, while others thought it to be worse "in those forms of insanity in which the mental excitement runs high for any length of time". It was thought to affect the left ear more often than the right. Psychiatrists advanced various theories linking it to abnormalities of bone, blood, or brain in the insane. Others argued that it resulted from an interaction between nervous system degeneration in the insane, and mechanical causes such as the insane hitting themselves or being boxed around the ear by asylum staff (and it was pointed out that this might be the easier explanation for the higher prevalence in the left ear, since most staff were right-handed, rather than convoluted arguments linking it to the origin of the left common carotid artery). It was noted that it could occur to a lesser extent in sportsmen due to an interaction between mechanical blows and the heat and excitement of physical combat. By the end of the First World War the topic disappeared from the medical press and the experts moved onto new fashions. Its mainstream acceptance as a psychiatric symptom has been said to have relevance to scientific and conceptual concerns over psychiatric diagnosis today.

External links

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