Othematoma
| Classification according to ICD-10 | |
|---|---|
| S00.4 | Superficial injury to the ear |
| ICD-10 online (WHO version 2019) | |
A swelling of the ear caused by a bruise ( hematoma ) between the cartilage membrane and the cartilage structure of the auricle is called an othematoma or auricular haematoma .
root cause
In humans, the disease known as ear hematoma often occurs as a result of bruises or strains in the tissue, for example in wrestlers and boxers . In veterinary medicine, the injury is mainly known to domestic dogs ; it arises mainly traumatically through violent head shaking or as a result of inflammation of the outer ear ( otitis externa ).
Symptoms
The othematoma is usually painless. There is a bulging, serous, bloody effusion between the cartilage and the auricular cartilage on the anterior auricular side with fluctuation .
treatment
Human medicine
A human othematoma should be punctured, and an incision is also possible. Because of the risk of perichondritis , always proceed aseptically . In addition to applying a pressure bandage, antibiotic therapy can also be considered.
Veterinary medicine
Conservative therapy can be attempted in animals with low severity and fresh hematomas, for example systemic treatment with dexamethasone and, after a few days, puncture of the bruise, if necessary with instillation of dexamethasone into the wound cavity.
However, extensive hematomas must also be surgically removed in animals, as otherwise severe deformations of the auricle can result from the connective tissue organization of the hematoma or cartilage softening ( cauliflower ear ). For this purpose, the skin around the hematoma is opened, if necessary the ear cartilage is windowed and the hematoma is massaged and rinsed. Alternatively, the skin can be fenestrated with a skin punch. Then compressing swabs or special compresses are sewn on both sides of the ear, which exert pressure on the tissue for at least a week and, together with wound drainage, prevent the blood cavity from refilling. Alternatively, the skin can be firmly adapted to the ear cartilage with sutures made of non-absorbable monofilament suture material. After 10 to 14 days, the sutures are pulled. Antibiotic coverage is common. Another treatment option is to insert a drainage tube with a subsequent head bandage. The making of small incisions with a carbon dioxide laser with simultaneous activation of the attachment of the ear skin is also described. Alternatively, multiple treatments with leeches can be considered.
With both conservative and surgical treatment, any primary causes such as otitis externa or allergies must be eliminated.
literature
- H. Weerda: Oto-Rhino-Laryngology in Clinic and Practice. Volume 1, Thieme 1994, pp. 511-512.
- Thomas Lenarz, Hans-Georg Boenninghaus: Ear, Nose and Throat Medicine, 14th edition, Springer 2012, p. 69.
- Peter F. Suter, Hans G. Nobody (ed.): Internship at the dog clinic. 10th edition. Paul-Parey-Verlag, Stuttgart 2006, ISBN 3-8304-4141-X .
- Jeanette Bannoehr: "Blood in the ear" - othematomas in dogs and cats . In: kleintier specifically Volume 19, 2016, No. 1, pp. 10-20. doi : 10.1055 / s-0041-110289
