Aural hematoma (hematoma of the ear)

A hematoma of the ear is an accumulation of blood between the cartilages of the ear flap, following a rupture of its tiny blood vessels. It is often caused by excessive scratching and agitation of the head. This is a condition that can affect both dogs and cats, though; those with droopy ears are at greater risk. Otitis externa is often to blame; however, the problem may be the result of a generalized dermatological condition, such as allergies.

A diagnosis is made from the owner’s story and clinical signs (the affected animal shakes its head and/or scratches his ears and there is swelling of the ear flap). We must then determine whether it is a hematoma of the ear, an abces, a seroma or a tumor. This is done by an aspiration of the ear’s liquid by a very fine needle and the macroscopic and microscopic evaluation of that liquid. An otoscopic examination of the ear canal permits us to identify otitis externa, a possible foreign body, and evaluate the integrity of the ear drum. A microscopic evaluation of the secretions drawn from the canal, may determine the evidence of ear mites, yeast or bacteria. In the last case, a bacterial culture of the secretions is indicated. Supplemental testing may be necessary to determine the cause of a generalized dermatological problem (thyroid profile, intradermic atopy, flee search, a hypoallergenic diet trial in cases suspected of food allergies) or to detect the presence of concomitant otitis media (from a scan or x-rays of the skull).

Otitis externa must be aggressively treated to cease agitation of the ear. Cortisone may be administered so as to reduce inflammation and itch. Antibiotics should be administered to treat possible secondary infections. The hematoma should be drained as quickly as possible. Several techniques may be used; surgery, placing a cannula, placing a negative pressured drain, or creating openings (small holes) on the inside of the ear flap. The goal of thee procedures is to permit continuous drainage so that the layers of tissue of the ear flap adhere to one another. A bandage must also be placed as to prevent further trauma from the animal and to promote adhesion of the tissues.

Simply removing the accumulated blood by aspiration with a needle will have an immediate effect on the hematoma, however, most of the time it will reappear a few hours later. A cortisone injection at the hematoma's site may increase the medical treatment’s success.

Possible complications of a hematoma of the ear are, a relapse following treatment especially when the primary cause has not been controlled and if drainage is inadequate. We may also observe a malformation of the ear flap following healing, especially if the hematoma was not recent when treated.

If you have any questions, we encourage you to contact our clinical staff.