Haematoma auris is a collection of blood between the auricular cartilage and perichondrium, usually caused by trauma that separates the perichondrium from the underlying cartilage on the anterior surface of the ear. Management requires evacuating the hematoma through aspiration or incision, with incision being made parallel to natural contours of the ear. Aspiration alone has a high rate of re-collection, so compression techniques like bandages or drains are used for 7 days to prevent re-accumulation before the perichondrium can re-adhere. After 7-10 days, surgery may be needed to remove organized hematoma and newly formed cartilage.

1. Haematoma auris
Haematoma auris is a collection of blood between the auricular cartilage & perichondrium.
Aetiology &pathology
The haematoma is usually produced by trauma although occasionally the spontaneous rupture of a
blood vessels may be the cause.
This haematoma occurs exclusively on the anterior surface of the auricle where the skin is tightly
adherent to the underlying perichondrium, so that the shearing forces applied to the ear separate
the perichondrium from the cartilage.
Skin glide over the perichondrium by intervening areolar tissue, so posterior surface of auricle no
haematoma.
Management options
The haematoma requires evacuation observing strict asepsis. This is achieved through either
aspiration with a thick bore or if this is inadequate an incision.
Incision on the anterior surface parallel to natural contours(helix or antihelix).
Posterior incision with removal of a small window of cartilage has been advocated.
Aspiration alone , a very high incidence of recollection until the perichondrium is again firmly
adherent (about 7days). In order to prevent this, the following options have been devised.
-the use of moulded pressure bandage or splits on both side of the pinna. Keeping them in
place long enough to effectively prevent re-collection can be difficult.
- a drain left in the incision site.
- a posterior incision with excision of a disc of cartilage & placement of a suction drain.
-through –and-through mattress or quilting sutures to apply compression.
After 7 to 10 days , aspiration is ineffective & most authors state that surgery for removal of the
organizing haematoma & newly formed cartilage with overlying perichondrium is necessary.