Tutorial - Aural Seroma and Haematoma
An aural seroma is a collection of fluid between the cartilage and the perichondrium of the pinna. They may arise for no reason (spontaneous seroma) or may form after ear trauma.
Most commonly they affect the upper part of the pinna but they can occur around the concha as well.
Symptoms and Signs
A soft, fluctuant swelling covered in normal, non-inflamed skin is seen. They aren't painful.
The images show the a seroma of the right upper pinna and other seromas around the concha.
Aspiration of the seroma is usually performed and a clear, yellow fluid is removed. It is sometimes blood stained. However, seromas tend to recur if this is all that is done. So a pressure dressing is very often required to prevent recurrence.
The simplest way to provide pressure is to stitch a button or a small cotton dressing over the aspirated seroma. The pressure dressing can be removed in around three to five days and the seroma is unlikely to return.
The images show the fluid that can be aspirated from a seroma and a button sutured over the seroma to orevent recurrence.
A cotton dressing can be used instead of a button.
This is a collection of blood between the cartilage of the pinna and the perichondrium. There are many similarities between this and an aural seroma except that these are nearly always caused by trauma, the fluid is blood or a blood clot and the skin over them is often bruised or bloody from trauma.
The images show two aural haematomas.
Simple aspiration of these does not usually work and it is common for an incision and drainage to be performed under local anaesthetic. Pressure dressings are often required to prevent recurrence. The local ENT department will be able to do this.
Untreated a haematoma will eventually resolve and be replaced by dense scarring and the appearance of a 'cauliflower ear' as seen below.