WHAT IS AN AURAL HEMATOMA?
A hematoma is swelling created by a broken blood vessel after bleeding has occurred inside a tissue. Hematomas within the earflaps (“aural hematomas”) occur when head shaking breaks a blood vessel within the earflap. The earflap may partially or completely swell with blood. The swelling may be so large that the opening of the ear canal is occluded. The extra weight of the earflap may be uncomfortable and may lead to a permanent change in the carriage of the ears. This condition is more common in dogs but can occur in cats as well. The earflap will feel fluctuant and fluid-filled, like a water balloon.
WHY IS AN AURAL HEMATOMA A PROBLEM?
A small hematoma may not actually be a problem and may not require repair. There are several situations where the hematoma should be repaired:
WHAT DO WE DO TO RELIEVE IT?
There are probably as many ways of correcting ear hematomas as there are veterinarians. The following are some commonly performed procedures:
ASPIRATION – This procedure involves simply using a syringe to remove the fluid contents from the hematoma. The problem is that a space is left behind when the fluid is removed and this space readily refills with more fluid leading to only temporary results. The benefits of the aspiration method are that it is inexpensive and relatively easy to perform but the disadvantages are that it may introduce infection and may require multiple attempts. If the clot in the hematoma is already well organized and on its way to scarring, there may not be much fluid left to aspirate and the technique may not work at all. Usually other methods are utilized.
WHAT IF THERE IS A CONCURRENT EAR INFECTION?
Usually there is a reason why a dog has been shaking his/her head: an ear infection. This means that the ear infection must be treated along with the hematoma. The ear will need cleaning, microscopic examination of the discharge, and medication. Sometimes ear shaking just happens and there is no underlying infection but one should be prepared for the expense and trouble of treating an ear infection along with that of the hematoma.
For more information on ear infections click here.
WHAT IF WE LEAVE IT ALONE?
If left alone, an ear hematoma will resolve by itself. The fluid will be re-absorbed back into the body and the earflap will no longer bulge. The problem is that a lot of scarring is associated with this process and the ear is often not cosmetically appealing afterwards (i.e. it becomes a “cauliflower” ear). Resolution of a large hematoma can take several months during which it may be uncomfortable for the pet. If the patient is a poor anesthetic risk it is certainly reasonable to forgo surgery.
Post-op photos - ear canal is open to prevent infection, but ear carriage does not match the normal ear.
As with dogs, the feline hematoma is generally brought about by ear infection and subsequent head-shaking. (In cats most ear infections stem from ear mites but there are plenty of exceptions). Bandaging is often used post-operatively as is the Elizabethan collar to protect the ear from scratching. The cat will need confinement during a healing period of approximately 3 weeks
Page last updated: 7/10/2013