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Hematoma of the Ear Flap

General Information

Hematoma of the ear flap is an accumulation of blood between the cartilage and skin of the ear flap. It is caused by damage to the cartilage from vigorous repeated head shaking, or scratching at the ears with back feet. Occasionally the damage results from the ear striking a sharp edge during head shaking.

The most common underlying causes of head shaking are ear infections, ear mites and fleas. There is disagreement among the experts about the cause of some cases. It is important that we watch for the possibility of infection in the ear canal or coagulation defects contributing to the occurance of ear hematomas.

We usually recommend surgery to drain the fluid and to provide adhesions in the ear to prevent recurrance of the ear canal. It is true that draining the ear canal makes the ear canal flat again. However, it has been our experience that the hematoma almost always returns when this is done. It is also true that the hematoma will eventually resolve on it's own. However, if this is done the pressure will provide discomfort for a long time and the end result will usually be a twisted ear.

Important Points in Treatment

1. In most instances, general anesthesia is necessary for withdrawal of the hematoma fluid and surgical repair.

2. Treatment of ear infections and/or ear mites is necessary to allow healing and prevent recurrence of the conditions that caused the hematoma.

3. Give all medication as directed. Call the doctor if you cannot give the medication as directed or are unsure if you are properly treating the ear.

4. If your pet has a bandage or restraint device attached to the ear flap, please make an appointment for its removal.

5. Instructions for care of incisions, drain tubes and/or sutures: ____________

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Notify the Doctor if Any of the Following Occur:

* Your pet exhibits discomfort by rubbing or pawing at its ears or by shaking its head.

* Fluid continues to accumulate under the skin of the ear.

Question and Answer

Ear hematomas are one of the more common ear problems seen by veterinarians. These hematomas are very painful and if not treated correctly can result with a permanent deformation of the ear. There is usually an underlying medical condition that causes a dog to traumatize his ear resulting in a hematoma. Proper diagnosis and treatment of the underlying problem is necessary to prevent reoccurrence.

What is an ear hematoma?
Ear hematomas, medically known as 'aural hematomas' or 'auricular hematomas', are a collection of blood and fluid between the skin and cartilage of the ear. A blood vessel in the ear ruptures and the loose space under the skin will fill up with blood. The pressure from the ruptured vessel will often cause the entire surface of the ear to swell creating a very painful condition. These hematomas will occur very quickly, often within minutes of the vessel being ruptured. Affected animals will have a noticeably swollen, fluid filled ear that is extremely painful to the touch. If left untreated the pain will subside somewhat after several days, but the swelling will continue and eventually as the fluid filled space generates scar tissue the ear may become permanently disfigured.

Who is at risk for getting hematomas?
Any cat or dog of any age can develop an ear hematoma. Animals with chronic ear infections, ear mites, or allergies that cause the ears to itch are at the greatest risk of developing an ear hematoma. Animals will scratch their ears or shake their head if their ears are itchy or painful, which can result in a ruptured blood vessel. Dogs that fight frequently or run through heavy brush are also at risk of injuring their ear and developing a hematoma.

What is the treatment?
There are several different treatment options for ear hematomas. The treatment will depend on how quickly the hematoma is identified and treated (the sooner the better), the size of the hematoma, and the personal preferences of the attending veterinarian.

The most widely used treatment consists of a surgical procedure that involves incising the skin on the underside of the ear, draining the blood and then suturing (stitching) through the ear with multiple sutures. The ear may or may not be bandaged and then the underlying infections, mites, or allergies are diagnosed and treated. The benefit of this procedure is that there is a good chance that the ear will look normal when healed and a low chance of the hematoma reoccurring.

Another treatment option includes surgically opening and draining the ear and then not placing stitches but taping the ear up over a rolled bandage and allowing the ear to heal. This procedure may be more favorable in dogs where it is very important that the ear not be disfigured but it also requires more intensive aftercare.

In cases where the hematoma is very small or old some veterinarians will remove the fluid with a syringe and if there is no clot present, will allow the ear to heal without surgery. Some veterinarians will also surgically place a cannula or drain to allow blood and fluid to be released and will avoid the surgery and suture placement.

Prevention
Prevention primarily consists of preventing any trauma to your pet's ear. Self-trauma from scratching or head shaking is still the most common cause of ear hematomas. Prompt treatment of all infections and ear mites as well as the proper diagnosis and treatment of allergies, is the best way to prevent hematomas. At the first sign of your pet shaking her head or scratching at her ears be sure to have her examined by a veterinarian so the problem can be diagnosed and treated properly.

The information on this page was obtained from the site www.peteducation.com