Cauliflower ears / ring ear • What is it and how is it made?

Author: Monika Preuk, medical writer
Last updated: August 02, 2021

Violent attacks on the ear – such as boxing or football – not only lead to a bruise, but also damage the cartilage. If the right treatment is not given, the auricle becomes permanently deformed. This is commonly referred to as a cauliflower ear or a ring ear.

At least one completely overgrown, swollen auricle used to be the trademark for boxers and wrestlers – just like the tennis elbow is typical for tennis players and the runner’s knee is typical for long-distance runners. The structure of the so-called cauliflower or ring’s pipe is actually reminiscent of vegetables. Although most athletes in martial arts today wear ear protection, this typical sports damage still exists.

At a glance:

Tips for healthy ears

How is a cauliflower ear made?

Bouncing, rubbing, and twisting ankle usually do not cause permanent deformation in most other areas of the body. For example, a knee bruise usually swells up again and after a while the knee looks the same as it did before the injury. However, if the ear is injured and the right treatment is not applied immediately, it can be assumed that the auricles will mutate into ugly lumps.

The auricle is made of cartilage. There are no blood vessels in the cartilage. Numerous veins run only in the skin that surrounds the cartilage. They ensure that the cartilage receives sufficient nutrients. If the auricle is kinked or bruised in a blunt injury, blood vessels in the cartilage will burst. A bruise (hematoma) forms between it and the cartilage, which cannot drain away. On the ear, the doctor calls this an othematoma.

The ear swells. The flexible cartilage is often grotesquely deformed in the process. The result: Because the supply between it and the cartilage skin is interrupted, this deformation remains permanent. Even if the hematoma has broken down a little after a while. In addition, the cartilage is no longer supplied with nutrients in the injured areas. In the worst case, the cartilage can even die. It shrinks and infections can form.

Rapid help with ear injuries is important

Every bruise on the ear – no matter how small – should therefore be treated by a doctor. First he will puncture the area so that the blood can drain away. Then he puts on a pressure bandage. This guarantees that the cartilage does not deform and that the auricle rests against the head. The earlier this therapy starts, the more successful it is and the less permanent damage the cartilage has suffered.

Surgery for a major ear injury

However, if the ear is particularly severely injured, surgery is necessary. There are various techniques that depend on the size and location of the hematoma:

  • The cartilage fenestration: The surgeon cuts a small window in the cartilage so that blood and serum can drain away.
  • Close the cartilage. Here the damaged cartilage skin is correctly placed over the cartilage so that this structure receives nutrients again and does not die.

If the cartilage has already died or is badly disfigured, the surgeon removes this part and replaces it with some cartilage from a healthy area.

Consequences: Cauliflower ears can impair hearing

Anyone who neglects to have the injury to the auricle treated immediately must reckon with the fact that the ossified bruise and the deformation of the auricle will remain in the long term. The cauliflower ear no longer hurts later. But the deformations are not only ugly. They can affect your hearing. Hearing impairment and distorted hearing are the consequences. A hearing test clarifies whether and to what extent the hearing is impaired.

Operation for the cauliflower ear

If the cauliflower ear persists, only aesthetic surgery can straighten the auricle. To do this, the surgeon removes the ossified bruise through an incision and brings the cartilage back into its correct shape. The intervention is time-consuming and is not a cash benefit. The costs amount to around 1500 euros, depending on the surgical effort.

Prevention: It’s best to avoid cauliflower ears

In all sports that could literally go on the ears, i.e. basketball, rugby, boxing, wrestling and Asian martial arts: Not only professionals but also amateur athletes should protect their ears here. Simple ear protection and helmets with integrated ear protection are not unsportsmanlike, they only show the responsibility that you take for yourself and your own health.

Piercing and cauliflower ear

What most do not know: Even improperly performed piercing on the auricle in the cartilage area can lead to bruises and damage the cartilage. Instead of attracting attention with earrings, the cauliflower ears are the eye-catchers. When piercing the ear – whether inner or outer auricle – you should make sure that the ear is x-rayed before shooting. This is how the blood vessels can be identified. The piercing is best placed in such a way that it does not damage a small vein.

Source: Lifeline | Das Gesundheitsportal by

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