The Definitive Cauliflower Ear Thread (please sticky)

[supertac]

Every time I log on, there seems to be a new "How do I treat my cauliflower?" or "How do I prevent cauliflower?" thread. So, because I was so sick of seeing this topic done so repetitively, I decided to make this thread. I know I'm only a white belt, but this is a topic I am quite familiar with. So without further ado I give you the...

Definitive Cauliflower Ear Thread

*I take no responsibility for any harm that comes to you or your ear if you choose to drain it at home*

What it is:

Cauliflower ear is term commonly used to describe the appearance of an ear that has had a perichondrial hematoma. A perichondrial hematoma occurs when the ear is struck, hit, or excessively and abrasively rubbed. When hit, the skin on the ear tears away from the underlying cartilage. The perichondium, which supplies nutrients to the cartilage, is also ripped off of the cartilage. If left untreated, the cartilage will be starved of nutrients and die. The blood and puss that filled the gap when the skin was torn off of the cartilage will harden and leave a cauliflower like appearance.

How it happens:

Cauliflower ear occurs when the ear receives a hard strike, or is grinded against for extended periods of time. This is why it is so common among combat athletes and rugby players. In rugby, when tackles occur, the ear can be hit against the athlete being tackled, resulting in cauliflower. In jiu jitsu and wrestling, the ear can not only be struck hard (for instance: during a takedown, your ear hits his hip bone), but also abrasively rubbed (escaping from chokes, headlocks etc

 

[SFinclined]

A lot of good information.

 

[pittfrog]

The doctor lanced the front of his ear with a scalpel and the sucked and scraped all of the blood and puss out of the ear. He then stitched the ear back up using cotton rolls (he put one cotton roll on back, and one on front and then stitched around them to make an improvised compression bandage). While this is certainly an imaginative way to treat cauliflower ear, it is most definitely not the best.

The above is ignorant and wrong. What you describe is, in fact, the exact way that a well informed doctor will treat cauliflower ear. The procedure is known as bolstering, and is the quickest and most effective way to insure that the drained ear does not refill. Syringes and compression bandages are not nearly as effective in allowing the skin and cartilage to re-attach. While I'm at it, when an ear is bolstered, the stitching is not around your ear, it's through it. 2-3 stitches are placed through the ear to compress the skin to the cartilage through the cotton bolster pads.

I've drained my own ear with a syringe once, which I had to do multiple times, and kept refilling, over the course of 10 days. I've also had my ears bolstered twice, those healed in 4 days. The doctor who did the bolsters in both cases is a board certified Plastic surgery and Ear, Nose and Throat guy. I'll assume he's more familiar with standards of care for this injury than you are.

Now I wear headgear, all the time.

 

[pittfrog]

Bolstering looks like this.

 

[supertac]

I have no doubt that bolstering can prevent recurrent filling, but it also requires stitches and subsequent visits to the doctor's office to have said stitches removed. I know people who have had both methods done. The problem with the bolstering is that it left a small scar on my friends ear. Please don't call me ignorant, as I have quite a bit of experience with cauliflower. The bolstering method works, but you have to first go to doctor for the procedure and to get the stitches out. While you may have to re-drain your ear by doing it the way I described, it is something that you can do at home for very little cost. In addition to the very low cost, if done correctly, it will leave no scar and you ears will look perfectly normal.

 

[armbarking]

Thanks for the info. My method of dealing with it is to leave it alone. Nature says it's cauli for me, so who am I to argue?!?

 

[itlnheat]

Pretty solid post, I vote toward stickyness!

 

[DPS831]

i've had that bolstering procedure done and it was one of the most painful experiences of my life. I would either use the syringe method or just let your ears get cauli.

Honestly, unless my ears start to look like randy couture's im not too concerned about them.

 

[ABomB]

I too support this thread being stickied, it is very informative.

 

[pittfrog]

I've had each ear bolstered once, and drained one ear multiple times over the course of 10 or so days. Bolstering was more painful, but it also healed my injured ears more quickly than the ear that I drained myself.

If there's a scar from my ears being bolstered, I can't see it, nor can my wife. My wife is kind of anal, and she's on my ass about cauli, because she's concerned my kid will get it from Judo. Believe me, if my persnickety wife can't see the scar, there isn't one. My ears also look entirely normal(ask Frodo), although the cartilage is a bit hard in the spots I've been injured.

As for calling you ignorant, I stand by it. Google the words "auricular hematoma treatment" and you'll quickly see that bolstering is the accepted standard of care, because it effectively mitigates the risk of the hematoma re-filling. Additionally, those who have their ears bolstered, will also most likely be prescribed covering antibiotics, minimizing the risk of infection when compared with multiple rounds of bathroom surgery by a layman. Given that those doing this to themselves are grapplers, the infection risks are not insignificant.

You made bolstering sound as if it was some quack treatment applied only by ignorant doctors, when nothing could be further from the truth. Indeed, there could easily be some people who find that draining their ear injuries themselves is finally too much, and would seek medical attention. The provider of that attention will likely then bolster their ears, which, if that person was stupid and listened to you, they would resist.

I don't want to turn this into a flame war over draining yourself/seeking medical attention. Bottom line, if you're susceptible to cauli, and susceptibility seems to be in part genetic, either wear headgear or just suck it up and resign yourself to effed up ears. I choose headgear.

 

[pittfrog]

I'll offer the alternative view, from the "seek medical attention" side. First off, unless you live in a major city, and can get to an emergency room with an on-call Otolaryntologist (ear nose and throat) specialist, don't waste your time with an emergency room. Most regular ER docs will not want to do anything to your ears. If your ears are badly swollen and you want them fixed, seek out a plastic surgeon, or an otolaryntologist.

I've had bolstering done both in the ER (1 hospital in my city has an on call ear nose and throat specialist, and yes I've made a point to find out which) and in an operating room. There was one follow up visit required in each case, to remove the stitches. That visit was quick and painless. There is no visible scar.

I will say this, I have very good medical insurance. If you live in the US, depending on your coverage, I could understand that you would prefer to drain your ears yourself, despite the significant infection risk. I'd argue, however, that if this is the situation with your medical coverage, that you'd be better off wearing $30 headgear than worrying about your medical deductible.

 

[Trasher]

u do NOT want any type of velcro headgear unless ur washing it like a motherfucker everyday, all that dirt and sweat gets trapped in there and well rub on ur head/forehead constatly, we lost 3 kids on my wrestling team this year from impetigo

 

[Trasher]

u do NOT want any type of velcro headgear unless ur washing it like a motherfucker everyday, all that dirt and sweat gets trapped in there and well rub on ur head/forehead constatly, we lost 3 kids on my wrestling team this year from impetigo

 

[supertac]

pittfrog,

Although I hoped it wouldn't, I certainly expected our conversation turn into a flame-fest. But, you, unlike most people on sherdog, conducted yourself in a very professional manner, and I respect that. All of the people that I have seen who have had their ears bolstered ended up with scars. I will take your word for you not having a scar and in the spirit of providing accurate and proper information, amend my original post.

Thanks,

ST

 

[kaboom187]

great post

 

[pittfrog]

u do NOT want any type of velcro headgear unless ur washing it like a motherfucker everyday, all that dirt and sweat gets trapped in there and well rub on ur head/forehead constatly, we lost 3 kids on my wrestling team this year from impetigo

Impetigo is an infection with either strep or staph bacteria. Cleanliness makes *any* infection from grappling sports less likely.Grapplers need to keep their gear, including headgear, religiously clean. Wash your gi/singlet/shorts, spray your headgear with bleach or iodophor solution, clean your body, and keep the lather of the soap on your body for at least 20-25 seconds to maximize the mechanical action that washes bacteria away.

Headgear is good, cleanliness is good, grappling is good.

 

[supertac]

Headgear is good, cleanliness is good, grappling is good.

Amen

 

[Jimmy Cerra]

I had the same experience as pittfrog, even though I think we had different otolaryngologists (ENT doctors). I had 3 different bolsterings - one in the ER (after they called in the ENT) and 2 in operating room with an ENT. There is no visible scar, and after a week of rest and hell, it was pain-free (though you need to wear headgear for a few months afterward). I had it bad, and even though they are still deformed (I had fractured cartilage, multiple drainings, etc), there is no pain. Don't risk an infection: see your doctor and use your health insurance!!!

 

[ShanghaiBJJ]

we lost 3 kids on my wrestling team this year from impetigo

They died??? :icon_surp

 

[superc0ntra]

Can we sticky this thread? It should be important to many of us.