Ear Hematoma
Also Known As: Aural hematoma
Transmission or Cause: The cause is due most commonly to self-inflicted trauma
such as scratching and shaking of the head. This behavior causes the tiny blood vessels
of the ear to rupture and hemorrhage under the skin forming a pocket of blood within the
earflap. Allergies, an infection or inflammation of the ear, the presence of a foreign body,
or ear parasites all cause pain, itchiness or irritation that an animal would seek to alleviate
by head shaking or scratching.
Affected Animals: Dogs or cats
Overview: When an animal has a painful or itchy ear, it may swing its head about or
scratch its ear to alleviate the discomfort. This behavior can cause trauma to the animal’s
pinna, or earflap, that can add even more irritation to the ear.
An aural, or ear, hematoma is a swelling in the earflap resulting from an injury. When the
tiny blood vessels in the ear’s cartilage rupture and bleed, the hematoma, a firm, fluid filled swelling, will appear within the animal’s ear. The examining veterinarian will be able
to treat this hematoma by any of several procedures that drain the fluid. Minor surgery
may be required.
Clinical Signs: The pinna of the ear will have a soft, fluid filled, fixed swelling on the
inside or concave side that can vary in size. The swelling may be warm to the touch.
Usually there is an underlying allergy or ear disease, called otitis, that can have many
different causes.
Symptoms: The flap of the ear will have a firm swelling on its inside that may be red
and warm to the touch. The swelling can sometimes be at the base of the ear. Many dogs
with this condition have a history of ear problems or infections.
Description: An ear hematoma is a firm, fluid-filled, swollen mass that is visible on the
inside of the earflap. Usually, an animal will get an ear hematoma from shaking its head
or scratching its ear because it has an underlying allergy or ear disease.
Diagnosis: The veterinarian will be able to diagnose an aural hematoma upon observation
of a swelling in the pinna or flap of the ear. An aspirate, which involves withdrawing
fluid from the swollen area into a syringe and looking at it under a microscope, may be
performed during the examination. The presence of blood in this fluid will confirm an aural
hematoma.
Prognosis: The prognosis is excellent for the correction of the hematoma. However,
unless the underlying cause of the irritation to the ears is controlled, it is possible that
another hematoma will develop at a later time.
Treatment: There are several procedures for treating aural hematomas; the veterinarian’s
approach to the problem will depend on the severity of the pet’s condition. One method
for correction which requires that the animal be sedated lightly is placing a drain, called a
teat cannula, securely into the tip of the ear and allowing the ear to drain from the cannula
for a period of three weeks. The ear eventually seals back together as the owner milks the
fluid from the hematoma through the cannula each day.
Another method, performed under general anesthesia, involves making a surgical incision
into the swelling on the ear, allowing the fluid to drain. Then, multiple sutures will be
stitched into the ear to seal it back together. Approximately seven to 10 days following the
procedure, after the ear has drained and healed fully, the sutures will be removed.
Failure to treat a hematoma can lead to enlargement of the swelling to encompass the
entire earflap. Also, scar tissue formation within the hematoma will result in a severely
wrinkled, thickened earflap that will predispose the pet to further ear problems.
Prevention: To help prevent aural hematoma formation, it is essential that the
veterinarian determine what is causing the irritation that is making the animal shake
its head or scratch its ears. A thorough examination of the ears will be necessary. The
veterinarian may use an otoscope to look down into the ear canals to determine the
presence of a foreign body or inflammation in the ears. Ear swabs often are taken and the
material is evaluated under the microscope to look for causes of otitis such as yeast, ear
mites, or bacteria. Allergies also can cause irritation to the ears. Wounds of the pinna or
earflap should be treated to prevent trauma to the ear caused by shaking and scratching.
He presented with #ceruminouscystomatosis bilaterally with infection. 
