Dec. 5, 2004

Brian Dallas, ATC-L
Graduate Assistant Athletic Trainer
North Carolina State University

With forceful aggressive throwing moves, injuries are not uncommon in the world of wrestling. There are even certain injuries that are specific to the direct blow caused by being thrown onto a mat. One such injury is the unmistakable "Cauliflower Ear." This direct-trauma induced injury damages the cartilage tissues of the external ear. If this injury is left unattended to it may lead to permanent deformity and possible hearing loss.

"Cauliflower Ear" begins when the athlete receives a direct blow to any part of the ear. A shearing force applied to the ear may also cause the same reaction by the body. This trauma causes the skin layer to pull or tear away from the cartilage tissue within the ear. When this occurs the biological response to this trauma is to increase blood flow to the area, creating a blister like swelling under the skin. This swelling can be felt by touching the surface and may create pain for the athlete.

Although the outside portion of the ear is the most common place for this trauma to occur, swelling may be found to accumulate inside of the inner ear as well. With this occurrence of swelling, the athletes' ability to hear and/or balance may be affected. For this reason it is important for athletic trainers to evaluate an athletes hearing and balance, through special testing to help determine what style of care is needed

In all cases of "Cauliflower Ear" once swelling and deep red irritated skin is noticed, the athlete should be referred to a physician. Immediate treatment calls for application of an ice bag and direct pressure; however, complete care calls for the blood accumulation to be removed from the area and constant direct pressure to be applied, allowing reattachment of the two tissues. A physician may also feel that it is necessary for the athlete to be put on an antibacterial medication.

The key to reversing this injury is maintaining direct pressure after all fluid has been removed. This can be maintained by wither suturing cotton rolls onto the ear, or applying a collodion cast. Either a physician or athletic trainer can apply a cast made with sterile gauze pads and collodion, a topical adhesive that may be applied directly to the skin.

If not properly taken care of, this injury will lead to permanent damage and/or deformity. Once the fluid has hardened and destroyed the cartilage tissue in the ear, only surgery will provide the ability to correct the problem. Problems are only seen in the ear when the growth of tissue moves into the ear canal, causing a decrease in the amount of hearing that takes place. Other than hearing, the only problem with this injury is one of a cosmetic appearance of the ear.