What is an ear haematoma?
An ear haematoma (aural haematoma, AH) is a blood-filled swelling between the cartilage and skin of the ear flap. It produces a soft, fluctuating, balloon-like lump that can affect part or all of the pinna. It is most common in breeds with long, pendulous ears (Cocker Spaniel, Basset Hound, Labrador, etc.).
Causes
Violent head shaking or repeated scratching ruptures small blood vessels within the pinna. The most common underlying causes:
- Otitis externa: infection or inflammation of the ear canal causing itching.
- Ear mites (Otodectes cynotis): produce intense pruritus and head shaking.
- Foreign bodies in the ear canal.
- Allergies (environmental or food) causing recurrent otitis.
Without treating the underlying cause, ear haematomas tend to recur.
Treatment
- Surgical drainage: most effective option. An incision is made on the inner surface of the pinna, the blood is drained and mattress sutures are placed to prevent reaccumulation. Performed under general anaesthesia.
- Needle aspiration: quicker, no general anaesthesia, but high recurrence rate (>60 %).
- Intralesional corticosteroids (triamcinolone): for small or recent haematomas; reduces inflammation and promotes reabsorption.
Untreated, the blood organises into fibrous tissue, producing the classic "cauliflower ear" — a permanent cartilage deformity.
Treat the underlying cause
Treating the otitis, mites or allergy that triggered the head shaking is essential. Without this, the cycle repeats.
Prevention
- Regular inspection and cleaning of the ear canal, particularly in drop-eared breeds.
- Treat any otitis promptly before itching triggers violent head shaking.
- Parasite control including treatment for ear mites.