CAULIFLOWER EAR- Overview, Facts, Types and Symptoms


Cauliflower ear is a physical deformity that results from trauma to the external ear. It is the result of the accumulation of blood in the area between the cartilaginous portion of the ear and its fibrous part. The area that is blood vessel rich is also the area that supplies the ear with nutrients causing swelling and malformation of the external ear resembling that of a cauliflower.

This type of ear deformity is commonly seen among persons that engage in sports that involve physical contacts such as boxing, football, mixed martial arts, or those individuals that get into a brawl now and then. Cauliflower ear is also seen after a soft tissue infection involving the outer ear.


Yotsuyianagi et al. devised a classification that can be used in assessing the extent of the damage, and these are as follows:

Two broad types : 

  • Type 1- the presence of minimal deformity with or without visible change in the appearance of the ear
  • Type 2 – the presence of significant damage that disrupts the outline of the ear

Five subtypes:

  • Type 1A- Damage is limited to the concha of the ear
  • Type 1B- Damage is up to the antihelix (the uppermost portion of the external ear)  and the helix (second curved line on the inside part of the ear )
  • Type 1C- Damage extends into the margin of the outer ear
  • Type 2A- Damage is apparent, but the entire form of the ear is still visible
  • Type 2B- Borders and margins of the ear cannot be delineated well


Symptoms of cauliflower ear can start as any of the following:

  • The difference in the size and shape of the ear
  • Presence of a violaceous discoloration of the outer ear
  • Tinnitus or the feeling of a bee circling in your ear
  • Decreased hearing or complete loss of hearing
  • Doubling of vision or loss of vision ( occurs in severe cases)


Unlike other disease conditions that utilize ancillary procedures for diagnosis, determining Cauliflower ear is mainly by thorough history (involvement in contact sports, history of trauma to the listener either by accident or intentional) and physical examination of the affected ear (presence of bruises, swelling and disparity between the affected and the normal ear). There may be tenderness in the affected area with discoloration. Once the diagnosis is made, the treatment options can quickly be decided.


After the time of the initial injury, a cold compress of the affected area is “golden” or of utmost importance within 48 hours. The cold temperature stops any active bleeding and reduces the formation of the blood clot that can cause deformity. 

The incision and debridement of the affected ear after the diagnosis has been made is necessary to remove the causative agent of the blockage (this may either be a blood clot or a pus formation). Prompt debridement will save the tissue from going into necrosis and eventually shrinkage of the affected tissue. 

Plastic surgery reconstruction or otoplasty. Once the deformity is apparent, restoration of the affected ear to make it look normal again is possible with the advent of modern medicine. 

Prevention of further cases of cauliflower ear can be avoided with the use of appropriate headgear before engaging in contact sports and the like. 

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