What is a hematoma of the ear, and how does it occur?
An aural (ear) hematoma is a collection of blood or serum, and sometimes a
blood clot within the pinna (ear flap). When present, the pinna will be very
thick. The swelling may involve the entire pinna or it may involve only one
area. When something irritates the ear canal, the dog responds by scratching
or shaking the head. Excessive shaking causes blood vessels to break, resulting
in bleeding. An understanding of the ear's anatomy makes the sequence of events
more logical. The ear flap is composed of a layer of skin on each side of a
layer of cartilage. The cartilage gives the ear flap its shape. Blood vessels
go from side-to-side by passing through the cartilage. Violent shaking causes
the vessels to break as the skin slides across the cartilage.
How is it treated?
There are four steps in treatment.
- The blood is removed from the pinna. This is accomplished by making
a small incision in each end of the hematoma A rubber drain tube is passed
through the hematoma and sutured to the ear. This assures drainage of any
more blood or serum that accumulates in the area.
- The space where the blood accumulated is obliterated. Since the skin
over the hematoma has been pushed away from the cartilage, it must be reattached
to it to prevent another hematoma from occurring. This is accomplished by
a series of sutures that are passed through the ear flap.
- The pinna is stabilized to prevent further damage. The presence of
the drain tube will cause the dog to shake its head even more. Shaking at
this time may cause further damage to the pinna. Therefore, the pinna is laid
on top of the dog's head and bandaged in place. Although the bandage may be
somewhat cumbersome, it will prevent further damage to the pinna and allow
proper healing to progress.
- The cause of the problem is diagnosed and treated. On some occasions
the fluid may be drained and the hematoma injected without incision. Another
important aspect of treatment is dealing with the cause of the shaking. If
an infection is present, medication is dispensed to treat it. However, some
dogs have no infection but have foreign material (a tick, piece of grass,
etc.) lodged in the ear canal. If so, the foreign material is removed. It
is also possible that a foreign body initiated the shaking but was later dislodged.
If that occurs, and no infection is present, further treatment of the ear
canal is not needed.
Will I need to bring my dog back for further treatment?
The drain tube and bandage are generally removed in about 3-5 days. At that time, the hematoma is usually healed. There will be two holes in the skin where the drain tube entered.
They will close within a few days. If discharge occurs from the holes before
they close, it should be cleaned off with an antiseptic solution such as Savlon.
If an infection was present, it will be necessary to recheck the ear canal to
be sure that the infection is gone. Otherwise, another hematoma may occur.
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