Management of pinna haematoma study (MaPHaeS): A multicentre retrospective observational study

Management of recurrent pinna haematoma following rugby injury: a surgical approach

A young adult male developed a left-sided pinna haematoma after a rugby injury. The haematoma reaccumulated after multiple attempts at drainage under local anaesthetic in emergency rooms and required incision and drainage in the theatre under general anaesthetic. Intraoperatively, multiple venous bleeding points were identified and these were controlled with bipolar diathermy. The wound was closed and dressed with bolster and crepe bandage. On day 7 postoperatively, the sutures and dressings were removed and the haematoma had not recurred. He returned to playing rugby on day 21 postoperatively and sustained another blunt impact to his left ear. He noticed new swelling over the posterior aspect of the same ear. This was drained via needle aspiration and there was no further reaccumulation of the pinna haematoma.

Ear magnetic discs to prevent cauliflower ear: a case gone wrong

We present a case of pinna pressure necrosis secondary to the use of ear magnetic discs, used in the management of auricular haematoma. A man in his 20s sustained a left auricular haematoma while wrestling. His coach aspirated the haematoma and advised the use of commercially available compression magnets on either side of the pinna to prevent haematoma reaccumulation. 5 days later, he presented to accident and emergency with left ear pain and swelling. Perichondritis was evident on examination and the compression magnets were removed to reveal significant pressure necrosis of the pinna. The skin underlying the placement of magnets (both anteriorly and posteriorly) was black and necrosed, with erosion of the underlying cartilage. In addition to this, the haematoma had reaccumulated in the surrounding pinna. The haematoma was drained via an incision, and pressure dressing applied with dental rolls. The patient was given a course of oral antibiotics to manage the perichondritis. He was reviewed regularly in the ear, nose and throat emergency clinic to monitor wound healing. 3 months later, he was reviewed in the otology clinic; there was persistent helical rim deformity, and delayed cartilage augmentation was advised.

This case highlights the importance of prompt and effective management of auricular haematoma, to prevent long-term deformity. Commercially available pinna magnets for auricular haematoma should be used with caution, and patients should be counselled as such.

ENT audit and research in the era of trainee collaboratives

Large surgical audits and research projects are complex and costly to deliver, but increasingly surgical trainees are delivering these projects within formal collaboratives and research networks. Surgical trainee collaboratives are now recognised as a valuable part of the research infrastructure, with many perceived benefits for both the trainees and the wider surgical speciality. In this article, we describe the activity of ENT trainee research collaboratives within the UK, and summarise how INTEGRATE, the UK National ENT Trainee Research Network, successfully delivered a national audit of epistaxis management. The prospective audit collected high-quality data from 1826 individuals, representing 94% of all cases that met the inclusion criteria at the 113 participating sites over the 30-day audit period. It is hoped that the audit has provided a template for subsequent high-quality and cost-effective national studies, and we discuss the future possibilities for ENT trainee research collaboratives.

Cauliflower ear - a minimally invasive treatment method in a wrestling athlete: a case report

Acute auricular hematoma can be caused by direct blunt trauma or other injury to the external ear. It is typically seen in those who practice full contact sports such as boxing, wrestling, and rugby. “Cauliflower ear” deformity, fibrocartilage formation during scarring, is a common complication of auricular hematomas. Therefore, acute drainage of the hematoma and postprocedural techniques for preventing recurrence are necessary for preventing the deformity. There are many techniques although no superior method of treatment has been found. In this case report, we describe a novel method using needle aspiration followed by the application of a magnet and an adapted disc to the affected area of the auricular. This minimally invasive, simple, and accessible method could potentially facilitate the treatment of cauliflower ear among full contact sports athletes.