Every now and again, some of MMA’s medical-related topics are worth revisiting.
This week, MMAjunkie.com medical columnist and consultant Dr. Johnny Benjamin reexamines one such topic: cauliflower ear.
Why devote a new Ask the Fight Doc column to the topic? Well, check out the embedded video, which includes an airborne chunk of a fighter’s ear, and it quickly becomes evident.
Doc, Is there any real danger in not treating a cauliflower ear? – Too many to name
This is a rather common question and one that I’ve addressed in the past. Every now and then, something happens that makes me think it may be time to revisit the subject.
While watching the brief MMA careers of Kevin “Kimbo Slice” Ferguson and the now-defunct EliteXC, “Kimbo” battled with a gentleman by the name of James Thompson. Kimbo entered the cage with an enormous amount of anticipation and hype from his days of backyard brawling on the Internet, and Thompson entered with a massive cauliflower ear.
If my fading memory serves me, Kimbo didn’t display a wide array of tools other than a respectable haymaker, and Thompson stood toe-to–toe, traded blows and bled profusely from his dismembered ear.
So, what inspired me to return to the subject of cauliflower ears? Take a look at the embedded video above. (Warning: It’s not for the squeamish.)
Until viewing that video clip, I was not familiar with Shane Tyner. I still must admit that I know next to nothing about his MMA skills, but Tyner will serve as my latest example of the potential risks associated with an untreated or improperly treated cauliflower ear.
A cauliflower ear is caused by a collection of blood in the external ear that separates the skin away from the underlying cartilage. This cartilage provides shape and structure to the ear but has no significant internal blood supply. It derives its blood supply from the overlying layers of skin.
Therefore, other than being cosmetically disfiguring, a significant collection of blood can leave the cartilaginous scaffold of the ear with a tenuous blood supply – possibly leading to injury or death of a portion of the external ear.
As the collection of blood lingers, it coagulates (thickens) with time. The blood will eventually become more firm and produce fibrous nodules that create classic cauliflower appearance.
Is it dangerous? Hmm. Take a look at the video again.
Treating a cauliflower ear is simple, safe and effective in the properly trained hands. So, a word to the wise: If you choose to utilize the “services” of a dojo doctor in the restroom of your local gym, don’t say that I didn’t try to warn you.
To be effective, the blood must be aspirated (drained) as soon as possible – certainly within the first few hours before it coagulates (thickens) and will not easily flow through a needle into a syringe.
Some general steps/tips:
- Take a good shower, and wash the ear vigorously with soap and water.
- Your medical professional will cleanse your ear with an antiseptic solution.
- A local anesthetic will be injected into the overlying skin to numb the site.
- Once numb, a large-bore hypodermic needle will be placed to aspirate (drain) the collection of blood. If not done properly, this can be exquisitely painful since the needle must be large (at least 18-gauge) since the pooled blood is likely to be thick.
- A pressure dressing is then placed to close the dead space and retard re-accumulation of blood.
- Discuss your tetanus shot status with your healthcare professional, and you may be placed on a few days of antibiotics for safety.
- The pressure dressing is usually maintained for 24 hours.
- Take the dressing off in the shower since it is likely to be a bit bloody and stuck to the ear.