Aural Hematoma, what about causes and remedies?
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“Hey buddy, what is that?
Oh…it’s your ear”
Aural Hematoma, what about causes and remedies?
Aural or ear hematoma in dogs, shows as a swelling on the pinna of the ear and it is due to a subcutaneous blood accumulation.
Ear hematomas occurs when a blood vessel in the ear bursts and bleeds into the space between the ear cartilage and the skin.
The swelling, is usually caused by a trauma such as scratching, shaking the ears, bite wounds or crushing. In some cases, it could be caused by foreign bodies stocked in the ear canal, such as a tick or foxtails.
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Ear hematoma may be unilateral or bilateral and can affect both dogs and cats, although more frequent in dogs.
In early stages the hematoma can be warm to the touch, the skin may be erythematous, and the pet may experience discomfort.
When the Aural Hematoma is left untreated, it can lead to complications such as otitis. Primary and secondary causes of otitis in dogs and cats are:
Primary causes of otitis
• Hypersensitivities (atopy, food reactions, contact reactions)
• Parasites
• Foreign bodies
• Inflammatory polyps
• Endocrine disorders
• Neoplasia
• Keratinization disorders
• Juvenile cellulitis (auto-immune)
• Conformational abnormalities
Secondary causes of otitis
• Bacterial infection
• Yeast infections
• Otitis media
• Chronic pathological changes to the ear (e.g., aural hematoma, calcification of ear canal, ceruminous gland hyperplasia, inflammatory mass in ear canal)
Remedies for Aural Hematoma in dogs
The treatment typically includes the draining of the hematoma with a needle and a subsequent intra-lesional instillation of a steroid together with a daily oral steroid treatment. The use of a butterfly needle (19 or 21 gauge) and line is very effective for drainage. But the simple drainage of the ear often causes recidivism and therefore cannot give long-term benefit, mainly because of the same non-healed lesion and the continuous loose of blood. The use of antibiotics and/or painkillers alone is not able to solve the problem.[2]
Surgery is the most common treatment for hematoma both in dogs and cats All surgical approaches are performed under heavy sedation or general anesthetic. S-shaped or linear incision are performed during the surgery: An incision is made through the concave surface of the pinna overlying the hematoma. Multiple staggered, full thickness or partial thickness, interrupted mattress sutures are placed parallel to the long axis of the pinna over the entire area of the hematoma. Alternatively, a continuous intra-dermal suture line performed on the inner surface of the hematoma has been described as a common approach.
A new treatment, the PRP
A novel treatment with platelet rich plasma (PRP) has been described for intralesional injections. The aim of this study was to report the clinical efficacy of autologous PRP obtained with a double centrifugation in the treatment of canine aural hematoma and perianal fistula. [3].
The procedure is the same as described above: draining of the blood, and injection of small PRP volume.
Autologous platelet-rich plasma (PRP) 0.5 mL derived from whole blood, no steroids used in course of treatment.
PRP is able to enhance regenerative process, ensuring the recovery of the tissue, the formation of the required aural cartilage and the regeneration of blood vessels.
