Aural Hematoma (Handout & Information Provided by Courtesy
of: ST. BETHLEHEM
ANIMAL CLINIC | Ronald E. Whitford, DVM | 400A Warfield Blvd. Ct. | Clarksville,
TN 37043)
What is a hematoma of the ear, and how does it occur?
An aural (ear) hematoma is a collection of blood, serum, or 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. 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 hydrogen peroxide.
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.
