Q: Dr. Eppley, I’m trying to remove my cauliflower ear in which I been having for years. Can it really be improved in the way the ear looks and how is it done?
A: The well known cauliflower ear, in appearance much like the vegetable plant, is the result of ear trauma. Specifically it is the production of cartilage as a response to its covering, known as the perichondium, being sheared off from its underlying cartilage. Ear cartilage is an avascular tissue that receives its blood supply and nutrition from its enveloping perichondrium. When it gets torn away from the cartilage, it bleeds and creates a blood clot between the two. This serves as a stimulus for the cartilage to grow and eventually replace the space where the blood was. Since the ear’s shape (with the exception of the earlobe) is determined by the shape of the cartilage, the traumatized ear becomes deformed in appearance.
Surgical treatment of the cauliflower ear is done by removing a flap of skin over the deformed area, shaving down and reshaping the cartilage, and then putting the skin flap back in place. The key to the success of the procedure us two-fold. First the skin flap over the deformed ear part must be raised in such a way that its blood supply is not destroyed and skin necrosis results afterwards. Secondly, the skin must be held into place with intimate contact to the cartilage after it is reshaped so blood does not form between the two and re-create the original problem. This form of ear reconstruction is done as an outpatient procedure under anesthesia.
Dr. Barry Eppley