Interventions for acute auricular haematoma

 

Abstract

Background

This is an update of a Cochrane Review first published in The Cochrane Library in Issue 2, 2004 and previously updated in 2005 and 2008.

Acute haematoma of the pinna is a condition where a collection of blood forms beneath the perichondrial layer of the pinna. It is usually caused by blunt trauma and if untreated will ultimately result in a deformity commonly known as 'cauliflower ear' or 'wrestler's ear'. Various treatments are employed to relieve the haematoma but no clear consensus exists on the best way to do so in order to produce the best cosmetic result with the least permanent deformity.

Objectives

To assess the effectiveness of treatment options in acute auricular haematoma.

Search methods

We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 13 January 2011.

Selection criteria

Randomised controlled trials, case controlled trials and cohort studies including children and adults undergoing any intervention for acute auricular haematoma.

Data collection and analysis

No studies are included in the review. We identified 59 references from the original searches; we retrieved and assessed 48 for eligibility. None met the inclusion criteria. No studies which met the inclusion criteria were identified when the search was updated in November 2005 (from 16 references), November 2008 (6) or January 2011 (10).

Main results

Due to the lack of data from trials fulfilling selection criteria no results could be presented.

Authors' conclusions

There is no clearly defined best treatment for acute auricular haematoma. There are no good quality data to determine either the optimal management strategy or even whether post-drainage intervention (such as splinting or bandaging) is necessary. Further research is required before any specific treatment may be recommended.

 

Plain language summary

Interventions for acute auricular haematoma

Acute auricular haematoma is a condition where a collection of blood forms in the pinna (external ear), often following blunt trauma. If untreated it will result in the 'cauliflower ear' or 'wrestler's ear' deformity.

We searched for trials in adults or children who had sustained a haematoma. Treatments could be simple aspiration of the haematoma, incision and drainage and any post-drainage procedures (such as splinting or bandaging) to prevent re-accumulation of the haematoma. We found no trials of good quality to demonstrate that any one technique to remove the haematoma and prevent its recurrence gives the best cosmetic outcome. The literature, however, generally suggests that treatment is better than leaving a haematoma untreated. Well-designed studies are required.

 

摘要

背景

急性耳廓血腫之處理

血液蓄積在耳廓軟骨膜層下稱為耳廓急性血腫，通常是由鈍傷造成，如果不治療最終會造成耳廓畸形，即俗稱的”花椰菜耳“或”摔角手之耳“。有各種不同的治療來消除血腫的蓄積，但目前還無明確共識何種是最好的方式來得最好的外觀結果及最少的永久畸形

目標

評估各種急性耳廓血腫處理的效果

搜尋策略

以上述設定的名詞來搜尋the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library Issue 2, 2003), MEDLINE (1966 – 2003)及EMBASE (1966 – 2003)。2005年11月再次進行搜尋所有資料庫

選擇標準

兒童及成人接受急性耳廓血腫處理的隨機對照試驗、病例對照試驗、及群體研究

資料收集與分析

搜尋到59篇參考文獻，作者摘選其中48篇來評估其適當性，但卻沒有文章符合收集標準。2005年11月再次搜尋時也沒有找到新的研究

主要結論

由於沒有試驗完全符合挑選標準而缺少資料，因此無結論可提出

作者結論

對於急性耳廓血腫，沒有明確的最佳治療。無論是針對最佳的處置方式或是否需要引流後的處理(例如夾板固定或繃帶包紮)，皆無相關的設計品質優良的資料。在建議任何特殊治療前，需要更多的研究

翻譯人

本摘要由國泰綜合醫院方德詠翻譯

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

對於急性耳廓血腫的治療，沒有好的證據建議何種方式是最佳治療。急性耳廓血腫是血液蓄積在耳殼，常發生在鈍傷之後，如果不治療將會造成“花椰菜耳”或“摔角手之耳”畸形。這篇回顧沒有找到品質良好的試驗來證明任何移除血腫或防止它再發生的技巧以得到最好的外觀結果。但一般文獻都建議治療比留著血腫而不治療好。我們需要一些設計良好的研究