Aural Hematoma... A Blood-Filled Pocket in the Ear

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While a hematoma is any abnormal blood filled space, an aural hematoma is a collection of blood under the skin of the ear flap (sometimes called the pinna) of a dog (or cat).

Ear hematomas (pictured below) occur much more commonly in dogs than in cats; they are generally the result of trauma to the ear flap, either from an injury or from the dog scratching at the ear. Itchiness can also be an underlying causative factor, often occuring due to ear mites, allergies, infections or foreign matter in the ear canal. 

Since there is little strength or depth to the tissues of the pinna, clotting may be delayed, especially if the dog or cat continues to upset the clotting by additional self trauma. Despite this, hematomas are capable of heling on their own, but will usually leave behind a scarred, crinkled and shrunken pinna.

However, you should always bring your pet to a veterinarian,as the hematoma can reoccur if the underlying cause is not treated.

Veterinarians generally will recommend surgery to open and drain the hematoma and remove dead and degenerating clots and fibrin. Sutures are then used to tack the skin layers over the thin cartilage center tight to the cartilage to eliminate any space for more blood or serum to accumulate. Of course this is done only under general anesthesia, and antibiotics and anti-inflammatory medication are used post operatively. 

After two weeks, minor cleaning of the surgical wound is done at home with peroxide, after which your dog is readmitted for a final inspection and suture removal. As with many kinds of ear troubles in dogs (allergies, infections, wax build-up, mites, etc), diligent aftercare is necessary to keep scar tissue and long term pathology from occurring. 

The Hematoma is outlined.  It could spread along the entire underside of the pinna within days.  The ear canals are examined and any pathology is vigorously treated.	The incision is made through the skin down to the thin cartilage to drain and explore the Hematoma.  Once healed, hematomas rarely affect the same ear again.	As many sutures as needed are placed through the entire pinna to tack the skin back to the cartilage. Healing is uneventful and generally occurs within two weeks after surgery.