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Wednesday, April 1, 2020

MDM - Cauliflower Ear


[##]-year-old [male/female] with history and exam consistent with auricular hematoma (cauliflower ear) of the [right/left] ear.

Initial considerations in this patient included auricular hematoma (cauliflower ear), otitis externa, and tympanic membrane rupture among others.

Patient presented with [right/left]-sided otalgia with recent history of trauma from [describe], and evidence of swelling of the pinna consistent with auricular hematoma.  No evidence of associated otorrhea, swelling or debris in the external auditory canal, fever, or other findings suggestive of otitis externa.  After discussion of risks, benefits, and alternatives and after obtaining appropriate consent, [incision and drainage/needle aspiration] of the patient’s [right/left]-sided auricular hematoma was performed in the ED.  An appropriate pressure dressing was placed over the ear with discussion of wound care and follow up.  No other evidence of significant injury noted on exam.  No associated hearing loss or evidence of rupture of the tympanic membrane.

Prior to discharge, we discussed return precautions, treatment with appropriately placed pressure dressing, and follow up with primary care doctor within one week for further evaluation, and the patient demonstrated understanding and agreement.

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