A 20-year-old boxer presents two days after a left ear injury with a tense, fluctuant, non-erythematous swelling involving the pinna that does not blanch the overlying skin folds. The correct immediate management is:

• A Reassurance, as it resolves spontaneously
• B Incision and drainage with a pressure dressing ✓
• C Systemic steroids to suppress inflammation
• D Wide excision of the swelling

Explanation

This is an auricular haematoma, a collection between the perichondrium and cartilage that deprives cartilage of its perichondrial blood supply. Untreated, fibrosis and new cartilage formation produce the deformity called cauliflower ear. Treatment is evacuation by aspiration or incision, followed by a conforming pressure dressing to prevent reaccumulation. Steroids do not address the collection, and excision destroys normal architecture.

Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.