Wrestler's ear: pathophysiology and treatment.

Management of auricular hematomas has always been a challenge for physicians. This injury is very common among wrestlers since early olympic competition times. Initial treatment usually involves simple aspiration and a compression bandage. Most of these hematomas recur; then it must be decided how to manage this recurrent problem and the eventual "cauliflower ear." A treatment is proposed that directs attention to the pathophysiology of the injury and involves total excision of the newly formed fibroneocartilaginous layer. Unless this layer is successfully removed the hematoma will persist and a thickened ear will result. This treatment can be performed on an outpatient basis under local anesthesia and allows immediate resumption of wrestling competition.