No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Auricular Endochondral Pseudocysts: Diagnosis and Management
Abstract
The auricle can be the site of a variety of cystic lesions, many of which involve either potential spaces between the auricular cartilage and the perichondrium or spaces within the skin and subcutaneous tissues. An auricular endochondral pseudocyst is a fluid collection located within the cartilaginous structure of the auricle. The auricular hematoma and the auricular pseudocyst may represent opposing ends of a continuum of damage and repair of traumatic insults. Whereas the hematoma represents a significant acute traumatic event resulting in cleavage between the perichondrium and the cartilage, the pseudocyst could be the outcome of chronic lower grade trauma. In this instance, the perichondrium not only separates from the cartilage but may be induced to regenerate an outer cartilaginous wall exacting the contour of the separated perichondrium, thus completing a cartilaginous auricular pseudocyst. This firm, cartilaginous outer cyst wall accounts for the increased difficulty in treating pseudocysts and clearly requires a different surgical treatment than for the hematoma. Having reviewed a substantial number of case reports, we recommend incision and drainage of the cavity followed by obliteration of the cavity by curettage, sclerosing agent, and pressure dressing. More invasive techniques should be reserved for an uncommon recurrence after adequate initial treatment.
... 21 Since then, many different treatments have been employed, with varying success. 5,7,9,14,[21][22][23][24][25][26][27][28] The auricle can be the site of a variety of cystic lesions, many of which involve potential spaces between the auricular cartilage and the perichondrium or within the skin and the subcutaneous tissues. 22 Therefore, it is important to properly diagnose and treat auricular pseudocysts. ...
... 5,7,9,14,[21][22][23][24][25][26][27][28] The auricle can be the site of a variety of cystic lesions, many of which involve potential spaces between the auricular cartilage and the perichondrium or within the skin and the subcutaneous tissues. 22 Therefore, it is important to properly diagnose and treat auricular pseudocysts. If misdiagnosed and treated inappropriately, or left untreated, permanent deformity of the auricle may result. ...
Objective:
We investigated lactate dehydrogenase isoenzyme patterns in the cyst fluid of auricular pseudocysts and autogenous blood, to assist the diagnosis of auricular pseudocyst.
Methods:
Twenty patients with auricular pseudocysts participated in this study conducted in Kaohsiung Medical University Hospital between February 2007 and June 2010. Patterns of lactate dehydrogenase in cyst fluid and autogenous blood were analysed.
Results:
Levels of lactate dehydrogenase 1 and 2 were lower in auricular pseudocysts than in autogenous blood, whereas levels of lactate dehydrogenase 4 and 5 were higher; this difference was statistically significant (p < 0.001).
Conclusion:
Lactate dehydrogenase isoenzyme patterns in auricular pseudocyst fluid indicated higher percentage distributions of lactate dehydrogenase 4 and 5 and lower percentage distributions of lactate dehydrogenase 1 and 2. An effective laboratory method of evaluating the different lactate dehydrogenase isoenzyme components was developed; this method may improve the accuracy of auricular pseudocyst diagnosis.
... Clinically, this variability appears to be of little consequence. Inevitable gaps between the jigsaw of connecting cartilages does, however, provide a likely explanation for the etiology of congenital auricular pseudocysts that can occur in multiples between the perichondrium and the skin of the external ear, requiring drainage and pinna reconstruction (Secor et al., 1999). ...
The mammalian ear is made up of three parts (the outer, middle, and inner ear), which work together to transmit sound waves into neuronal signals perceived by our auditory cortex as sound. This review focuses on the often-neglected outer ear, specifically the external auditory meatus (EAM), or ear canal. Within our complex hearing pathway, the ear canal is responsible for funneling sound waves toward the tympanic membrane (ear drum) and into the middle ear, and as such is a physical link between the tympanic membrane and the outside world. Unique anatomical adaptations, such as its migrating epithelium and cerumen glands, equip the ear canal for its function as both a conduit and a cul-de-sac. Defects in development, or later blockages in the canal, lead to congenital or acquired conductive hearing loss. Recent studies have built on decades-old knowledge of ear canal development and suggest a novel multi-stage, complex and integrated system of development, helping to explain the mechanisms underlying congenital canal atresia and stenosis. Here we review our current understanding of ear canal development; how this biological lumen is made; what determines its location; and how its structure is maintained throughout life. Together this knowledge allows clinical questions to be approached from a developmental biology perspective.
... 4 The cyst is composed of newly synthesized cartilage, auricular cartilage and fluid. 15 When the perichondrium differentiates into cartilage, the leakage of fluids from the perichondrium is terminated. 14 The adhesion between newly synthesized cartilage and auricular cartilage may cause auricular thickening and deformation. ...
Objective:
To compare the efficacy of two different treatment approaches for auricular pseudocyst.
Methods:
This retrospective study reviewed data from patients with auricular pseudocyst that were treated with either anterior wall resection plus radiofrequency ablation compression (surgical group) or simple aspiration and compression suturing (control group). The following outcomes were compared between the two groups: therapeutic response (cure, good or none), duration of postoperative medication (antibiotics) use, duration of postoperative pain, duration of recovery of appearance and rate of complications (infection, auricular thickening, incision swelling and recurrence).
Results:
A total of 386 patients were enrolled in the study: 218 in the surgical group and 168 in the control group. Duration of postoperative medication use, duration of postoperative pain, duration of recovery of appearance and rate of postoperative complications were significantly lower in the surgical group compared with the control group. The overall therapeutic response (cure and good response) was significantly greater in the surgical group than in the control group.
Conclusion:
Auricular pseudocyst can be effectively treated by both of these methods, but anterior wall resection plus radiofrequency ablation compression might be more effective.
... Certain authors have been aggressive in their approach by excising of the anterior wall of the pseudocyst followed by abrasion of granulation tissue on the inner wall with a diamond burr, followed by a bolster dressing and two weeks postoperatively the patient had an area of exposed cartilage that required a full thickness post auricular skin graft. 9 In our study following the aspiration, contour dressing and splint application, in all 27 patients (100%), there was complete resolution of swelling. No patient had reaccumilation of fluid in the ear. ...
BACKGROUND
Pseudocyst of the auricle is a common benign disease. Many
treatment modalities have been described for this benign condition
ranging from simple aspiration to complex cutaneous surgeries
involving skin de-roofing and debridement with diamond burr.
the aim of treatment is to successfully resolve the seroma without
damaging the underlying healthy cartilage, thus maintaining the
normal contour of the auricle, and to prevent its recurrence.
METHODS
In this study we describe incision and drainage of the pseudocyst
with auricular splinting.
RESULTS
Resolution was seen in 100.00 %, skin discolouration in 33.33%,
skin thickening in 29.63% and deformity in 25.93% of the patients.
CONCLUSION
The use of corrugated drain sheet splint is an ingenious method
of aural pseudocyst management. This method is simple can
be performed by even less experienced surgeons and highly
economical which prevents the recurrence maintains the auricular aesthetics
... At recurrent cases, more invasive surgical approaches are necessary to prevent recurrences and poor cosmetic appearances. Anterior wall excision was defined for recurrent cases 10 . In this technique if the posterior wall is weak, cosmetic deformites such as 'floopy ear deformity' may ocur. ...
The pseudocyst of auricle is a rare and a benign condition of the ear that is located in the anterior aspect of the auricle. Clinically, this condition presents as a painless, prominent, fluctuant swelling on the upper anterior surface of the auricle. Although etiology is unclear, low-grade minor trauma was blamed as an inducing factor of this condition. In the literature treatment of this condition varies widely. Incisional drainage or needle aspiration followed by a compressive dressing is one of the most commonly applied methods but, this method of treatment has high recurrence rates. Chemical or mechanical obliteration of the cavity is necessary for a successfull treatment as reported in the previous studies. At recurrent cases more invasive surgical approaches such as anterior wall excision are necessary. We present a treatment of a non-traumatic and non-recurrent auricular pseudocyst by needle aspiration and intralesional steroid injection therapy. This minimally invasive technique is easy to apply in an office setting and give a good cosmetic outcome without complications associated with intralesional steroid administration.
... 6 The diagnosis is suggested by clinical findings 15 and confirmed by visualization of the intracartilaginous cavity. 16 Histologic and biochemical features complement the investigation. In our case, diagnosis was enhanced by the visualization of cystic formations by nuclear magnetic resonance. ...
Background:
Auricular pseudocysts are benign fluid accumulations of the ear of uncertain etiology. Little is known about the optimal modality to successfully treat these lesions. No systematic review addressing auricular pseudocysts have been published to date.
Objectives:
The aim of this study is to summarize all the published data regarding diagnostic and therapeutic challenges of auricular pseudocysts.
Methods:
On May 28, 2020, a systematic search of Medline, Embase, and Cochrane databases was conducted. All the studies describing treatment of auricular pseudocysts, procedure description, outcome, and follow-up period were included in this review.
Results:
After full-text article review, 74 articles were included, representing a total of 1,011 lesions. The commonly used treatments for auricular pseudocysts were deroofing (493 lesions), aspiration (284 lesions), incision and drainage (171 lesions), intralesional steroids (53 lesions), and observation (10 lesions). The highest cure rate was found with the deroofing procedure (97.2%) followed by incision and drainage (95.9%). The mean follow-up period was 6.7 months.
Conclusion:
Surgical procedures (anterior deroofing or incision and drainage) showed the highest cure rates and should be considered as first-line treatment for auricular pseudocysts. Future adequately designed randomized controlled trials are warranted to compare the efficacy of the techniques described.
Pseudocyst of the auricle is a disease of degenerative cartilage associated with asymptomatic swelling of the external ear caused by an intracartilaginous accumulation of serous fluid. Histological examination shows an intracartilaginous cavity without an epithelial lining. This disease is characterized by frequent relapses despite various therapeutic approaches. In this report we describe one patient with pseudocyst of the auricle who was successfully treated with intralesional injection of 1 mg/mL of minocycline hydrochloride.
– Pseudocysts of the auricle are an infrequent pathology of the pinna, which may pose diagnostic and therapeutic difficulties. In our case, we propose punch biopsy as a diagnostic test and therapeutic solution in a patient with a bilateral presentation.
In contrast to the osseus part that develops from the tympanic ring of the squamous part of the temporal bone after birth, there is little information on fetal development of the cartilages surrounding the human external acoustic meatus. Using routine histology and immunohistochemistry, we examine sections of 22 fetuses (CRL 100-270mm) to study the development of these cartilages. Early external ear cartilages are composed of three groups: (1) a ring-like cartilage at the putative tragus on the anterior side of the meatus, (2) two or three bar-like cartilages along the inferior wall of the meatus, and (3) a plate-like cartilage in a skin fold for the putative helix on the posterior side. In contrast to the first and second pharyngeal arch cartilages, all the external ear cartilages express glial fibrillary acidic protein. Notably, the bar-like cartilages along the meatus are connected with a fascia-like structure to the second pharyngeal arch cartilage. Later, with considerable individual variation, new cartilage bars extend from the inferior cartilages to the superior side of the meatus. Thus, via an intermediate stage showing a chain of triangular elastic cartilages, a chain of bar-like cartilages on the inferior side appears to change into a complex of H-shaped cartilages. Numerous ceruminous glands are seen in the thick subcutaneous tissue overlying the cartilaginous part of the meatus. However, they do not insert into the cartilage. The external ear cartilages develop much earlier than, and independently of, the osseus part.
Benign idiopathic cystic chondromalacia, also known as pseudocyst of the auricle, is a rare but intriguing condition which is frequently misdiagnosed by clinicians and pathologists. It is characterized by an asymptomatic swelling of the anterior surface of the auricle caused by an intracartilaginous accumulation of fluid. The aetiopathogenesis remains unclear. The distinctive histopathological features, coupled with an awareness of the condition, are crucial to establishing a definitive diagnosis and, in turn, instituting the appropriate treatment.
Abstract Auricular pseudocyst is clinically characterized by asymptomatic, non-inflammatory benign cystic swelling, usually located on the anterior or posterior helix. Recurrences have been observed frequently after simple drainage or aspiration of the lesions. Certain treatment modalities for the condition have been reported with variable success, complications and cosmetic results. These include intralesional steroid injection, sclerosing agent administration such as minocycline, fibrin glue, trichloracetic acid with or without compression, compressive treatment alone (e.g surgical bolsters, prosthesis) and surgical intervention. Here we report the successful treatment of an auricular pseudocyst using clothing button bolsters alone.
Auricular pseudocyst is a benign idiopathic disease, which typically presents as painless spontaneous swelling over the anterior part of the auricle. It has usually been diagnosed in young healthy male patients. Its aetiology remains unknown, but hypothetically congenital dysplasia or chronic low-grade trauma could be the main causes. We present two case reports and a discussion of the auricle pseudocysts, their origin and treatment options.
This study determined the effects of chondrocyte source, cell concentration, and growth period on cartilage production when isolated porcine cells are injected subcutaneously in a nude mouse model. Chondrocytes were isolated from both ear and articular cartilage and were suspended in Ham's F-12 medium at concentrations of 10, 20, 40, and 80 million cells per cubic centimeter. Using the nude mouse model, each concentration group was injected subcutaneously in 100-microl aliquots and was allowed to incubate for 6 weeks in vivo. In addition, cells suspended at a fixed concentration of 40 million cells per cubic centimeter were injected in 100-microl aliquots and were incubated for 1, 2, 3, 4, 5, 6, 9, and 12 weeks. Each concentration or time period studied contained a total of eight mice, with four samples harvested per mouse for a final sample size of 32 constructs. All neocartilage samples were analyzed by histologic characteristics, mass, glycosaminoglycan level, and DNA content. Control groups consisted of native porcine ear and articular cartilage. Specimen mass increased with increasing concentration and incubation time. Ear neocartilage was larger than articular neocartilage at each concentration and time period. At 40 million cells per cubic centimeter, both ear and articular chondrocytes produced optimal neocartilage, without limitations in growth. Specimen mass increased with incubation time up to 6 weeks in both ear and articular samples. No significant variations in glycosaminoglycan content were found in either articular or ear neocartilage, with respect to variable chondrocyte concentration or growth period. Although articular samples demonstrated no significant trends in DNA content over time, ear specimens showed decreasing values through 6 weeks, inversely proportional to increase in specimen mass. Although both articular and ear sources of chondrocytes have been used in past tissue-engineering studies with success, this study indicates that a suspension of ear chondrocytes injected into a subcutaneous location will produce biochemical and histologic data with greater similarity to those of native cartilage. The authors believe that this phenomenon is attributable to the local environment in which isolated chondrocytes from different sources are introduced. The subcutaneous environment of native ear cartilage accommodates subcutaneously injected ear chondrocyte transplants better than articular transplants. Native structural and biochemical cues within the local environment are believed to guide the proliferation of the differentiated chondrocytes.
Pseudocyst of the auricle is a rarely seen fluctuant swelling of the ear. Although various hypotheses on the etiology have been suggested, the exact cause still remains unclear. Chronic minor trauma, which is believed to create intracartilaginous cavity, is accepted to be the most probable cause. Several treatment methods have been used for this benign lesion, but higher recurrence rates can be seen if not properly treated.
To discuss a new treatment modality for this rare disorder.
A 44-year-old man presented with a large pseudocyst of the auricle that had been treated several times previously with unsuccessful outcomes. For its treatment, we performed curettage and then used fibrin glue as a sealer between the two leaves of the cartilage.
At postoperative 6-months follow-up, there was no evidence of recurrence. The cosmetic outcome was excellent.
The use of fibrin glue both to obliterate the pseudocyst space and to make the two leaves of the cartilage adhere to each other should be kept in mind in this rare disorder in order to avoid recurrences.
Auricular pseudocysts are a benign condition characterized by the asymptomatic, usually unilateral swelling of the helix or antihelix. The condition is often difficult to treat because recurrences and subsequent auricular deformities are common. We successfully treated a patient with an auricular pseudocyst of the left ear using needle aspiration followed by application of a surgical bolster. In this article, we discuss the features of auricular pseudocysts and propose a simple, first-line approach to the management of this disease.
There are few reports regarding auricular seroma, and the definition for it is unclear. Herein, we report 16 cases of auricular seroma. We found several common characteristics: ( 1) no obvious history of trauma, insect bite, or bruising, ( 2) accumulation of a small amount of rose- wine - or straw-colored serum in the hypodermis but above the perichondrium, determined by puncture aspiration, ( 3) most often located between the antihelix and concha, ( 4) no sign of marked inflammation or severe pain, and ( 5) disappearance without marked disfigurement. We advocate treating auricular seroma as an independent disease entity apart from other auricular swellings such as hematoma and pseudocyst.
An auricular pseudocyst is a fluid filled cavity unlined by epithelium in the intracartilaginous space of the ear. Clinically, it presents as a painless outpouching on the upper anterior surface of the auricle with sterile straw coloured fluid found upon aspiration. If left untreated, permanent deformity of the pinna may result. Treatment of the pseudocysts has varied in the literature with techniques involving aspiration alone or incision and drainage; however, due to the high recurrence rates with these methods more aggressive therapies have been instituted. Although these techniques have achieved reasonable results with few recurrences, their invasive nature and chemotherapeutic and toxic agents used have caused significant morbidity. We present treatment of an auricular pseudocyst by simple aspiration and local pressure application using an auricular prosthesis formulated with the creation of a moulage fitted to the ear by our prosthetist. This minimally invasive and simplistic approach can avoid some of the complications related to other therapies, such as cartilage deformity, depigmentation of skin, and scarring and yields optimal cosmetic results.
Pseudocyst of the auricle is characterized by asymptomatic swelling caused by an intracartilaginous fluid accumulation. If left untreated, permanent deformity of the pinna may occur. Many modalities of treatment have been reported. This article summarizes a 2 year retrospective study (2005-2007) performed in the Children Teaching Hospital in Bratislava. This study presents two children who had bilateral pseudocyst of the auricle, and who were treated with different types of surgical treatment and reviews the literature. Purpose of this study is to compare the effectiveness of the two different methods of surgical treatment. The recognition of the ideal way of surgical method of treatment may lead to standardized approach, which can result in successful repair of the auricle with no recurrence (Fig. 4, Ref 16). Full Text (Free, PDF) www.bmj.sk
Bilateral pseudocysts of the auricle have been described in a 20-year-old Puerto Rican female. No definite etiology has been established for this clinical entity at the present time. Biopsy of the anterior wall of the cyst from our patient showed histologic characteristics similar to those described by Engel.¹ Combined technique using curettage, painting the inner surface of the cyst wall with 1% tincture of iodine and application of contour pressure dressings for several days resulted in uneventful healing in two weeks and restoration of the normal appearance of the auricles.
To the Editor.—The article by Cohen and Grossman1 on the "Pseudocyst of the Auricle" was very good. However, their conclusion that "corticosteroids do not play a role in the management of pseudocyst of the auricle" based on two cases, one by systemic treatment and another by intralesional injection, seems to be contrary to my experience with the latter. The technique used is to first cleanse the area with an antiseptic, then inject a local anesthetic with epinephrine into the skin overlying the swelling. A 22-gauge needle is then inserted into the pseudocyst and the fluid is aspirated. The first syringe is removed and a second syringe with the steroid is attached. The cavity is then flushed with triamcinolone acetonide suspension (10 mg/mL) (Kenalog 10) through the same needle that was left in place. The cavity is then aspirated once more to remove the excess steroid. Occasionally, pressure may
Four male patients with pseudocyst of the auricle were successfully treated with oral corticosteroids. This condition is an asymptomatic, non-inflammatory, cystic swelling, usually located in the scaphoid or triangular fossa of the anti-helix which if untreated, leads to deformity of the pinna. All successful methods of treatment described in the literature so far have been invasive. All four patients in the above series responded to oral steroid therapy alone.
Pseudocyst of the auricle is an asymptomatic, noninflammatory cystic swelling that typically involves the anthelix of the ear and results from an accumulation of fluid within an unlined intracartilaginous cavity. We report a patient with a recurrent pseudocyst of the auricle and describe a new surgical technique for treating this condition by applying 50% trichloroacetic acid to the intracartilaginous cavity and utilizing external button bolsters for compressive therapy. This therapeutic approach is simple to perform in the office, results in permanent resolution of the pseudocyst, preserves the normal architecture of the external ear, and provides excellent postoperative and long-term cosmetic results.
Auricular pseudocyst is an asymptomatic cystic swelling of the upper portion of the auricle. Various therapeutic approaches have been employed with variable success. We report our results with nine patients treated by needle aspiration and bolstered pressure sutures applied over both aspects of the cyst for 1 week. Treatment resulted in complete resolution with no recurrence of the lesion in any of the patients. This procedure is simple, does not require an operating room setting, and is more comfortable and more acceptable aesthetically by the patient.
Although pseudocyst of the auricle is a common disease in China, its cause and mechanism are still not clear. Several methods of treatment have been advocated: repeated aspirations combined with physiotherapy, and incision and drainage with contour pressure dressing, magnetotherapy etc. In recent years, a new technique with a drainage tube inserted into the pseudocyst using a guide needle has been used in our hospital in the treatment of this condition. We report 45 cases treated by this method, none of whom had the condition previously.
Four children with severe atopic eczema developed painless endochondral pseudocysts of the external auricle. The lesions were bilateral in two cases. In one case the lesion spontaneously resolved; of the remaining five lesions, one contained haematoma and the other four contained serous fluid. The aetiology of these lesions and their association with atopic eczema are unclear, but repeated minor trauma from rubbing may play a part.
A pseudocyst of the auricle (benign idiopathic cystic chondromalacia) is an intracartilaginous cystic swelling of the anterior auricle. The cause is uncertain, and most patients deny any history of inflammation or trauma. A patient had antecedent trauma and a fracture in the conchal cartilage; a simple surgical procedure was used to treat this patient.
Pseudocyst of the auricle (benign idiopathic cystic chondromalacia) is rare. Only 20 cases have been previously reported in the literature. Our study retrospectively reviews 21 additional cases. We conclude that idiopathic cystic chondromalacia can occur in both sexes, in all races, and at any age. The differential diagnoses for idiopathic cystic chondromalacia are relapsing polychondritis and chondrodermatitis nodularis chronica helicis. Recurrence of idiopathic cystic chondromalacia is uncommon following adequate local treatment.
Pseudocyst of the auricle is an uncommon lesion characterized by intercartilaginous cyst formation affecting the upper half of the anterior aspect of the auricle (Engel, 1966). Most reports are from young males in China, and Malays in Malaysia and Singapore (Shanmugham, 1985). The aetiology of this condition is unknown. Various treatment methods are described and recurrences are frequent (Shanmugham, 1985). Engel (1966) was the first to report a series of pseudocysts of the auricle in Chinese, and Hansen (1967) reported a similar series in Caucasians. Both Engel and Hansen found these only in males. However, Santos et al. (1974) and Shanmugham (1985) reported two cases in females. Two cases of pseudocyst of the auricle are presented occurring in Indians from South India, one male and the other a female. These are the first reported cases in Indians.
Pseudocyst of the auricle is an uncommon, asymptomatic swelling of the ear, resulting from an accumulation of fluid within an unlined intracartilaginous cavity. Numerous therapeutic approaches have been employed in the past with variable success. In this paper we utilized a procedure comprising aspiration of the cystic structure followed by compression with bolstered sutures, with complete resolution of the lesion.
We reviewed and studied the histologic features of 23 cases of pseudocysts of auricular cartilage. Our aim was to determine and describe the histologic spectrum of this condition and to delineate the histologic differential diagnostic points. Lesions for which this condition has been mistaken include relapsing polychondritis, chondrodermatitis nodularis helicis, traumatic perichondritis, hemangioma, chondroma, angiosarcoma, and chondrosarcoma. The pathologist who is familiar with the histologic patterns of this condition usually can recognize it readily. When biopsy specimens are small, and the diagnosis is uncertain, clinical features can often suggest the correct diagnosis.
Pseudocyst of the auricle is a distinct clinical entity with certain characteristic features. These cysts occur more frequently in Chinese and develop spontaneously, without trauma or infection. The cysts contain clear yellow coloured fluid. A simple but effective method of treatment is described.
NONTENDER cystic swellings of the auricle which are traumatic or spontaneous in origin are classically referred to as subperichondrial effusions or hematomas. A collection of fluid or blood is incarcerated between the perichondrium and the cartilage. This is treated by opening or needling the perichondrium and packing the auricle in contour. The author noted when attempting to incise a spontaneous cystic bulge of the auricle that even though the perichondrium had been opened the cyst had not yet been reached. The cartilage was then opened and the fluid exposed and drained. The serous fluid was enclosed by a cartilaginous wall in all parameters and was then an intracartilaginous collection of fluid. Weeks later a similar problem was seen and the identical situation was found. During the next four years, four more cases were seen. When this paper was being prepared the author had used the term "intracartilaginous cyst" but Engel's1
Pseudocyst of the auricle is an intracartilaginous collection of serous or serosanguineous fluid resulting in a noninflammatory cystic swelling of the upper ear. The histology is distinctive, consisting of an intracartilaginous cavity due to cartilaginous degeneration and replacement by fibrous tissue. The condition is likely due to ischemic necrosis of auricular cartilage. Inappropriate therapy may result in a permanent deformity of the auricle.
A 35-year-old man had the insidious onset of an asymptomatic cyst-like swelling of the auricle. Serous fluid was evacuated but continued to reaccumulate. Application of a pressure dressing resulted in resolution without deformity. Distinguishing features of seroma, pseudocyst, and hematoma are discussed.