Today’s column is about fucked-up ears.
It should come as no surprise that if you hit someone really hard in the ear, you can fuck it up or, sometimes, rip it off. Same goes for grinding someone’s head against a wrestling mat over and over again. The friction and pressure together create ideal conditions to forever change the cartilaginous topography of the human ear, a condition commonly referred to as cauliflower ear. When the ear is damaged in this way, blood begins to collect between the cartilage and the skin; if left untreated, the ear will permanently deform. It’s even possible to rupture a cauliflower ear, and ooh boy, when they pop, they sure do pop.
When I was in college, I worked in a veterinary clinic, and lo did I love it. There was a giant jar of isopropyl into which we would deposit any and all ticks removed in office. The game was to remove them intact and without popping them; the more swollen, the better. I developed a hard-earned reputation for abscess care, my fortitude in the face of certain smells exceeded only by my enthusiasm and steadiness of hand. There is deep satisfaction in fixing something discrete and a little gruesome, be it cleaning string cheese pus out of a goat’s neck, removing a carpet of ticks from the underside of a spaniel’s ear, or, in the case of a cat with a serious mite infestation, draining cauliflower ear.
The poor cat’s ears were swollen and crumpled in on themselves. She’d been shaking her head and scratching so much that she’d developed a subperichondrial hematoma, the precursor to cauliflower ear. Her ears were bleeding into the space between the cartilage and the skin, the pressure of the ensuing clot reducing blood flow to the area. We treated the cat by draining the blood from her swollen ears, the same way doctors have tended to battered pugilists for millennia.
Originally featured in the Baths of Constantine in ancient Rome and today housed in the city’s Museo Nazionale Roman, “Boxer at Rest” is a masterpiece of bronze and a testament to mankind’s enduring love of fighting. The statue features the aftermath of a fight: facial swelling and abrasions, evidence of broken nasal bones, and a couple of clean cuts to his tumid ears, complete with bright copper blood dripping onto his thighs. The treatment today, as it was then, is the same.
The main effect of the blunt or grinding trauma to the ear relates to how it changes the dynamic between the cartilage itself and the connective tissue that covers it, called the perichondrium. When blood starts to pour into the damaged area, it deprives the ear cartilage of some of its blood supply, a problem that the body now needs to fix. The damaged connective tissue that covers the cartilage kicks into gear and begins to make new cartilage, a rippling sheet of neocartilage that nestles up against the convolutions of the original shape of the ear. It take a while for the body to resorb all that blood, especially considering the poverty of circulation in the area. This means that the neocartilage which forms around the blood stretches out to cover the new expanse of territory. As the blood is broken down and reclaimed by the body, the new growth begins to retract, buckling as it goes. Voila, cauliflower ear.
It’s an aesthetic worry, to be sure. In researching this column, I found many a forum post soliciting opinions on whether or not cauliflower ear would reduce romantic prospects. (Ladies: How unsexy is cauliflower ear?). Wear your protective gear, trainers will say, lest you turn out like me, tilting their heads to one side, displaying the end of their cautionary tale. To some, it’s a badge of honor; to others, it’s a gruesome fate to be avoided. Nevertheless, with proper protection and prompt treatment, most of the permanent disfiguration can be avoided.
Like tick removal and abscess draining, early treatment of cauliflower ear can be a simple, satisfying fix. Using a syringe, remove the fluid from the ear, over and over again if necessary, and the bloated combat badge is transformed back into an approximation of the adorable little lugholes your mama made for you. There’s a neatness to it, the way start-to-finish tasks flatter our need for resolution. Nevermind the concussion soup lurking between your newly slimmed ears. We’ll get to that next week.