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Facial Plastic and Reconstructive Surgery

Auricular Hematomas in a High-Volume Trauma Population

Wednesday, October 4, 2023
11:24 AM - 11:30 AM East Coast USA Time
Location: 205ABC

    Presenting Author(s)

  • Alisa L. Phillips, MS

    Medical Student
    University of Tennessee Health Science Center College of Medicine
    Memphis, TN, United States

    • Co-Author(s)

  • JL

    Jordan B. Luttrell, MD

    Resident
    University of Tennessee
    Memphis, TN, United States

    • Senior Author(s)

  • Anas Eid, MD

    Assistant Professor - Facial Plastic & Reconstructive Microsurgery
    Department of Otolaryngology - Head and Neck Surgery University of Tennessee Health Science Center
    Memphis, TN, United States

Disclosure(s):
Alisa L. Phillips, MS: No relevant relationships to disclose.
Anas Eid, MD: No relevant relationships to disclose.
Introduction: Auricular hematomas are generally associated with sports-related injuries with a higher incidence in males, with studies predominantly in white populations in high neighborhood socioeconomic status (NSES) counties, with limited low NSES data . A previous population-based study of trauma patients in our county showed that those who live in high versus low NSES experienced socioeconomic variation in injury. Our goal is to determine if NSES correlates with clinical management and outcomes in these patients.

Methods: We performed IRB-approved retrospective chart review in patients from two systems, one with six hospital systems and a single center, diagnosed with auricular hematomas from Jan 1, 2008-Jan 1, 2023. Patients included those seen outpatient or inpatient with at least one follow-up, adequate clinical description, and comment on any complications or recurrences were included in this study.

Results: 26 patients, ranging from age 0-83 with a median age of 31, were identified with 81% undergoing a drainage procedure and an overall recurrence rate of 38%. The most common etiology was assault/non-accidental trauma (NAT) at 46%, and was equally distributed across all NSES. There were no sports related injuries. Facial trauma team consults resulted in lower recurrence rates, 30% versus 67% in non-consult patients. Bolster placement resulted in a 20% recurrence rate compared to 67% for those without a bolster. 65% of our patients were black and had the highest recurrence rate at 47%, compared to recurrence rates of 25% in white and 0% in the one patient with unknown/other race. Consults were ordered 71% of the time for black patients versus 88% for white patients and black patients ended up with bolster placement 56% of the time versus 71% in white patients. The highest rates of recurrence at 87% occurred in the $35,000-$45,999 range, independent of race.

Conclusions: Higher rates of assault/NAT etiologies existed in our population independent of NSES. Low NSES appears to correlate with a higher recurrence rate. Our study reiterates the importance of facial trauma team consultation and bolster usage to reduce recurrence.