Auricular hematoma cases caused by mobile phones

ARTICLE IN PRESS Oral and Maxillofacial Surgery Cases xxx (2015) 1–2

Contents lists available at ScienceDirect

Oral and Maxillofacial Surgery Cases j o u r n a l h o m e p a g e : w w w. o r a l a n d m a x i l l o f a c i a l s u r g e r y c a s e s . c o m

1 Case Report 2 3 4 Q25 Q3 Halil E. Özel, bs_bs_query

bs_bs_query

bs_bs_query

Auricular hematoma cases caused by mobile phones

bs_bs_query

bs_bs_query

6

bs_bs_query

MD *, Selahattin Genç, Erkan Esen, MD, Fatih Özdoğan, MD, Adin Selçuk

Department of Otolaryngology, Kocaeli Derince Research and Training Hospital, Kocaeli, Turkey

7

bs_bs_query

8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27

bs_bs_query

A R T I C L E

I N F O

A B S T R A C T

bs_bs_query

bs_bs_query bs_bs_query

bs_bs_query bs_bs_query

bs_bs_query bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

Article history: Received 19 August 2014 Revised 28 October 2014 Accepted 31 October 2015 Available online

bs_bs_query

bs_bs_query bs_bs_query

bs_bs_query bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56

Keywords: Auricular hematoma Prognosis Treatment

We report auricular hematoma cases caused by mobile phones. A 32-year-old male and a 23-year-old female presented with auricular hematoma, having no significant histories of trauma. The patients underwent simple hematoma aspiration. Hematoma re-accumulated in the first case. Incision and drainage were performed, and then auricular skin was stabilized by suturing a gauze pad over the area. Both patients recovered without sequelae after treatment. Judging from these cases, we want to postulate that prolonged mobile phone use may cause auricular hematoma. © 2015 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

bs_bs_query

bs_bs_query

1. Introduction

61

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

Auricular hematomas usually occur following blunt trauma to the external ear structures, which causes blood and serum accumulation between the perichondrium and cartilage. They are relatively common injuries in contact sports such as wrestling and boxing. Auricular hematomas may be on the ventral (anterior) or dorsal (posterior, near the scalp) side or both. Hematomas usually occur just below the helix [1]. We report auricular hematoma cases caused by mobile phones, with users having no significant histories of trauma.

bs_bs_query

bs_bs_query

62

1.1. Case report 1

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

A 32-year-old male presented with complaint of painless swelling on the right ear growing for the last 2 days. He had no significant previous medical history or trauma to the ear. The patient stated that he had recently been using his mobile phone up to 4 hours per day, listening with his right ear. On examination, a slightly compressible swelling affecting the concha, limited to an area of approximately 10 × 5 mm was present (Figure 1).

bs_bs_query

bs_bs_query

1.2. Case report 2 Figure 1. Auricular hematoma affected the concha.

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

The second case was a 23-year-old female who presented with complaint of painless swelling on the right ear growing for the last 3 days. She had no significant previous medical history or trauma to the ear. The patient stated that she had been using her mobile

57 58 Q1 * Corresponding author. Kocaeli Derince Eğitim ve Araştırma Hastanesi Kulak Burun Boğaz Kliniği, Kocaeli, Turkey. Tel.: +90 5055604015; fax: +90 2622335536. 59 E-mail address: [email protected] (H.E. Özel). 60 bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

63 64

phone up to 3 hours per day for the past 2 weeks, listening with her right ear. On examination, a slightly compressible swelling affecting the crura anthelicis, limited to an area of approximately 10 × 10 mm was present (Figure 2). In both cases, the diagnosis of an auricular hematoma was made, and the patients underwent simple hematoma aspiration. A

2214-5419 © 2015 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). http://dx.doi.org/10.1016/j.omsc.2015.10.002

65 66 67 68 69 70

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

ARTICLE IN PRESS 2

H.E. Özel et al. / Oral and Maxillofacial Surgery Cases xxx (2015) 1–2

1

bs_bs_query

2

bs_bs_query

3

bs_bs_query

Figure 2. Auricular hematoma affected the crura anthelicis.

4

bs_bs_query

5 6 7 8 9 10 11 12

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34

compression bandage was placed onto the ear, but in case 1, the hematoma re-accumulated within 2 days. Incision and drainage were performed under local anesthesia, leaving a penrose drain, and then auricular skin was stabilized by suturing a gauze pad over the area. After 7 days, the hematoma had not re-accumulated and the compression bandaging was removed. The second case was re-evaluated every day for 1 week and continued to have no re-accumulation. Both patients recovered without sequelae after treatment.

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

Consent Written informed consent was obtained from the patient(s) for publication of this case report and case series and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request.

The authors declare there are no conflicts of interest. If auricular hematomas are left untreated, destruction of the underlying avascular cartilaginous structures develops, which leads to fibroneocartilage formation, then a permanent ear deformity called cauliflower ear. Therefore, auricular hematomas should be treated immediately. Simple aspiration is often an inadequate method of managing this problem due to the high rate of re-accumulation. To prevent re-accumulation, incision, drainage, penrose drain placement, and suturing a gauze pad over the area to force apposition of the skin is necessary in most cases to get the best results [1,2]. In the early stages following injury, a simple aspiration is an option, especially if the hematoma affects a small region. In our first case, this was ineffective. We believe this was due to the difficulty of adequately packing the concha and then maintaining pressure on both sides of the auricle. The effect of mobile phone radiation on human health is a subject of recent interest. Mobile phones are more dangerous than regular phones in some respects. All mobile phone networks worldwide use an ultra-high frequency for the transmission and reception of their signals, which are absorbed by the body. A well-understood effect

65 66 67 68 69 70 71

2. Discussion

bs_bs_query

35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64

Conflict of interest

bs_bs_query

bs_bs_query

of radiation is heating, in which any dielectric material (such as living tissue) is heated by the electromagnetic field. In mobile phone use, most of the heating effect will occur at the ventral surface of the ear. Additionally, the prolonged physical irritation caused by pressure from holding the device against one’s ear may cause rupture of dilated small blood vessels, leading to the formation of an auricular hematoma. A typical type of trauma that causes a more wellknown auricular hematoma is an acute blunt trauma. In our patients, however, no significant history of trauma was present. Both patients stated that they had made prolonged mobile phone calls in recent days, listening with their right ears, but that they do not work in jobs requiring frequent phone calls. Hematoma affected the concha and the crura anthelicis in the first and second cases, respectively. Hematoma was on the ventral side of the ipsilateral ear in both cases. These findings suggest a mild and relatively chronic trauma on the areas where the mobile phone was in contact with the external ear structures. Both patients had no complaint of pain. In their cases, a relatively chronic, slowly forming hematoma may have prevented excess tissue tension and pain. Although the majority of the world population has mobile phones, auricular hematoma caused by mobile phones has not been previously documented. Further studies are required to investigate the predisposing factors of auricular hematoma that are related to mobile phone use and the mechanism of the complication. From our cases, we postulate that prolonged mobile phone use may cause auricular hematoma. This cause should be kept in mind in patients without histories of apparent traumas. In the early stages, simple aspiration following a compression bandage may be an option for treatment, but daily follow-up to check for re-accumulation is necessary.

72 73 74 75

Acknowledgments Presented as a poster number PS2-052 in the 35th Congress of Turkish National Otorhinolaryngology and Head & Neck Surgery, November 2-6, 2013, Max Royal Hotel, Antalya, Turkey. No financial support was received for this paper. All authors have made substantial contributions to all of the following: (1) the conception and design of the study, acquisition of data, and analysis and interpretation of data, (2) drafting the article and revising it critically for important intellectual content, (3) final approval of the version to be submitted.

76 77 78 79 80 81 82 83 84 85 86 87

References

88

[1] Greywoode JD, Pribitkin EA, Krein H. Management of auricular hematoma and the cauliflower ear. Facial Plast Surg 2010;26(6):451–5. [2] Ghanem T, Rasamny JK, Park SS. Rethinking auricular trauma. Laryngoscope 2005;115(7):1251–5.

89 90 91 92

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query

bs_bs_query