Cartilage conundrum: The story behind cauliflower ear

Kouros statue - Cauliflower ears
The head of Kouros (sporting cauliflower ears, of course) — photo by F. Tronchin

Wrestling fans from all over the country made the pilgrimage to Carver Hawkeye Arena this weekend, where the nation’s wrestling elite, dreaming gold medal dreams, grappled to punch their ticket to the 2016 Rio de Janeiro Summer Olympic Games.

So I know the question on everyone’s minds: what was the deal with all of those strange ear formations? I must have seen dozens, maybe hundreds of folks with calloused, tree burl-like ears poking out under their ball caps. Come to think of it, these ears kind of looked like one of my favorite brassicas, cauliflower. As it turns out, this gnarly ear condition affecting many wrestlers just so happens to be dubbed cauliflower ear.

Cauliflower ear, a brand of auricular hematoma, occurs after the ear suffers a blow or receives some other physical trauma. And one can imagine that any wrestler, over the course of their career, would be the recipient of countless blows to the ear and head. Like other forms of bruising, the ear swells with blood, filling with fluid until this pressure eventually causes the outer portion of the ear to detach from the cartilage.

“Acute trauma causes the tissue of the outer ear to scar and calcify,” said Dr. Andrew R. Peterson, MD, of the University of Iowa’s Department of Orthopaedics and Sports Medicine. “Typically treatment involves draining the fluid from the ear. Though repeated trauma and calcification can lead to very deformed ears and possibly impaired hearing.”

Victorian physicians and psychiatrists believed cauliflower ear to be a physical manifestation of mental insanity, a diagnosis that was later dismissed as absurd. But given the growing concern regarding CTE (Chronic traumatic encephalopathy) in sports, could the same head trauma that produces cauliflower ear also lead to degenerative brain disease?

“I think it’s a very big stretch,” said Dr. Andrew R. Peterson, “CTE is not common among amateur wrestlers. Only two cases have been confirmed and those occurred in professional wrestlers. Chris Benoit — who murdered his family and killed himself — is one.”

In 2013, President Obama designated the creation of the CENC (Chronic Effects of Neurotrauma Consortium), a federal agency investigating traumatic brain injuries in athletes and veterans. For some, this move by the president seemed like the tolling of the death knell for football, wrestling, and other sports associated with a high risk of head injury. But seeing the number of die-hard wrestling fans that swarmed Iowa City this past weekend, it seems any changes to the sport would be met with a fair share of consternation.

“We have more stories than actual cases,” said Dr. Peterson, “There have only been 150 documented cases of CTE in our country, and hardly any among wrestlers.”