Surgical Management of Aural Hematoma in a Dog

Abstract
A Saint Bernard dog was presented TVCC of COVAS, Parbhani with history of swelling on left ear and constant head shaking. Fluctuant and fluid filled swelling on concave surface of pinna was diagnosed as aural hematoma. The hematoma was treated surgically and drained out completely. The dog had an uneventful recovery.

Introduction
Aural hematoma can be caused by direct damage (e.g. bite wounds, vehicular trauma) but are more common from head shaking and ear scratching associated with otitis externa. Aural hematoma occurs in dog due to self-inflicted trauma. Head shaking or ear scratching is secondary to acute or chronic inflammation of ear canal, parasites such as ear mites or ticks, allergy and foreign body in or near to the ear canal. Aural hematoma is the most common due to physical injury of ear pinna and most apparently on concave surface. When pets vigorously shake their head or scratch their ears, trauma to ear cause blood vessel and capillary in pinna to rupture. An aural hematoma is collection of blood or serum and sometimes blood clot within the pinna or ear flap. This blood collected under skin and cause ear flap to thicken. The swelling may involve entire ear flap or may involve only a small area. This condition is usually unilateral.

History and Diagnosis
Saint-Bernard female was presented with history of unilateral swelling on concave surface of right ear pinna and constant head shaking infested with mites. Physical examination revealed fluctuant and fluid filled swelling on concave surface of pinna was diagnosed as aural hematoma. The hematoma was treated surgically.

Treatment
Preoperative precaution has been taken care of by cleaning with soap and shaving both sides of affected ear pinna. Cotton gauze was fixed in external orifice of ear to prevent overflow of hematoma fluid in ear canal. Animal was kept on fasting overnight. Anesthesia was induced by using combination of Xylazine 1 mg/Kg b. wt. and Propofol 4 mg/kg b. wt.Animal was placed in lateral recumbency and incision was given throughout the length of hematoma on concave surface of pinna. Serosanguinous fluid along with blood clots and fibrin clots was drained out. The cavity was washed with normal saline containing dexamethasone and gentamicin. Through and through interrupted mattress sutures using 0.7mm nylon thread with knots on concave surface were taken leaving a gap of 1.5 to 2 mm between two ends of incision line for drainage. Pagadi bandage was applied to maintain pressure and to keep the operated ear in vertical direction to facilitate early recovery and easy drainage. E-collar was applied around the neck to avoid damage of wound by the dog herself by scratching.

Post-operative care was taken using Ceftriaxone Tazobactum (Intacef Tazo) 25 mg/Kg b. wt., Dexamethasone 0.4mg/ Kg b. wt., for five days. Fly repellent sprays were applied periodically throughout day. Dressing of wound was done once in a two days by cleaning wound using iodine and re-bandaging. Sutures were removed on 15^th post-operative day and animal recovered un eventfully. After a month ear was normal without wrinkles maintaining its original shape. Though treatment appears to be simple, aural hematoma is very painful and very uncomfortable condition for dogs. Regular cleaning and grooming along with maintaining dog free from internal as well as external parasites and cutting sharp nails periodically can minimize chances of occurrence of such condition.