Wearing appropriate ear protection during contact sports or activities that involve ear trauma can help reduce the risk of pseudocyst formation. For individuals using headphones or protective gear, choosing well-fitted devices and taking regular breaks can minimise prolonged pressure on the ear. After treatment, maintaining proper ear hygiene and avoiding direct trauma to the area helps prevent recurrence.
Auricular Pseudocyst Treatment in Singapore
An auricular pseudocyst is a painless, fluid-filled swelling that develops between the cartilage layers of the outer ear.
This condition creates a smooth, dome-shaped bulge on the ear’s front surface, typically appearing suddenly without prior trauma or infection. While not medically severe, the swelling can alter the ear’s appearance and may recur if not treated properly.
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
Symptoms of Auricular Pseudocyst
The following signs and indicators help identify an auricular pseudocyst, though patients may experience varying combinations of these symptoms.
- Painless swelling: A soft, fluid-filled bump develops on the front of the ear, typically measuring 1-4 centimetres in diameter.
- Skin colour changes: The affected area maintains normal skin tone initially but may develop a slight bluish tint as fluid accumulates beneath the surface.
- Fluctuant mass: The swelling yields to gentle pressure and demonstrates fluid movement without surrounding hardness or inflammation.
- Progressive enlargement: The pseudocyst expands gradually over several days to weeks before reaching a stable size.
Causes and Risk Factors
Auricular pseudocysts develop when fluid collects between the layers of ear cartilage, often due to structural changes or external pressure. Contributing factors include:
Cartilage degeneration
Breakdown of ear cartilage creates space for fluid accumulation between cartilage layers, leading to pseudocyst formation
Mechanical trauma
Repeated pressure or friction on the ear, particularly common in wrestlers and martial artists, can initiate pseudocyst development
Age and gender
Males between 30 and 60 years show higher occurrence rates of this condition
Occupational factors
Regular use of headphones or protective ear equipment increases the likelihood of development.
Diagnostic Methods
- Physical examination: ENT specialist assessment includes palpation of the ear to evaluate swelling characteristics, mobility, and tenderness. Specific physical findings help differentiate pseudocysts from other ear masses.
- Needle aspiration: A fine needle withdraws fluid from the swelling for analysis. The extracted fluid appears clear or straw-coloured and confirms the diagnosis while excluding infection or blood accumulation.
- Imaging studies: Ultrasound or MRI scans may be conducted in complex cases. These techniques reveal the exact location and extent of the pseudocyst while showing any underlying structural changes.
Treatment Options
Auricular pseudocysts can be managed through non-surgical or surgical approaches, depending on the severity, recurrence risk, and response to initial treatment.
Non-Surgical Treatment
- Aspiration and Compression: Fluid is drained using a needle at the clinic, followed by the application of a pressure dressing to prevent reaccumulation. Dressings are changed regularly for 1–2 weeks to maintain continuous pressure.
- Intralesional Steroid Injection: Corticosteroids are injected into the pseudocyst cavity after drainage to reduce inflammation and minimise fluid recurrence. Multiple sessions may be needed for effective results.
Surgical Treatment
- Incision and Drainage with Buttoning: Small incisions allow fluid drainage, followed by through-and-through sutures to hold cartilage layers together during healing. This method reduces recurrence rates by maintaining direct cartilage apposition.
- Deroofing Procedure: The anterior wall of the pseudocyst is partially removed, promoting controlled scarring that prevents fluid reaccumulation. While effective, careful post-operative care is required to preserve ear shape and prevent deformity.
Surgical treatment for auricular pseudocyst is in general a safe procedure. Risks or side effects are not common but may include recurrence, minor bleeding, infection, changes to ear shape and scars.
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Frequently Asked Questions (FAQ)
Can auricular pseudocysts resolve without treatment?
While small pseudocysts may spontaneously resolve, most cases need medical intervention to prevent recurrence and potential cartilage deformity (cauliflower ear).
Does the condition affect hearing?
Auricular pseudocysts do not impact hearing as they occur in the outer ear cartilage, separate from the ear canal and hearing mechanisms.
What is the typical recovery period after surgical treatment?
Recovery spans 2-4 weeks, with pressure dressings maintained for the first 1-2 weeks. Patients typically resume normal activities within this timeframe, though contact sports should be avoided for at least 6 weeks.
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.
Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.
- 2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
- 2016 – Best Educator Award (Eastern Health Alliance)
- 2016 – “Wow” Award (Patient Compliment)
- 2014 – Eastern Health Alliance Caring Award – Silver
- 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
- 2012 – Human Manpower Development Award (Ministry of Health, Singapore)
- 2007 – Singhealth Best Doctor Award
Qualifications
- MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
- MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
- MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
- FAMS – Fellow of the Academy of Medicine Singapore
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