Ear Canal Haemangioma - Symptoms, Causes, Risks, Treatment

An ear canal haemangioma is an unusual growth of blood vessels in and around the external auditory canal. Haemangiomas are the most common benign tumour in infants (infantile haemangioma) and young children. They often distort the shape of the ear, leading to permanent external ear deformities. The external ear canal can also become compressed due to parotid haemangioma (a haemangioma on the salivary gland in front of the ear). 

Stages of Ear Canal Haemangioma

While an ear canal haemangioma develops during the first few days or months of life, it fades away by the time a child is ten. The following table shows the usual stages or phases of an ear haemangioma. 

There are three main types of ear canal haemangiomas:

1. Capillary Haemangioma (or Superficial Haemangioma): A capillary ear canal haemangioma forms just beneath the epidermis (top layer of the skin). It is bright red and sometimes referred to as a strawberry birthmark. 
2. Cavernous Haemangioma: A cavernous ear canal haemangioma forms deeper into the hypodermis (skin’s bottom fatty layer). It appears blue or skin-coloured. Cavernous haemangioma of the auditory canal is extremely rare and, when present, usually includes the tympanic membrane. 
3. Mixed Haemangioma: This type of haemangioma is present both on the surface and in the deeper layers of the skin. It has a strawberry look with a skin bulge. 

An ear canal haemangioma can become visible in a child soon after birth. While the signs and symptoms of haemangioma can be witnessed as the lesion develops, it does not always cause symptoms. The signs and symptoms of an ear canal haemangioma include:

1. A red or reddish-purple raised, bumpy patch on the skin
2. A raised blue tumour with visible blood vessels
3. A firm, rubbery feel 
4. Sometimes becomes sore
5. Grows rapidly in the first few months
6. It is one-quarter to two inches in size

Infantile haemangioma is the most common type of haemangioma. However, experts are not sure what causes ear canal haemangioma in children. Some theories proposed by experts related to the causes of ear haemangioma include:

1. It is an inherited condition caused by certain genetic traits.
2. Certain proteins develop in the placenta that causes the cells to multiply. These cells clump with blood vessels and grow into non-cancerous patches. 

Any child can develop an ear canal haemangioma at birth or a few months later. However, certain factors can increase the risk of an ear haemangioma. These factors include:

1. Gender: Females are 2 to 3 times more likely than men to develop haemangiomas. 
2. Weight: Birth weight less than 2.5 kg can increase the risk of haemangioma.
3. Premature birth: A premature child (birth before the 37th week of pregnancy) is more prone to developing ear canal haemangioma. 
4. Multiple births: Haemangiomas are more common in twins, triplets, or more. 

Currently, there is no way of preventing ear canal haemangioma since the exact cause of haemangioma is not known. However, below are some general tips for caring for haemangioma so that it does not get severe.

1. Avoid scratching and scraping the haemangioma.
2. Keep the haemangioma away from direct sunlight.
3. Keep the area clean and dry.

The doctor can diagnose a haemangioma of the ear canal based on its appearance during a physical exam. Usually, no tests are required. However, depending on the type and size of the haemangioma, the doctor may decide to conduct certain tests if it is likely to cause problems with hearing. Tests to determine the depth of an ear canal haemangioma include:

1. MRI Scan
2. CT Scan
3. Skin Biopsy

How to Prepare for Doctor Consultation?

While preparing for a doctor consultation, one must make sure to:

1. Take a prior appointment
2. Note down the signs and symptoms experienced
3. Write down the family history
4. Enlist the questions for the doctor

Here’s what a patient can expect from the doctor during the consultation:

1. When did you first notice signs and symptoms?
2. How severe are the symptoms?
3. Do you have any family members who had ear canal haemangioma in the past?
4. Do you experience hearing problems?

For an ear canal haemangioma, some basic questions for the doctor include:

1. What do these signs indicate?
2. What is the possible cause of these signs and symptoms?
3. What kind of tests are needed for the diagnosis?
4. Would you recommend treating the haemangioma or waiting for it to fade on its own?
5. If it is recommended, which treatment is best?
6. Is surgery required?
7. What are the common side effects of the treatment?
8. Are there any complications to look out for?

Most haemangiomas resolve entirely when the child is five to ten years old without surgery. The doctor may recommend early treatment if the ear canal haemangioma:

1. Affects hearing
2. Is large or grows rapidly
3. Significantly affects the patient’s appearance or self-esteem
4. Ear Canal Haemangioma treatment without surgery

The treatment options for an ear canal haemangioma include:

1. Beta-Blockers: These medicines reduce the blood flow to the haemangioma, slowing its growth. The doctor may prescribe gel or ointment for application on the affected area. They may also prescribe oral medications for large haemangiomas that interfere with hearing. 
2. Corticosteroid medications: Steroid medicines may also inhibit hemangioma growth. These work best when utilised throughout the early stages of development.
3. Interferons: These drugs take a little longer to take effect and are only used if beta-blockers and corticosteroids are ineffective.

Ear Canal Haemangioma treatment with surgery

1. Surgery: The doctor may recommend surgery if the haemangioma can cause some potential complications. Ear haemangioma may also sometimes cause ear deformities. This may need surgery to remove extra skin and fatty scar tissue. In some cases, the patient may need surgical reconstruction of the ear. 
2. Laser Therapy: Laser therapy may treat any remaining red or purple pigmentation after surgical resection. 

The treatment approach and procedure selection are based on the patient’s condition and the doctor’s opinion. 

Haemangiomas of the ear canal usually do not need treatment as they are harmless tumours. However, when the haemangioma multiplies or is large, it may require treatment. Some potential risks and complications of ear canal haemangioma include:

1. Bleeding (if the haemangioma becomes injured)
2. Hearing problems
3. Psychological problems (from skin appearance)
4. Visible changes in the skin
5. Infections and sores
6. Affect hearing
7. Cause skin problems and deformities
8. It can affect hearing.
9. It can cause skin problems and deformities. 

When to See a Doctor?

One should consult their doctor if their child experiences the following signs and symptoms of an infection:

1. Redness
2. Pain
3. Pus
4. Skin breaks down and develops a sore
5. Oozing from the haemangioma
6. Fever above 101℉

Haemangiomas are common tumours among children that are not harmful. However, the occurrence of a haemangioma in an ear canal is rare. When they do develop, they eventually fade without treatment. The doctor may recommend treatment when the large haemangioma affects the child’s appearance and self-esteem. Beta-blockers can shrink the tumour and make it less noticeable. However, if the haemangioma becomes large and causes hearing problems, your child may need surgery. 

You can consult with an expert at HexaHealth to know more about haemangioma meaning, symptoms, causes, and treatments. Our doctors will guide you through the best treatment approach if required.