Lump on Ear: How to Get Better

A) Pseudocyst: Lump on Ear

This is a special kind of cyst which forms when fluid collects between the cartilage and its lining. This can occur after physical trauma. For example, after an accident or while playing contact sports like rugby, boxing or mixed martial arts, we see many MMA fighters with a pseudocyst on their ear who commonly mistake it for a haematoma or blood clot initially.

The main concern is the recurrence of the pseudocyst. There is a risk of infection if we insert a needle into the cyst to aspirate the fluid out. Our advice is to always have it fully excised. This means including the abnormal cartilage lining and underlying damaged cartilage, to prevent the risk of recurrence. A special pressure dressing is then sutured onto the ear for about a week. This ensures that the cartilage layers are sandwiched firmly together to prevent fluid from pooling again in the loose space. We do this easily under local anaesthesia as a minor day-surgery procedure.

B) Keloid: Lump On Ear

Keloids are hard painless lumps of scar tissue which tend to grow that tend to grow on the external ear from the underlying cartilage. They commonly occur after ear piercings in this area or after an initial episode of infection. Once keloids start to form, they keep growing slowly to get bigger and bigger. This may cause pressure-related pain and be obviously unsightly.

The main risk of any treatment option for keloids is the risk of recurrence. When we remove the keloids surgically, we usually inject steroid medication into the keloid area to prevent recurrence. There is often a plane or line of division visible under the microscope between the keloid itself and the surrounding normal soft tissue.

It is important to try to remove the keloid tissue entirely before injecting the intra-keloid steroids. We routinely use the ENT microscope to make sure we remove all the keloid tissue, while preserving enough skin to close up the wound without causing the ear to look deformed. Avoiding any further trauma and/or infection after surgery is critical to prevent the keloid from growing back again.

C) Sebaceous Cyst: Lump on Ear

If your ear lump becomes increasingly painful, tender and red, or even starts to leak some yellow smelly fluid, then it may be an infected sebaceous cyst, a type of cyst which forms in the skin when the normal sebum gland becomes infected and its duct then becomes blocked. Avoid squeezing and pressing it because this will just make the infection worse and cause further swelling!

You might need a course of antibiotic tablets to treat the infection but ultimately, you will need the entire sebaceous cyst, including its contents and lining, removed completely to prevent future recurrent infections. We usually do this surgery under local anaesthesia as a day case.

D) Enlarged Lymph Node

Sometimes, the lump on or next to your ear may be a swollen lymph gland, which may have become inflamed due to an infection inside the ear, mouth or throat. Lymph nodes have an important job of draining infected fluid from the structures near them so it is important to examine the inside of your ear canal and eardrum, jaw, teeth and mouth, throat and nose to find out why.

A course of antibiotics may be prescribed for you and if you do not improve, then an ultrasound scan may be arranged for you to investigate this further. Sometimes, a biopsy may even be required to analyse the lymph node tissue itself to exclude more sinister causes.

Pressing your lymph node repeatedly certainly is unhelpful and will just cause more inflammation to make the enlarged lymph node take longer to resolve.