Clinical Implications of Intralesional Steroid Injections in the Management of Otohematoma

To evaluate the long-term effects of intralesional steroid injections (ILSIs) in patients with otohematoma and to suggest the clinical implications, especially with regard to the duration of otohematoma.Retrospective analysis.Fifty-six patients were enrolled and classified into short-term otohematoma (n = 30) and long-term otohematoma (n = 26) groups according to the period of time after auricular trauma. After the first ILSI, all patients underwent weekly examinations during the 21-day observational period to determine the treatment outcomes and were then followed up for reevaluation for a maximum of 36 months. We considered ILSIs to be ineffective if the otohematoma persisted after the third ILSI, and we opted to perform surgical treatment in such cases. In addition, we evaluated early recurrence, late recurrence, and ILSI-related complications.After up to three ILSIs, 29 out of 30 cases (96.7%) with short-term otohematoma and 20 out of 26 cases (76.9%) with long-standing otohematoma were treated without complications. Three patients with long-term otohematoma, however, experienced late recurrences at 4, 15, and 18 months, respectively. Seven patients who showed no response after ILSIs underwent surgical treatment. The duration of otohematoma (P = .043) and a higher initial aspirated fluid volume (P = .014) were shown to significantly increase the risk of treatment failure after ILSIs.Multiple and immediate ILSIs in patients with otohematoma appear to be an effective treatment approach with no complications. Patients with short-term otohematoma showed better outcomes following ILSIs. The treatment approach may be optimized based on the duration and degree of otohematoma.4 Laryngoscope, 129:459-465, 2019.