Abstract
BACKGROUND: Cauliflower ear is a deformity caused by trauma, leading to a thickened external ear with indistinct cartilaginous features. Historically perceived as a "badge of honor" by athletes, it may also cause significant cosmetic, functional, and psychosocial challenges. This study aims to elucidate the functional and psychosocial burden of cauliflower ear and evaluate awareness and interest in reconstruction.
METHODS: An anonymous survey was distributed by e-mail via REDCap to members of the National Wrestling Coaches Association (NWCA). Demographic information, history of cauliflower ear, psychological and functional experience with cauliflower ear, and history of reconstruction for cauliflower ear were collected.
RESULTS: A total of 1,338 responses were analyzed. The mean age of respondents was 45.2, and 3% were female. Of those surveyed, 910 (69%) reported having a history of cauliflower ear. Of those affected, 15% reported feeling self-conscious or embarrassed by their ears in social interactions. 19% believe their cauliflower ear has played a role in relationships. 12% reported issues with hearing, 59% have experienced pain, 30% had issues with sleeping, and 5% reported medical complications. 57% were not aware or somewhat aware of surgical options to treat their cauliflower ear(s). 100 respondents (11%) reported that they are currently or have previously considered surgical treatment of their ears.
CONCLUSIONS: Cauliflower ear imposes significant functional and psychosocial challenges, with many affected individuals expressing interest in reconstruction. However, awareness of surgical options remains low. This highlights the need for greater patient education and outreach by plastic surgeons to address this unmet need.
LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .