As a result, the outer ear becomes permanently swollen and deformed, resembling a cauliflower, hence the name.

The condition is common in wrestling, boxing, and kickboxing, in martial arts such as Brazilian jiu-jitsu, judo, sumo, and mixed martial arts, and in full-contact sports such as rugby league or rugby union.

This means that the medical provider will make the diagnosis by using elements of the history of the injury (examples: participation in contact sports, trauma to the ear, previous similar episodes) and combine this with findings on physical exam (examples: tenderness to the area, bruising, deformation of the ear contours) to confirm the diagnosis and decide on the appropriate treatment for the patient.

[2] To assist with settling on the best form of treatment for cauliflower ear, Yotsuyanagi et al. created a classification system for deciding when surgery is needed and as a guide to what the best approach would be.

The structure of the ear is supported by a cartilaginous scaffold consisting of the following distinct components: the helix, antihelix, concha, tragus, and antitragus.

[1] Cauliflower ear can also present in the setting of nontraumatic inflammatory injury of auricular connective tissue such as in relapsing polychondritis (RP), a rare rheumatologic disorder in which recurrent episodes of inflammation result in destruction of cartilage of the ears and nose.

[1] If left untreated, disorganized fibrosis and cartilage formation will occur around the aforementioned cartilaginous components.

[1] Auricular hematoma most often occurs in the potential space between the helix and the antihelix (scapha) and extends anteriorly into the fossa triangularis.

[6] Because an acute hematoma can lead to cauliflower ear, prompt evacuation of the blood can prevent permanent deformity.

In these cases it has been suggested that open surgical treatment is more effective in returning the cosmetic appearance and prevention of recurrence.