Auricular seroma in a preterm infant as a severe complication of nasal continuous positive airway pressure (nCPAP)

Nasal continuous positive airway pressure (nCPAP) in preterm infants is closely linked to improvements in the primary management of respiratory failure. We report on a severe complication involving the external ear, which is usually covered by the fixing straps of the nCPAP application system. The very low birthweight infant (23 3/7 weeks' gestation) was treated with nCPAP for more than 2 months. At the age of 51 days, the child developed a fluctuating seroma of the right external ear. Applied surgical treatments including punctation and compression of the ear resulted in full recovery after 3 months. Due to shearing forces associated with straps used for attaching the nasal application system, the infant developed a severe auricular trauma. Ear trauma can be minimised by careful padding of these straps. Continuous monitoring of the nCPAP-system, including the straps, is required.