Management of Acute Soft Tissue Injury to the Auricle

ABSTRACT

The external ear is commonly involved in facial trauma. Injuries to the ear can range from simple lacerations to complete avulsions. We review the normal auricular anatomy and vascular supply, as well as the initial management of any auricular injury. Furthermore, we review the literature on soft tissue injuries of the ear and present a simple algorithm for classifying injuries. The classification is based on whether or not cartilage is involved. Injuries to the lobule do not involve cartilage and thus are more easily repaired by simple closure or Z-plasty. Injuries involving cartilage are further classified into partial or complete avulsions. A complete avulsion is then categorized by having a wide or narrow pedicle. There is no standardized, definitive management for the various types of auricular trauma, and this schema may assist in deciding which of the various reconstructive options is most appropriate for a particular case.

KEYWORDS

Ear - auricle - trauma - avulsion - laceration - replantation

REFERENCES

• 1 Steffen A, Klaiber S, Katzbach R, Nitsch S, Frenzel H, Weerda H. [Epidemiology of auricular trauma].  Handchir Mikrochir Plast Chir. 2007;  39 98-102
• 2 Bardsley A F. The injured ear: a review of 50 cases.  Br J Plast Surg. 1983;  36 466-469
• 3 Stierman K L, Lloyd K M, De Luca-Pytell D M, Phillips L G, Calhoun K H. Treatment and outcome of human bites in the head and neck.  Otolaryngol Head Neck Surg. 2003;  128 795-801
• 4 Sclafani A P, Mashkevich G. Aesthetic reconstruction of the auricle.  Facial Plast Surg Clin North Am. 2006;  14 103-116, vi
• 5 Elsahy N I. Ear replantation.  Clin Plast Surg. 2002;  29 221-231, vi–vii
• 6 Templer J, Renner G J. Injuries of the external ear.  Otolaryngol Clin North Am. 1990;  23 1003-1018
• 7 Webster J P. Refrigerated skin grafts.  Ann Surg. 1944;  120 431-448
• 8 Krueger E. Absorption of human rib cartilage grafts transplanted to rabbits after preservation by different methods.  Br J Plast Surg. 1964;  17 254-264
• 9 Shelley O P, Villafane O, Watson S B. Successful partial ear replantation after prolonged ischaemia time.  Br J Plast Surg. 2000;  53 76-77
• 10 Mladick R A, Horton C E, Adamson J E, Cohen B I. The pocket principle: a new technique for the reattachment of a severed ear part.  Plast Reconstr Surg. 1971;  48 219-223
• 11 Baudet J, Tramond P, Goumain A. [A new technic for the reimplantation of a completely severed auricle].  Ann Chir Plast. 1972;  17 67-72
• 12 Kind G M. Microvascular ear replantation.  Clin Plast Surg. 2002;  29 233-248, vii