Facial Plast Surg 2015; 31(06): 645-656
DOI: 10.1055/s-0035-1568140
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Injury Patterns and Reconstruction in Acquired Ear Deformities

Kenneth Stewart
1   Department of Plastic Surgery, St John's Hospital, Howden Livingston, United Kingdom
,
Ewa Majdak-Paredes
1   Department of Plastic Surgery, St John's Hospital, Howden Livingston, United Kingdom
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
14. Dezember 2015 (online)

Abstract

Reconstruction following ear trauma presents a heterogeneous group of abnormalities with significantly more variation in presentation. The aim of the study was to analyze our experience and expound some broad principles of auricular reconstruction in acquired ear deformities. A total of 117 patients with human, animal bites and revision otoplasty presented to our clinic. Demographic data were extracted from medical records and photographs. Management options included no reconstruction, external silicone prosthesis, or autologous reconstruction. Fifty percent of patients with human bite injuries and 62% with animal bite injuries opted for autologous ear reconstruction. A flap with either a costal cartilage framework (37/39; 95%) or conchal cartilage (2/39; 5%) was used. In revision otoplasty group, 12% required autologous reconstruction either with conchal or costal cartilage. We discuss our indications, techniques, complications, and predictable pattern of injuries in human bites. Autologous auricular reconstruction of traumatic injuries is a safe procedure associated with aesthetically pleasing outcome and improved quality of life despite physical and psychosocial comorbidities. Elderly patients are more likely to opt for prosthetic camouflage.

 
  • References

  • 1 Brent B. The versatile cartilage autograft: current trends in clinical transplantation. Clin Plast Surg 1979; 6 (2) 163-180
  • 2 Brent B. Technical advances in ear reconstruction with autogenous rib cartilage grafts: personal experience with 1200 cases. Plast Reconstr Surg 1999; 104 (2) 319-334 , discussion 335–338
  • 3 Brent B. Microtia repair with rib cartilage grafts: a review of personal experience with 1000 cases. Clin Plast Surg 2002; 29 (2) 257-271 , vii
  • 4 Nagata S. Modification of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg 1994; 93 (2) 221-230 , discussion 267–268
  • 5 Nagata S. Modification of the stages in total reconstruction of the auricle: Part II. Grafting the three-dimensional costal cartilage framework for concha-type microtia. Plast Reconstr Surg 1994; 93 (2) 231-242 , discussion 267–268
  • 6 Nagata S. Modification of the stages in total reconstruction of the auricle: Part III. Grafting the three-dimensional costal cartilage framework for small concha-type microtia. Plast Reconstr Surg 1994; 93 (2) 243-253 , discussion 267–268
  • 7 Firmin F. Ear reconstruction in cases of typical microtia. Personal experience based on 352 microtic ear corrections. Scand J Plast Reconstr Surg Hand Surg 1998; 32 (1) 35-47
  • 8 Firmin F. Auricular reconstruction in cases of microtia. Principles, methods and classification [in French]. Ann Chir Plast Esthet 2001; 46 (5) 447-466
  • 9 Firmin F. State-of-the-art autogenous ear reconstruction in cases of microtia. Adv Otorhinolaryngol 2010; 68: 25-52
  • 10 Firmin F, Marchac A. A novel algorithm for autologous ear reconstruction. Semin Plast Surg 2011; 25 (4) 257-264
  • 11 Pearl RA, Sabbagh W. Reconstruction following traumatic partial amputation of the ear. Plast Reconstr Surg 2011; 127 (2) 621-629
  • 12 Szychta P, Orfaniotis G, Stewart KJ. Revision otoplasty: an algorithm. Plast Reconstr Surg 2012; 130 (4) 907-916
  • 13 Momeni A, Liu X, Januszyk M , et al. Microsurgical ear replantation-is venous repair necessary? A systematic review. Microsurgery 2015;
  • 14 Bardsley AF, Mercer DM. The injured ear: a review of 50 cases. Br J Plast Surg 1983; 36 (4) 466-469
  • 15 Momeni A, Parrett BM, Kuri M. Using an unconventional perfusion pattern in ear replantation-arterialization of the venous system. Microsurgery 2014; 34 (8) 657-661
  • 16 Norman ZI, Cracchiolo JR, Allen SH, Soliman AM. Auricular reconstruction after human bite amputation using the Baudet technique. Ann Otol Rhinol Laryngol 2015; 124 (1) 45-48
  • 17 Hussey AJ, Kelly JI. Microsurgical replantation of an ear with no venous repair. Scand J Plast Reconstr Surg Hand Surg 2010; 44 (1) 64-65
  • 18 Jenkins AM, Finucan T. Primary nonmicrosurgical reconstruction following ear avulsion using the temporoparietal fascial island flap. Plast Reconstr Surg 1989; 83 (1) 148-152
  • 19 Aguilar III EF. Ear reconstruction. Clin Plast Surg 2004; 31 (1) 87-91
  • 20 Walton RL, Beahm EK. Auricular reconstruction for microtia: Part II. Surgical technique. Plast Reconstr Surg 2002; 110 (1) 234-249
  • 21 Giot JP, Labbé D, Soubeyrand E , et al. Prosthetic reconstruction of the auricle: indications, techniques, and results. Semin Plast Surg 2011; 25 (4) 265-272
  • 22 Chummun S, Addison P, Stewart KJ. The osmotic tissue expander: a 5-year experience. J Plast Reconstr Aesthet Surg 2010; 63 (12) 2128-2132
  • 23 Reinisch JF, Lewin S. Ear reconstruction using a porous polyethylene framework and temporoparietal fascia flap. Facial Plast Surg 2009; 25 (3) 181-189