Facial Plast Surg 2021; 37(04): 510-515
DOI: 10.1055/s-0041-1726465
Original Article

Reconstructive Options for Auricular Trauma

Kevin Wong
1   Department of Otolaryngology, The Mount Sinai Hospital, New York, New York
2   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
,
Anni Wong
1   Department of Otolaryngology, The Mount Sinai Hospital, New York, New York
2   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
,
Joseph J. Rousso
1   Department of Otolaryngology, The Mount Sinai Hospital, New York, New York
2   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
3   Division of Facial Plastic Surgery, Manhattan Facial Plastic Surgery, New York, New York
› Author Affiliations

Abstract

Given its prominent lateral position, the auricle is a common site of injury after blunt trauma. Auricular injuries can lead to both functional and aesthetic complications. A careful history and examination will help determine the mechanism of injury and identify factors that may influence repair. Auricular reconstruction is highly individualized and depends on the size, location, and nature of injury. Understanding the complex three-dimensional anatomy of the external ear is a necessity for appropriate reconstruction. This article reviews the reconstructive options for simple and complex auricular injuries based on the anatomical site and the intricate three-dimensional structures that form the auricle.



Publication History

Article published online:
14 April 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Cox TC, Camci ED, Vora S, Luquetti DV, Turner EE. The genetics of auricular development and malformation: new findings in model systems driving future directions for microtia research. Eur J Med Genet 2014; 57 (08) 394-401
  • 2 Boffano P, Kommers SC, Karagozoglu KH, Forouzanfar T. Aetiology of maxillofacial fractures: a review of published studies during the last 30 years. Br J Oral Maxillofac Surg 2014; 52 (10) 901-906
  • 3 Shaye DA, Sykes JM. Reconstruction of acquired auricular deformity. Oper Tech Otolaryngol 2011; 22 (01) 47-52
  • 4 Gault D. Post traumatic ear reconstruction. J Plast Reconstr Aesthet Surg 2008; 61 (Suppl. 01) S5-S12
  • 5 Zilinsky I, Erdmann D, Weissman O. et al. Reevaluation of the arterial blood supply of the auricle. J Anat 2017; 230 (02) 315-324
  • 6 Horlock N, Vögelin E, Bradbury ET, Grobbelaar AO, Gault DT. Psychosocial outcome of patients after ear reconstruction: a retrospective study of 62 patients. Ann Plast Surg 2005; 54 (05) 517-524
  • 7 Steffen A, Klaiber S, Katzbach R, Nitsch S, König IR, Frenzel H. The psychosocial consequences of reconstruction of severe ear defects or third-degree microtia with rib cartilage. Aesthet Surg J 2008; 28 (04) 404-411
  • 8 Tchorz K. ATLS Subcommittee, American College of Surgeons' Committee on Trauma, International ATLS working group. Advanced trauma life support (ATLS®): the ninth edition. J Trauma Acute Care Surg 2013; 74 (05) 1363-1366
  • 9 Cairns AM, Mok JYQ, Welbury RR. Injuries to the head, face, mouth and neck in physically abused children in a community setting. Int J Paediatr Dent 2005; 15 (05) 310-318
  • 10 Patel BC, Skidmore K, Hutchison J, Hatcher JD. Cauliflower Ear. StatPearls Publishing; 2020
  • 11 Mladick RA, Horton CE, Adamson JE, Cohen BI. The Pocket Principle. Plast Reconstr Surg 1971; 48 (03) 219-223
  • 12 Gailey AD, Farquhar D, Clark JM, Shockley WW. Auricular avulsion injuries and reattachment techniques: a systematic review. Laryngoscope Investig Otolaryngol 2020; 5 (03) 381-389
  • 13 Giot J-P, Labbé D, Soubeyrand E. et al. Prosthetic reconstruction of the auricle: indications, techniques, and results. Semin Plast Surg 2011; 25 (04) 265-272
  • 14 Brent B, Tanzer RC, Rueckert F, Brown FE. Auricular repair with autogenous rib cartilage grafts: two decades of experience with 600 cases. Plast Reconstr Surg 1992; 90 (03) 355-374 , discussion 375–376
  • 15 Nagata S. A new method of total reconstruction of the auricle for microtia. Plast Reconstr Surg 1993; 92 (02) 187-201
  • 16 Park C. Subfascial expansion and expanded two-flap method for microtia reconstruction. Plast Reconstr Surg 2000; 106 (07) 1473-1487
  • 17 Baluch N, Nagata S, Park C. et al. Auricular reconstruction for microtia: a review of available methods. Plast Surg (Oakville, Ont) 2014; 22 (01) 39-43
  • 18 Tezel E, Ozturk CN. Double helical rim advancement flaps with scaphal resection: selected cases over 10 years and review of the literature. Aesthetic Plast Surg 2011; 35 (04) 545-552
  • 19 Al-Shaham A. Helical advancement: pearls and pitfalls. Can J Plast Surg 2012; 20 (02) e28-e31
  • 20 Pickrell BB, Hughes CD, Maricevich RS. Partial ear defects. Semin Plast Surg 2017; 31 (03) 134-140
  • 21 Norris II, Cook J. The cheek interpolation flap for reconstruction of auricular Mohs defects. Dermatol Surg 2020; 46 (08) 1039-1044
  • 22 Kurbonov U, Davlatov A, Janobilova S, Kurbanov Z, Mirshahi M. The use of temporoparietal fascia flap for surgical treatment of traumatic auricle defects. Plast Reconstr Surg Glob Open 2018; 6 (05) e1741
  • 23 Zhu J, Zhao H, Wu K. et al. Reconstruction of auricular conchal defects with local flaps. Medicine (Baltimore) 2016; 95 (46) e5282
  • 24 Pool C, Lighthall JG. Reconstruction of lower third auricular defects. Oper Tech Otolaryngol—Head Neck Surg 2017; 28 (02) 119-124
  • 25 Narasimhan K, Jackson IT. A long-term review of Z-plasty technique for repair of split earlobes. Eur J Plast Surg 2010; 33 (03) 125-128
  • 26 Mancuso C, Mammino J, Holman L, Francis JK. The adaptability and utility of the bilobed transposition flap. JAOCD 2017; 38 (01) 9-12
  • 27 Singh A, Singh G. Earlobe reconstruction using a Limberg flap in six ears. Br J Plast Surg 2003; 56 (01) 33-36
  • 28 Cabral AR, Brinca A, Figueiredo A, Alonso N, Vieira R. Reconstrução do lóbulo auricular pela técnica de gavello e retalho bilobado. An Bras Dermatol 2013; 88 (02) 272-275
  • 29 Alconchel MD, Rodrigo J, Cimorra GA. A combined flap technique for earlobe reconstruction in one stage. Br J Plast Surg 1996; 49 (04) 242-244
  • 30 D'Hooghe PJ. Earlobe reconstruction with a bilobed, caudally-based flap. Plast Reconstr Surg 1977; 59 (05) 764
  • 31 Brent B. Earlobe construction with an auriculo-mastoid flap. Plast Reconstr Surg 1976; 57 (03) 389-391
  • 32 Chattopadhyay D, Gupta S, Murmu MB, Guha G, Gupta S. Revisiting Gavello's procedure for single-stage reconstruction of the earlobe: the vascular basis, technique and clinical uses. Can J Plast Surg 2012; 20 (02) e22-e24
  • 33 Sclafani AP, Mashkevich G. Aesthetic reconstruction of the auricle. Facial Plast Surg Clin North Am 2006; 14 (02) 103-116 , vi
  • 34 Reconstructive Facial Plastic Surgery. A Problem-Solving Manual: 9783131296429: Medicine & Health Science Books @ Amazon.com. Accessed November 12, 2020 at: https://www.amazon.com/Reconstructive-Facial-Plastic-Surgery-Problem-Solving/dp/3131296429
  • 35 Gupta DK, Devendra S. Single-stage earlobe reconstruction: a simple method with promising results. Eur J Plast Surg 2014; 37 (07) 393-396
  • 36 Patel PN, Jayawardena ADL, Walden RL, Penn EB, Francis DO. Evidence-based use of perioperative antibiotics in otolaryngology. Otolaryngol Head Neck Surg 2018; 158 (05) 783-800
  • 37 González-Castro J, Lighthall JG. Antibiotic use in facial plastic surgery. Facial Plast Surg Clin North Am 2016; 24 (03) 347-356
  • 38 Mottini M, Wolf R, Soong PL, Lieger O, Nakahara K, Schaller B. The role of postoperative antibiotics in facial fractures: comparing the efficacy of a 1-day versus a prolonged regimen. J Trauma Acute Care Surg 2014; 76 (03) 720-724
  • 39 Soong PL, Schaller B, Zix J, Iizuka T, Mottini M, Lieger O. The role of postoperative prophylactic antibiotics in the treatment of facial fractures: a randomised, double-blind, placebo-controlled pilot clinical study. Part 3: Le Fort and zygomatic fractures in 94 patients. Br J Oral Maxillofac Surg 2014; 52 (04) 329-333
  • 40 Greywoode JD, Pribitkin EA, Krein H. Management of auricular hematoma and the cauliflower ear. Facial Plast Surg 2010; 26 (06) 451-455
  • 41 Prasad HK, Sreedharan S, Prasad HS, Meyyappan MH, Harsha KS. Perichondritis of the auricle and its management. J Laryngol Otol 2007; 121 (06) 530-534
  • 42 Austin DF. Diseases of the external ear. In: Ballenger JJ, Snow JB. eds. Otolaryngology: Head and Neck Surgery. 15th ed.. Philadelphia: Williams & Wilkins; 1996: 974-988