Acquired Deformities of the Auricle

Abstract

Ear reconstruction after traumatic amputation is always a challenge because each patient presents with specific deformities that must be well evaluated preoperatively during surgical planning. There are numerous causes that might partially or totally destroy the auricles. It is useful to identify the origin of the issue that causes the ear amputation. The most frequent are human and animal bites, burns, car accidents, knives and scissors, piercings, and unfavorable results after previous ear surgeries.

The avulsed segment of the ear may be re-implanted during first aid in selected cases. A microvascular procedure can be performed when it is available in the emergency room. Because of the rich vascular network of the ear, one single anastomosis of an artery and a vein may provide an adequate blood supply to the organ. I do not recommend inserting the amputated ear cartilage into any region of the patient’s body because its behavior is not favorable for use in reconstruction.

The operation to use costal cartilage to excavate the new auricular framework, which is embedded during the first stage, is performed in two or three surgical stages. The second surgical stage of reconstruction is performed 6 months after the first stage by creating a cervical cutaneous flap to be rotated and sutured to cover the mastoid area after lifting the new auricle. When using skin flaps, minimize the skin graft area, which will avoid postoperative scar tissue retraction.