Non microsurgical ear replantation after acute traumatic avulsion

ABSTRACT

Auricular reconstruction possess one of the most difficult challenges in reconstruction surgery of the head and neck. This is due to the unique architectural topography of the external ear. The multiple concavities and convexities of the cartilage framework are enveloped by a very thin, tightly adherent skin envelope. The aim of this work was to review different methods of non microsurgical techniques and to present our experience in many amputated ears. Our study included 25 cases of acute amputated auricle, 10 of the due to human bites [35%], 3 due to animal bites, [12%], 12 patients due to motor car accidents [48%]. Males were the commonest affected victims [80%]. None cases were attached with a small pedicle managed with simple replantation with excellent cosmetic and functional results. Thee cases with excellent complete avulsion [2 cases managed with mladick principle one succeeded, third one, third one managed with simple reimplantation and faileld]. Mladick princile used also in one case of incomplete avulsion. Baudet technique was used in 3 cases [succeeded], two cases showed loss of cartilage treated by postauricular flap and cartilage graft. One case with Brent technique. Five cases were treated by wedge excision and simple closure. The last 3 cases presented with loss of lobule of the ear that were corrected with local flap and showed satisfactory results: