Subscribe to RSS
DOI: 10.1055/s-0035-1562882
Trauma Management of the Auricle
Publication History
Publication Date:
15 September 2015 (online)
Abstract
Smaller injuries of the auricle, such as lacerations without tissue loss, have more or less standardized treatment protocols that require thorough wound closure of each affected layer. Even extended lacerations of larger parts of the ear quite often heal with only minor irregularities. New in vivo diagnostic tools have aided the understanding of this outstanding “skin flap behavior.” At the other end of the trauma severity spectrum are partial or complete amputations of the ear. Here, the debate has become more intense over the last decade. There were numerous reports of successful microvascular reattachments in the 1990s. Consequently, pocket methods and their variations have received increasing attention because the results seem to be convincing. Nevertheless, the pressure damage due to banking larger parts of the elastic cartilage in the mastoid region is tremendous, and the tissue for secondary reconstruction is severely injured. Particularly in cases of acute trauma with relevant concomitant injuries to the patient and in cases in which the amputated area is in a critical state, direct wound closure is a straightforward and safe option. Subsequent thoughtfully planned secondary reconstruction using ear or rib cartilage, or even allogenous material as an ear framework, can achieve excellent aesthetic results.
-
References
- 1 Weerda H. Surgery of the Outer Ear. Stuttgart-New York, NY: Thieme; 2006
- 2 Lavasani L, Leventhal D, Constantinides M, Krein H. Management of acute soft tissue injury to the auricle. Facial Plast Surg 2010; 26 (6) 445-450
- 3 Greywoode JD, Pribitkin EA, Krein H. Management of auricular hematoma and the cauliflower ear. Facial Plast Surg 2010; 26 (6) 451-455
- 4 Park C, Lineaweaver WC, Rumly TO, Buncke HJ. Arterial supply of the anterior ear. Plast Reconstr Surg 1992; 90 (1) 38-44
- 5 Pinar YA, Ikiz ZA, Bilge O. Arterial anatomy of the auricle: its importance for reconstructive surgery. Surg Radiol Anat 2003; 25 (3-4) 175-179
- 6 Frenzel H, Wollenberg B, Steffen A, Nitsch SM. In vivo perfusion analysis of normal and dysplastic ears and its implication on total auricular reconstruction. J Plast Reconstr Aesthet Surg 2008; 61 (Suppl. 01) S21-S28
- 7 Steffen A, Klaiber S, Katzbach R, Nitsch S, Frenzel H, Weerda H. [Epidemiology of auricular trauma]. Handchir Mikrochir Plast Chir 2007; 39 (2) 98-102
- 8 Mladick RA, Carraway JH. Ear reattachment by the modified pocket principle. Case report. Plast Reconstr Surg 1973; 51 (5) 584-587
- 9 Pennington DG, Lai MF, Pelly AD. Successful replantation of a completely avulsed ear by microvascular anastomosis. Plast Reconstr Surg 1980; 65 (6) 820-823
- 10 Steffen A, Katzbach R, Klaiber S. A comparison of ear reattachment methods: a review of 25 years since Pennington. Plast Reconstr Surg 2006; 118 (6) 1358-1364
- 11 Pennington DG, Pennington TE. 30-year follow-up of the first successfully replanted ear. Plast Reconstr Surg 2010; 126 (1) 21e-23e
- 12 Steffen A, Wollenberg B, König IR, Frenzel H. A prospective evaluation of psychosocial outcomes following ear reconstruction with rib cartilage in microtia. J Plast Reconstr Aesthet Surg 2010; 63 (9) 1466-1473
- 13 Ihrai T, Balaguer T, Monteil MC , et al. [Surgical management of traumatic ear amputations: literature review]. Ann Chir Plast Esthet 2009; 54 (2) 146-151
- 14 Liu T, Song G, Zhang Q , et al. [Emergency treatment of large amputated ear defect with auricular cartilage replantation]. Zhonghua Zheng Xing Wai Ke Za Zhi 2014; 30 (4) 245-248
- 15 Bozonnet E, Sadek H, Bettega G, Lebeau J, Raphaël B. [Replantation of traumatic amputated ears by Mladick procedure: 6 cases]. Ann Chir Plast Esthet 2006; 51 (1) 38-46
- 16 Kyrmizakis DE, Karatzanis AD, Bourolias CA, Hadjiioannou JK, Velegrakis GA. Nonmicrosurgical reconstruction of the auricle after traumatic amputation due to human bite. Head Face Med 2006; 2: 45
- 17 Norman ZI, Cracchiolo JR, Allen SH, Soliman AM. Auricular reconstruction after human bite amputation using the Baudet technique. Ann Otol Rhinol Laryngol 2015; 124: 45-48
- 18 Aremu SK. Nonmicroscopic reconstruction of subtotally amputated/torn auricles: report of 3 cases. Ear Nose Throat J 2014; 93 (2) E1-E3
- 19 Magritz R, Siegert R. Reconstruction of the avulsed auricle after trauma. Otolaryngol Clin North Am 2013; 46 (5) 841-855
- 20 Hu J, Zhang Q, Zhang Y, Zhou X, Qian J, Liu T. Partial helix defect repair by use of postauricular advancement flap combined with ipsilateral conchal cartilage graft. J Plast Reconstr Aesthet Surg 2014; 67 (8) 1045-1049
- 21 Braun T, Gratza S, Becker S , et al. Auricular reconstruction with porous polyethylene frameworks: outcome and patient benefit in 65 children and adults. Plast Reconstr Surg 2010; 126 (4) 1201-1212
- 22 Steffen A, Frenzel H. [Psychometric evaluation in severe ear deformities: critical analysis of the current situation]. HNO 2014; 62 (8) 560-563