Semin Plast Surg 2017; 31(03): 134-140
DOI: 10.1055/s-0037-1603968
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Partial Ear Defects

Brent B. Pickrell
1   Division of Plastic Surgery, Harvard Medical School, Boston, Massachusetts
,
Christopher D. Hughes
1   Division of Plastic Surgery, Harvard Medical School, Boston, Massachusetts
,
Renata S. Maricevich
2   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
09 August 2017 (online)

Abstract

Reconstruction of partial ear defects represents one of the most challenging areas within reconstructive surgery of the head and neck. Each case of auricular reconstruction is unique and warrants a systematic approach that accounts for defect size and location, the quality of the surrounding skin, patient preference, and operator experience. In this article, the authors outline different reconstructive approaches for defects of the upper-, middle-, and lower-third of the auricle. The relevant anatomy is discussed in detail. Successful outcomes in auricular reconstruction rely on the surgeon's careful analysis of the defect as well as knowledge of the different reconstructive options available.

 
  • References

  • 1 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
  • 2 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
  • 3 Harris PA, Ladhani K, Das-Gupta R, Gault DT. Reconstruction of acquired sub-total ear defects with autologous costal cartilage. Br J Plast Surg 1999; 52 (04) 268-275
  • 4 Steffen A, Katzbach R, Klaiber S. A comparison of ear reattachment methods: a review of 25 years since Pennington. Plast Reconstr Surg 2006; 118 (06) 1358-1364
  • 5 Pearl RA, Sabbagh W. Reconstruction following traumatic partial amputation of the ear. Plast Reconstr Surg 2011; 127 (02) 621-629
  • 6 Elsahy NI. Acquired ear defects. Clin Plast Surg 2002; 29 (02) 175-186 , v–vi
  • 7 Talan DA, Citron DM, Abrahamian FM, Moran GJ, Goldstein EJ. ; Emergency Medicine Animal Bite Infection Study Group. Bacteriologic analysis of infected dog and cat bites. N Engl J Med 1999; 340 (02) 85-92
  • 8 Janis JE. Essentials of Plastic Surgery. 2nd ed. Boca Raton, FL: CRC Press; 2014
  • 9 Anniko M, Bernal-Sprekelsen M, Bonkowsky V, Bradley PJ, Iurato S. Otorhynolaryngology, Head and Neck Surgery. Heidelberg, Germany: Springer; 2010
  • 10 Crumley RL, Abemayor E. Burn of the auricle. Head Neck 1992; 14 (03) 243-246
  • 11 Shonka Jr DC, Park SS. Ear defects. Facial Plast Surg Clin North Am 2009; 17 (03) 429-443
  • 12 Sand M, Sand D, Brors D, Altmeyer P, Mann B, Bechara FG. Cutaneous lesions of the external ear. Head Face Med 2008; 4: 2
  • 13 Hudson DA, Krige JE, Strover RM, King HS. Malignant melanoma of the external ear. Br J Plast Surg 1990; 43 (05) 608-611
  • 14 Blake GB, Wilson JS. Malignant tumours of the ear and their treatment. I. Tumours of the auricle. Br J Plast Surg 1974; 27 (01) 67-76
  • 15 Sadler TW. Langman's Medical Embryology. 12th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2012
  • 16 Kelley PE, Scholes MA. Microtia and congenital aural atresia. Otolaryngol Clin North Am 2007; 40 (01) 61-80 , vi v i
  • 17 Netter FH. Atlas of Human Anatomy. 6th ed. Philadelphia, PA: Saunders; 2014
  • 18 Imanishi N, Nakajima H, Aiso S. Arterial anatomy of the ear. Okajimas Folia Anat Jpn 1997; 73 (06) 313-323
  • 19 Zilinsky I, Erdmann D, Weissman O. , et al. Reevaluation of the arterial blood supply of the auricle. J Anat 2017; 230 (02) 315-324
  • 20 Park C, Roh TS. Anatomy and embryology of the external ear and their clinical correlation. Clin Plast Surg 2002; 29 (02) 155-174 , v
  • 21 Park C, Lineaweaver WC, Rumly TO, Buncke HJ. Arterial supply of the anterior ear. Plast Reconstr Surg 1992; 90 (01) 38-44
  • 22 Zilinsky I, Cotofana S, Hammer N. , et al. The arterial blood supply of the helical rim and the earlobe-based advancement flap (ELBAF): a new strategy for reconstructions of helical rim defects. J Plast Reconstr Aesthet Surg 2015; 68 (01) 56-62
  • 23 McKinney P, Katrana DJ. Prevention of injury to the great auricular nerve during rhytidectomy. Plast Reconstr Surg 1980; 66 (05) 675-679
  • 24 Sharma VS, Stephens RE, Wright BW, Surek CC. What is the lobular branch of the great auricular nerve? Anatomical description and significance in rhytidectomy. Plast Reconstr Surg 2017; 139 (02) 371e-378e
  • 25 Janis JE, Hatef DA, Ducic I. , et al. Anatomy of the auriculotemporal nerve: variations in its relationship to the superficial temporal artery and implications for the treatment of migraine headaches. Plast Reconstr Surg 2010; 125 (05) 1422-1428
  • 26 Tubbs RS, Salter EG, Wellons JC, Blount JP, Oakes WJ. Landmarks for the identification of the cutaneous nerves of the occiput and nuchal regions. Clin Anat 2007; 20 (03) 235-238
  • 27 Bumsted RM, Ceilley RI. Local anesthesia of the auricle. J Dermatol Surg Oncol 1979; 5 (06) 448-449
  • 28 Brent B. Reconstruction of the auricle. In: McCarthy JG. , ed. Plastic Surgery. Vol 3. Philadelphia, PA: WB Saunders; 1990: 2094-2152
  • 29 Farkas LG. Anthropometry of the normal and defective ear. Clin Plast Surg 1990; 17 (02) 213-221
  • 30 Cheney ML, Hadlock TA, Quatela VC. Reconstruction of the auricle. In: Baker SR. , ed. Local Flaps in Facial Reconstruction. Edinburgh: Elsevier Mosby; 2007: 581-624
  • 31 Posnick JC, al-Qattan MM, Whitaker LA. Assessment of the preferred vertical position of the ear. Plast Reconstr Surg 1993; 91 (07) 1198-1203 , discussion 1204–1207
  • 32 Farkas LG. Vertical location of the ear, assessed by the Leiber test, in healthy North American Caucasians 6--19 years of age. Arch Otorhinolaryngol 1978; 220 (1-2): 9-13
  • 33 McDowell AJ. Goals in otoplasty for protruding ears. Plast Reconstr Surg 1968; 41 (01) 17-27
  • 34 Farkas LG. Anthropometry of normal and anomalous ears. Clin Plast Surg 1978; 5 (03) 401-412
  • 35 Farkas LG. Anthropometry of the Head and Face. 2nd ed. New York, NY: Raven Press; 1994
  • 36 Brent B. The acquired auricular deformity. A systematic approach to its analysis and reconstruction. Plast Reconstr Surg 1977; 59 (04) 475-485
  • 37 Levin BC, Adams LA, Becker GD. Healing by secondary intention of auricular defects after Mohs surgery. Arch Otolaryngol Head Neck Surg 1996; 122 (01) 59-66 , discussion 67
  • 38 Li D, Xu F, Zhang R. , et al; Li D1. Surgical reconstruction of traumatic partial ear defects based on a novel classification of defect sizes and surrounding skin conditions. Plast Reconstr Surg 2016; 138 (02) 307e-316e
  • 39 Stephen J. Plastic Surgery. 2nd ed. Philadelphia, PA: Elsevier; 2006
  • 40 Radonich MA, Zaher M, Bisaccia E, Scarborough D. Auricular reconstruction of helical rim defects: wedge resection revisited. Dermatol Surg 2002; 28 (01) 62-65
  • 41 Antia NH, Buch VI. Chondrocutaneous advancement flap for the marginal defect of the ear. Plast Reconstr Surg 1967; 39 (05) 472-477
  • 42 Calhoun KH, Slaughter D, Kassir R, Seikaly H, Hokanson JA. Biomechanics of the helical rim advancement flap. Arch Otolaryngol Head Neck Surg 1996; 122 (10) 1119-1123
  • 43 Al-Shaham A. Helical advancement: Pearls and pitfalls. Can J Plast Surg 2012; 20 (02) e28-e31
  • 44 Fukuzumi S, Tai Y, Kubota J. , et al. A new method of earlobe reconstruction. J Jpn Plast Reconstr Surg 1985; 28: 482-489
  • 45 Butler CE. Reconstruction of marginal ear defects with modified chondrocutaneous helical rim advancement flaps. Plast Reconstr Surg 2003; 111 (06) 2009-2013
  • 46 Majumdar A, Townend J. Helix rim advancement for reconstruction of marginal defects of the pinna. Br J Oral Maxillofac Surg 2000; 38 (01) 3-7
  • 47 Argamaso RV, Lewin ML. Repair of partial ear loss with local composite flap. Plast Reconstr Surg 1968; 42 (05) 437-441
  • 48 Bialostocki A, Tan ST. Modified Antia-Buch repair for full-thickness upper pole auricular defects. Plast Reconstr Surg 1999; 103 (05) 1476-1479
  • 49 Zenn MR. Helical advancement with a posterior auricular pull-through flap: A technique for reconstruction of combined helical and scaphal defects. Aesthetic Plast Surg 1999; 23 (02) 131-133
  • 50 Ha RY, Trovato MJ. Plastic Surgery of the Ear. Select Read Plast Surg 2011; 11 (03) 1-46
  • 51 Davis J. Reconstruction of the upper third of the ear with a chondrocutaneous composite flap based on the crus helix. In: Tanzer RC, Edgerton MT. , eds. Symposium on Reconstruction of the Auricle. St. Louis, MO: CV Mosby; 1974: 247
  • 52 Orticochea M. Reconstruction of partial loss of the auricle. Plast Reconstr Surg 1970; 46 (04) 403-405
  • 53 Yotsuyanagi T, Nihei Y, Sawada Y. Reconstruction of defects involving the upper one-third of the auricle. Plast Reconstr Surg 1998; 102 (04) 988-992
  • 54 Niamtu III J. Eleven pearls for cosmetic earlobe repair. Dermatol Surg 2002; 28 (02) 180-185
  • 55 Sharma R, Krishnan S, Kumar S, Verma M. Rotation flap lobuloplasty: technique and experience with 24 partially torn earlobes. Int J Oral Maxillofac Surg 2014; 43 (10) 1206-1210
  • 56 Narasimhan JK, Jackson IT. A long-term review of Z-plasty technique for repair of split earlobes. Eur J Plast Surg 2010; 33 (03) 125-128