• Archives of Reconstructive Microsurgery
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• v.14 no.2
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• pp.112-116
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• 2005

The auricle is easy to be amputated in the face due to its protruding position. When facial parts are amputated, the mechanism of injury usually involves some form of avulsion, which damages these fragile vessels over a distance and renders them unsuitable for anastomosis. Replantation of the ear remains a challenging problem because of the tiny vessels and the paucity of adequate veins for anastomosis. Reattachment as a composite graft of the total or subtotal amputated ear is unreliable. Microsurgical replantation can be performed in a minority of cases because of technical difficulties and long operation time. In this article, the authors report two case of a successful ear replantation of completely amputated auricle. Only one artery and one vein were anastomosed in first case. In the other case one artery was anastomosed without vein. Instead of venous repair, multiple incision was done with leech application therapy. and the outcome was successful. In spite of the technical difficulties and long operation time, microsurgical replantation of amputated ear is better than other reconstructive method or reattachment without microsurgery.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.660-662
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• 2009

Purpose: There are several modalities to reattach the amputated auricle. Microvascular replantation can achieve the best outcome, but technically difficult. Conventional composite graft is technically easy, but uniformly unsuccessful. Our successful experience of reattachment using postauricular subcutaneous pocket is presented. Methods: The amputated tissue was placed in its anatomical position with buried sutures. The amputated part is dermabraded to remove the epidermis and outer layer of dermis(Fig. 1, Center, left). Postauricular skin flap was then raised and the reattached dermabraded ear was buried beneath the flap(Fig. 1, Center, right). Two weeks after the original surgery, the buried ear was removed from its pocket (Fig. 1, Below, left). Results: The ear was reepithelialized spontaneously in 7 days. At 3 months, the reattached ear has satisfactory appearance without contour deformity(Fig. 1, Below, right). Conclusion: This technique provides increase in contact surface between the amputated segment and the surrounding tissues which supply blood, serum, oxygen and nutrients, maximizing the probability of "take". Minimally injured dermis can be healed from spontaneous reepithelialization and provides minimal contour deformity. We have used this non-microsurgical technique with very satisfying outcome.

• Archives of Reconstructive Microsurgery
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• v.19 no.1
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• pp.46-49
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• 2010

Purpose: It has been reported that the ear perfusion can maintain by a very small pedicle because the ear has good vascularized system. Replantation of an amputated ear with vascular anastmosis, has been reported before and offers the succeessful reconstructive results. But, in this paper we report a case of complete nonmicrosurgical salvage of a nearly amputated ear based on 7 mm-wide small skin pedicle with adjunctive therapies. Methods: A 49-year-old man was referred with a nearly complete detachment of left ear. The blood supply to the ear was maintained exclusively on 7 mm-wide small skin pedicle in the lobule. After we identified the fresh bleeding at the distal margin of the detached ear, we performed the primary repair. At the end of the procedure, the areas of the concha bowl and helical root appeared to be congested. So the immediate postoperative treatment for improving the tissue survival was done with Lipo-Prostaglandin E1 (Eglandin$^{(R)}$) injection, leech apply and antibiotics medications. Results: Assessment of the replanted ear on postoperative day 14 revealed a nearly viable auricle including the helical root. The ear appeared to be entirely healed, with excellent projection and fully restored normal elasticity. Conclusion: We found the complete salvage of a nearly amputated ear based on 7 mm-wide small skin pedicle with adjunctive therapies including Lipo-Prostaglandin E1 (Eglandin$^{(R)}$) injection, leech apply and antibiotics without microsurgery.

• Archives of Craniofacial Surgery
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• v.19 no.4
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• pp.304-308
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• 2018

Replantation using microvascular anastomosis is considered to be the optimal method in treating the amputated ear in terms of resulting color, texture, and shape. Only a few cases of ear replantation have been reported because it is anatomically difficult to identify suitable vessels for anastomosis. We successfully replanted the amputated helical rim of the ear using single arterial anastomosis. A 37-year-old man had his helical rim amputated by a human bite. The amputee was about $4{\times}1cm$ in dimension, composed of skin and soft tissue including auricular cartilage. Replantation was performed anastomosing a small artery of the amputee with a terminal branch of the posterior auricular artery. After replantation, intravenous heparinization was performed and prostaglandin E1 and aspirin were administered. Venous congestion was decompressed by stab incisions applied with heparin solution soaked gauze. Venous congestion of the amputee slowly began to resolve at 4 days after the operation. The amputated segment of the helical rim survived completely with good aesthetic shape and color. The authors propose that performing microvascular anastomosis should be attempted especially if it is possible to detect vessels on cut surfaces of ear amputee and stump. Proper postoperative care for venous congestion, arterial insufficiency, and infection should be followed for amputee survival.

• 대한미세수술학회:학술대회논문집
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• 1992.11a
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• pp.79-79
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• 1992

• Archives of Plastic Surgery
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• v.44 no.6
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• pp.568-570
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• 2017