• Archives of Plastic Surgery
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• v.44 no.6
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• pp.554-558
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• 2017

In many cases of complete ear amputation, microvascular surgery is required for tissue perfusion and organ survival. However, microvascular reconstruction is not always feasible in the absence of suitable vessels. Here, we present the case of a 76-year-old man who underwent complete amputation of the left ear after a collapse at home because of cardiogenic syncope. He was treated with primary replantation and underwent a postoperative salvage course including continuous local hyperbaric oxygen therapy (HBOT), platelet-rich plasma (PRP) injections, and polydeoxyribonucleotide (PDRN) injections. The ear was almost completely salvaged, with a tiny eschar at the mid-scapha on both the anterior and posterior aspects. This case demonstrates the efficacy of local HBOT with PRP and PDRN injections.

• Journal of Veterinary Clinics
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• v.18 no.4
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• pp.311-314
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• 2001

To elucidate the effect of dorsal acupoints for canine electroacupuncture anesthesia, mongrel dogs(6 heads: 2.6-10.5kg, 3 males and 3 females) were used. After needling perpendicularly to Tian-Ping(GV-5) and Bai-Hui(GV-20), the electrodes were connected with positive to Tian-Ping and negative to Bi-hui, respectively using with veterinary electroacupuncture apparatus(TEC AM-3000). The electric conditions were 2-4V and 30 Hz. The pain of body surface was checked by hemostatic forceps. The effect of electroacupuncture andesthesia was appreciated by application of laparotomy(2 heads), ear trimming and tail amputation(1 head), castration(2 heads) and enterotomy(1 head), respectively. Induction time, clinical findings and operation findings were investigated under the electroacupuncture anesthesia. The induction time of electroacupuncture anesthesia was very rapid, approximately 1 minute and the pain of body surface including the extremities was not detected. As for clinical findings during electroacupuncture anesthesia, consciousness was evident, pupil reflex was weak and blepharoreaction was existed. As for operation findings, pain was not detected during incision and suture, and bleeding was relatively small volume. The grade of electroacupuncture anesthesia was excellent in all cases applied with ear trimming and tail amputation, laparatomy, castration and enterotomy. Considering above all findings, it was thought that electroacupuncture stimulation at Tian-Ping and Bai-hui examined in the present study induced excellent electroacupuncture anesthesia for dogs.

• 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 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 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.