Complete ear replantation without venous anastomosis

Abstract

Traumatic amputation of the entire auricle is a rare occurrence. Management ideally consists of microvascular reconstruction of auricular arterial, venous, and nerve continuity. However, appropriately sized veins are often not available and venous drainage must be accomplished with leech therapy. In occasional cases where leeches are unavailable or cannot be made to attach, mechanical drainage and anticoagulation can give satisfactory drainage. The authors present a case of mechanical wick venous drainage of a complete ear replantation, resulting in virtually normal appearance and function of the ear. In addition, the ear regained normal touch and two-point sensibility, although the great auricular nerve had not been repaired.

Complete replantation of a small tissue segment at the auricular apex: A case report

“…Microsurgical reconstruction of auricular blood supply is well established. 1 , 2 , 3 , 4 However, replantation of the auricular apex remains technically demanding due to the tiny vessel diameters (∼0.3 mm) and anatomical variability. Identifying suitable veins for anastomosis is particularly challenging, often complicating both the surgery and postoperative care.…”

Auricular complications following temporal bone resection for temporal bone malignancies: a clinical consideration

“…A clear consensus on the guidelines for treating external ear congestion is lacking. Tissue milking, pin pricking,(12) use of medical leeches, (13,14) mechanical leeching, (15) and chemical leeching(16) are the current treatment methods for venous congestion. In our two cases, mechanical bloodletting effectively salvaged the auricular necrosis.…”

Microsurgical ear replantation—is venous repair necessary?—A systematic review

“…This finding confirms previous reports mentioning lack of a relationship between venous repair and transfusion requirement. 61 A meaningful analysis of the methods of venous decongestion (including medicinal leech therapy 5,9,13,14,[16][17][18]47,50,51,53,58,60,[62][63][64]68,72 and blood drainage through puncture wounds/small incisions 10,15,16,18,48,54,59,73 ), as well as postoperative anticoagulation regimen was not possible given the heterogeneous protocols employed and comparatively sparse datasets.…”