Reconstruction of the Upper Portion of the Ear by Using an Ascending Helix Free Flap from the Opposite Ear

Abstract

Reconstruction of partial, marginal defects of the ear has been a challenge. The ascending helix free flap based on superficial temporal vessels has been described and used solely to repair nose defects. We used reversed pedicle helical free flap for the repair of a major loss of the upper one-third of the opposite auricle. The method permits the transfer of tissue of the same quality with satisfactory cosmetic result. The equalization of the ears in dimension was accomplished with minimal donor-site deformity.

Nonmicrosurgical Single-Stage Auricular Replantation of Amputated Ear

“…Although total or partial traumatic amputation of the ear is a rare occurrence, many treatment modalities have been used till date. 1,4,5 However, none of them appears to have solved the problem in a consistent manner. 1,4 Microsurgical ear replantation was first reported in 1980 and has since proved to be a reliable method for the management of traumatic ear amputation.…”

“…3 Finally, the technical complexity of microsurgical procedures requires specialized medical personnel, as a result of which their use is not possible in many centers around the world. 4,5 The simple reattachment of the ear as a compound graft usually leads to necrosis and total loss of the organ. 1,4 Therefore, many techniques have been advocated to enhance the "take" of a replanted ear.…”

“…12 Other authors have suggested reconstruction of a partial or complete traumatic auricular defects with the use of a free flap from the opposite ear. 5,13 However, these techniques require the use of microsurgery, and thus face the limitations that were mentioned earlier.…”

“…1,4 Therefore, numerous techniques that increase the chance of survival of the replanted ear segment, have evolved in the past. 1,4,5 Microsurgical replantation can be performed in a minority of cases; however, difficulty with adequate venous drainage further complicates the technical complexity of these cases. 1 To enhance survival of a reattached ear segment, Mladick 2 advocated use of the retroauricular pocket principle.…”

Nonmicrosurgical reconstruction of the auricle after traumatic amputation due to human bite

“…On the other hand, simple reattachment of the amputated part as a composite graft is doomed to fail with almost certainty [1,4]. Therefore, numerous techniques that increase the chance of survival of the replanted ear segment have evolved in the past [1,4,5]. …”