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allied
academies
Dermatol Res Skin Care 2017 | Volume 1 Issue 1
World
Dermatologist Summit and Skin Care Expo
October 30-31, 2017 | Toronto, Canada
Background:
Traumatic auricular amputation due to human
bite is not a common event. Nonetheless, it constitutes
a difficult challenge for the reconstructive surgeon.
Microsurgery can be performed in some cases, but most
microsurgical techniques are complex and their use can only
be advocated in very specialized centers. Replantation of a
severed ear without microsurgery can be a safe alternative
as long as a proper technique is selected. Simple saturation
is doomed to failure.
Methods:
We present two cases, one of a big partial (about
40%) and one of a total traumatic auricular amputation, both
caused by human bites, which were successfully managed
in our Departments. The technique of ear reattachment as
a composite graft, with partial burial of the amputated part
in a pocket of the retro auricular region, as first described by
Baudet, was followed in both cases.
Results And Discussion:
Traumatic ear amputation (TEA) is
a complete avulsion of a part or of the total auricular tissue.
TEA are rare (only 74 cases have been described in the
literature) and their handling is complex. The prementioned
technique is described in detail, along with the postoperative
management and outcome of the patients. In addition, a
brief review of the international literature regarding ear
replantation is performed.The patients were satisfied with
the results and after 24 years follow-up both results were
stable and well received by the patients and their relatives.
Conclusion:
The Baudet technique has been used successfully
in two cases of traumatic ear amputation due to human bites.
It is a simple technique, without the need for microsurgery,
and produces excellent aesthetic results, while preserving
all neighboring tissues in case of failure with subsequent
need for another operation. Traumatic earpinna amputation
(TEA) is a complete avulsion of a part or of the total auricular
tissue. TEA are rare (only 74 cases have been described in
the. The surgeon’s objective is to obtain the best cosmetic
result without demolishing the auricular area in order to
allow future ear reconstruction in case of replantation failure.
Many techniques of ear replantation have been described
in the literature during the last 30 years: microsurgical
replantation, pocket techniques and reattachment
techniques. Microsurgical replantation should be seeked and
achieved every time, it is possible. When it is not possible,
the surgeon can choose between ear reattachment and a
pocket technique according to two clinical features: the size
of the amputated part and the involvement of the ear lobe.
Ear reattachment can be achieved when the amputated part
is smaller than 15 mm or when amputation involves the
earlobe. Pocket techniques, which are appropriate for the
replantation of the auricular cartilage, can be used when
the amputated part is bigger than 15 mm and does not
comprise the earlobe. The surgeon’s objective is to obtain
the best cosmetic result without demolishing the auricular
area in order to allow future ear reconstruction in case of
replantation failure. Many techniques of ear replantation
have been described in the literature during the last 30
years: microsurgical replantation, pocket techniques and
reattachment techniques. Microsurgical replantation should
be tried every time it is possible. When it is not possible, the
surgeon can choose between ear reattachment and a pocket
technique according to two clinical features: the size of the
amputated part and the involvement of the ear lobe. Ear
reattachment can be achieved when the amputated part is
smaller than 15 mm long or when amputation involves the
earlobe. Pocket techniques, which are appropriate for the
replantation of the auricular cartilage, can be used when the
amputated part is bigger than 15 mm and does not comprise
the earlobe.
e:
dkyrmiz@yahoo.comAuricle reconstruction without microscopic surgery after traumatic amputation due to human bite. Two
successful cases by using a pocket technique
Dionysios E. Kyrmizakis
Otorhinolaryngologist, Greece