Traumatic ear amputation and post-traumatic nose defect are aesthetic deformities that can have negative consequences (lead to psychological trauma), leading to a change in the quality of life. The presented clinical case describes a protocol for the reconstruction of a partially amputated defect of the external ear and nose, which required various surgical steps; including the removal of cartilage from the ribs, followed by the creation of a cartilaginous model of the ear, the introduction of its subcutaneous region behind the ear, taking into account the anatomy of the outer ear as much as possible. The second stage after 1.5 months is the restoration of the amputated ear area with a combined superficial temporal fascial flap, costal cartilage with suturing to the amputated part of the ear and dorsal rhinoplasty using modeling costal autocartilaginous flap. The postoperative result is satisfactory with the restoration of a good aesthetic appearance of the ear and nose. Reconstruction of the external ear after partial traumatic amputation and post-traumatic nose defect with autocartilage from the ribs provides a stable aesthetic result and becomes the method of choice for such injuries.

Tracheotomy is a surgical procedure in which a tracheocutaneous airway is created in the anterior neck. It is routinely done in critically ill patients requiring prolonged mechanical ventilatory support or in emergency cases of upper airways obstruction. Both open surgical tracheostomy and percutaneous dilatational tracheostomy are methods used to perform tracheostomy in select individuals. The best technique for performing tracheostomy remains a matter of debate. Each method has his advantages and disadvantages. The determining factors in deciding whether to use an open surgical or percutaneous dilatational tracheostomy in a particular situation depends on patient anatomical and physiological factors and as well on surgeon experiences and prefers. The basic technique and variations are described.

Tracheostomy is one of the more commonly performed procedures in critically ill patients under mechanical ventilation. Postoperative scarring is one of the bothersome sequelae of tracheostomies. Scars distort physical appearance, especially when found on the head and neck, which could have a negative impact on quality of life. The aim of this study was to evaluate and assess the impact of post-tracheostomy scars on quality of life according to the tracheostomy method. A prospective, single-center, observational, case-control study was conducted. One hundred fifty-six persons with a post-tracheostomy surgical scar for more than four months were observed using the Patient and Observer Scar Assessment Scale and Dermatology Life Quality Index questionnaire. Persons were divided into two groups depending on the method of tracheostomy, and the duration of the cannulated period was considered in both groups. Statistical analyses were performed using SPSS ver. 16.0 (SPSS Inc., Chicago, IL, USA), and P values of <0.05 were considered significant. The patients who had a tracheostomic tube cannulation period of fewer than 15 days had better cosmetic results than those who had tracheostomic tubes for more than 15 days, regardless of the tracheostomy method: 6.64 ± 0.082 versus 16.15 ± 0.096 (P < 0.001) in the surgical tracheostomy group and 7.26 ± 0.211 versus 14.17 ± 0.379 (P < 0.05) in the percutaneous dilatational group. The Dermatology Life Quality Index scores had a mean value of 0.6 ± 0.01, which means that post-tracheostomy scarring in the present study had no effect on the person's quality of life.The aesthetic outcomes of post-tracheostomy scars after the open surgical tracheostomy technique did not significantly differ from those of the percutaneous dilatational technique in the present study. Persons with a long duration of tracheostomic tube ventilation showed worse aesthetic