Replantation of totally amputated ears

Veselý, Jiří; Hrbatý, Josef; Výška, Tomáš; Stupka, Igor; Hýža, Petr

doi:10.1007/s00238-002-0405-5

European Journal of Plastic Surgery

2002

DOI: 10.1007/s00238-002-0405-5

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Replantation of totally amputated ears

Jiří Veselý

Josef Hrbatý

Tomáš Výška

et al.

Abstract: From a total of 1525 replantations or revascularizations performed at our clinic we report three replantations of totally amputated ears. In two the cause of amputation was a car accident and in the third case a dog bite. In the first case no suitable artery for anastomosis was found on the amputated part and the replantation was performed by means of arterialization of the venous system [3,8,12]. After 2 days the mild venous stasis subsided, and a normal blood supply to the ear was established. In the two oth… Show more

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Cited by 2 publications

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Atypical replantation and reconstruction of frozen ear

Dvořák

Stupka

2020

Medicine

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Rationale: The first successful ear replantation was performed by Pennigton in 1980 in Sydney. At least 84 ear replantations have been described in the literature over a period of 37 years since the first case. The authors have not found any previous case of frozen ear replantation in the literature. Patient concerns: We report the case of a 38-year-old man, who had an injury to the head while working with a machine. Diagnosis: The patient suffered total traumatic avulsion of the left ear. The ear was wrapped in moistened, sterile gauze and was transported on dry ice. At the time of admission to our department, the amputated ear was frozen to stiff, solid nonelastic matter. Interventions: We attempted replantation. Despite repeated arterial thrombosis during surgery, the ear was successfully replanted with arterial and venous anastomosis. Outcomes: Venous congestion occurred within 9 h of surgery and was treated using leeches. Freezing cold injury developed during reattachment. The radix and proximal parts of the helix exhibited necrosis and so were reconstructed by contralateral conchal cartilage graft, which was wrapped with a local subauricular skin flap. On completion of treatment, a satisfactory shape was achieved, although the replanted and reconstructed left auricle slightly was smaller than the contralateral auricle. Lessons learned: Our report confirms that the replantation of a frozen, amputated ear is possible, and we suggest that ear replantation should be the method of choice for the treatment of ear loss even under these conditions.

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Atypical replantation and reconstruction of frozen ear

Dvořák

Stupka

2020

Medicine

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Arterial only anastomosis associated with modified Baudet technique in ear replantation

et al. 2021

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Background: Total ear amputation is a relatively rare trauma with an absolute indication for surgical treatment. Numerous techniques for auricular reconstruction have been described. When local and general conditions allow microsurgical replantation, this must be the first choice. We propose the association of microsurgical techniques with some modification (modified Baudet technique) to obtain higher survival rate of the reimplanted stump. Methods: This study included cases of 3 male patients with total ear amputation, the injuries and their mechanism (workplace accident) being identical. Chief complaints were pain, bleeding, important emotional impact due by an unaesthetic appearance. The established diagnosis was traumatic complete ear amputation (grade IV auricular injury according to Weerda classification). Microsurgical replantation was performed only with arteriorraphy, and no vein anastomosis. Cartilage incisions and skin excisions were made to enlarge the cartilage-recipient site contact area. Medicinal leeches were used to treat venous congestion, to which systemic anticoagulant therapy was added. Results: The results showed the survival of the entire replanted segment in all cases, with good function and esthetical appearance. Patients were fully satisfied with the final outcome. Conclusion: Microsurgical replantation is the gold standard, for the surgical treatment of total ear amputation. We believe that cartilage incisions and the increased surface of contact between cartilage and recipient site has an adjuvant role in revascularization of the amputated stump (with only arterial anastomosis) and the use of hirudotherapy helps to relieve early venous congestion.

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Replantation of totally amputated ears

Cited by 2 publications

References 11 publications

Atypical replantation and reconstruction of frozen ear

Atypical replantation and reconstruction of frozen ear

Arterial only anastomosis associated with modified Baudet technique in ear replantation

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