A clinical study on reconstruction of traumatic auricular defects

Abstract

The auricle or external ear is an important aesthetic subunit of the face. The intricate anatomy due to multiple convolutions along with the thin integument poses a challenge to the reconstructive surgeon. The prominent position of the ear on either side of the face and over a bony prominence makes it more prone for injury. The objective of the study is to describe various traumatic auricular defects and their subsequent reconstructive methods. A retrospective analysis of 15 patients with traumatic auricular defects was carried out over a period of 2 years between the time period of January 2022 and December 2023. Various reconstructive methods such as Primary closure, use of chondral grafts and chondrocutaneous flaps, local flaps were employed depending on the size of the defect and according to the reconstructive ladder. Out of 15 patients, 12 were male and 3 were female, with traumatic ear defects secondary to road traffic accidents (12) and human bite (3). The site of the defect was upper 1/3d (8), upper+middle 1/3rd (3), lower+middle third (2), middle third (1) and lower 1/3rd (1) of the auricle. They were managed by debridement and primary closure in 5 cases, post auricular flap in 5 cases, preauricular flap in 2 cases, peninsular conchal island flap+postauricular flap in 1 case, and bilobed flap in 1 case. All the flaps settled well. 4 patients needed secondary procedures in the form of flap division and contour corrections. This study employed a variety of reconstruction methods of the auricle as per the reconstructive ladder. Some of the patients required secondary procedures. All patients in this study had a satisfactory end aesthetic outcome with no major complications.