A comparison of ear amputations replantation techniques

Abstract

Background

The management of traumatic ear amputations remains a rare and difficult occurrence for surgeons. This is due to the fact that the chosen replantation technique must ensure the best vascular supply and the surrounding tissues have to be preserved as to not jeopardize a future auricular reconstruction in the event of replantation failure.

Objective

This study aimed to review and synthesize the literature about the different surgical techniques described to date in the management of traumatic ear amputations (partial or total).

Materials and methods

Relevant articles were searched on PubMed, ScienceDirect, and Cochrane Library databases in accordance with the PRISMA statement guidelines.

Results

A total of 67 articles was retained. When possible, microsurgical replantation enabled the best cosmetic result but required important care.

Conclusion

Pocket techniques and local flaps should not be performed because of the lower cosmetic result and the use of the surrounding tissues. However, they could be reserved for patients without access to advanced reconstructive techniques. When possible, microsurgical replantation can be attempted after patient consent for blood transfusions, postoperative care and hospital stay. Simple reattachment for earlobe amputations and ear amputations up to one third is recommended. When microsurgical replantation cannot be attempted, and if the amputated segment is viable and bigger than one third, simple reattachment may be attempted with an increased risk of replantation failure. In case of failure, an auricular reconstruction by an experienced microtia surgeon or prosthesis may be considered.