The microsurgical reconstruction of an incompletely amputated ear: A case report

As the ear is richly vascularized, a partly avulsed auricle can usually be successfully reunited even though the attached connecting remnant is tenuous. However, in cases wherein extensive auricular tissue is attached by an extremely narrow pedicle, complete survival of the avulsed auricular tissue is more difficult to achieve. Herein, we report a case in which successful replantation of an incompletely amputated ear was achieved by microsurgical anastomosis of an artery. The patient, a 31-year-old male, was brought to us soon after a traffic accident. Inspection revealed that the left ear had been avulsed, leaving a 1.0cm bridge of ear lobe skin and a 1.5mm strip of skin on the posterior side of the auricle. The upper half of the auricle was cyanotic and necrosis seemed inevitable. However, on microsurgical arterial repair that was performed at the posterior aspect of the cymba conchae, the ear became immediately pink on release of the vascular clamp and the ear survived completely. We are confident that survival of this subtotally amputated ear was enhanced by this arterial repair. Further, the cosmetic result also justified our attempt to anastomose the artery in this case of an incompletely amputated ear.