External Ear Reconstruction By Antia-Buch Chondro-Cutaneous Advancement Flap in a Case of Human Bite – A Case Report

Abstract

Reconstruction of the external ear is a challenging problem encountered by plastic surgeons. Causes of external ear deformities can be of various etiologies (human bites, animal bites, fights, burns, infections, accidents, or even sports injuries). Full-thickness defects, which cannot be treated by approximating the wound edges, show good results with Antia-Buch’s chondro-cutaneous flaps. A 34-year-old male presented with a history of human bite to his right external ear. The patient had brought the amputated part with him. There was complete amputation of the superior part of the helix with exposed cartilage with a 2 cm defect on examination. The amputated part was an unhealthy crushedavulsed tissue. The patient underwent debridement and washout. Reconstruction of the external ear was done by Antia-Buch helical advancement flap designed over the posterior skin. Post-operatively, the external ear reconstruction yielded good cosmetic results. Animal or human bite defects used to be left open for fear of severe infections, and closure was planned later, but this can be complicated by fibrosis and can result in a change in the shape of the external ear. Primary repair using an Antia-Buch flap and appropriate antibiotic treatment shortens the hospital stay and dressing changes and improves the cosmetic outcome. Keywords: Amputation, Cartilage, External ear, Fibrosis, Human Bite, Reconstructive Surgical Procedures