New Concept for Severely Burned Ear Reconstruction: Grafting of the Frame Using Banked Ear Cartilage Combined with Costal Cartilage.

Abstract

Background:Damage and loss of ear cartilage can easily occur in a burned ear accompanied by severe extensive burns due to exposure of the cartilage or chondritis. Deformity can also occur due to later development of scar contracture despite minimal damage to the ear cartilage when the injury occurred. We have developed a new technique for treatment of a deep burn in the whole ear.Methods:In the new technique, the ear is amputated, and soft tissues are denuded. The cartilage is banked in a subcutaneous pocket in the chest and later regrafted in combination with costal cartilage.Results:Although techniques for regrafting banked ear cartilage have been reported, the reconstructed ear cannot acquire a good shape because of absorption of the cartilage or lack of intensity to sustain the outline of the ear. Meanwhile, when we tried to reconstruct an ear by only using costal cartilage, we found it difficult to fabricate a frame because most patients are adults in whom the costal cartilage is too rigid and fragile to be shaved or combined. In our technique, the frame has both the advantages of sufficient intensity in costal cartilage and a smooth curved surface together with elasticity in the ear cartilage. Ears reconstructed by our technique have a natural appearance.Conclusion:Our technique can be used for cases in which treatment for another large area of the body surface needs to be performed first to save the patient’s life.