Total ear reconstruction in post burn deformity

Abstract

Severe thermal injuries to the external ear, in most cases, lead to a total destruction of the pinna. Total ear reconstruction in such cases of burns is one of the most difficult problems faced by a plastic surgeon. This is because of the paucity and poor quality of the skin available in the auricular region. Depending upon the quality and quantity of skin available in the auricular region, patients with total loss of ear following burns were divided into five groups. The surgical procedure for ear reconstruction differed in each group due to differences in skin available for coverage of the cartilage framework. Different covering methods which were used for the draping of the cartilage framework were, normal post auricular skin, local grafted or scarred but soft and supple skin, post auricular fascia, temporoparietal fascia (pedicled or free) and free radial forearm fascial flap. A temporoparietal fascial flap was the cover of choice if local skin was not healthy. During the past eight years, seventy six cases of total ear reconstruction were done for post burn ear deformities. The technique and results are presented here.