Ear Deformity Research Articles

Question mark ear deformity-revisited

We report on two unusual cases of Cosman (question mark) ear; both required modifications of the standard techniques for surgical correction. The first patient presented with a unilateral question mark ear and concurrent ear prominence and bulging of the cartilage of the anti-helix. Simultaneous correction was done using a combination of cartilage suturing/scoring (for the prominence and the cartilage bulge) as well as Al-Qattan’s “v-y skin flap-cartilage graft-z-plasty” technique (for the correction of the ear cleft deformity). The second patient had aurico-condylar syndrome with bilateral ear deformity and complete separation of ear lobes from the external ear. Staged transposition followed by Al-Qattan’s technique resulted in a satisfactory outcome.Level of evidence: Level V, therapeutic study.

SOX10 mutation is relevant to inner ear malformation in patients with Waardenburg syndrome

Objective: To determine the relevance between the SOX10 mutation and Waardenburg syndrome (WS) accompanied with inner ear abnormality by analyzing the inner ear imaging results and molecular and genetic results of the WS patients with the SOX10 mutation. Methods: This study included 36 WS in patients during 2001 and 2015 in the department of otorhinolaryngology head and neck surgery, Chinese Peoples's Liberation Army General Hospital. The condition of the inner ear of each patient was assessed by analyzing HRCT scans of the temporal bone and MRI scans of the brain and internal auditory canal. Meanwhile, the possible pathogenic genes of WS, including SOX10, MITF, and PAX3, were also screened. Patients were divided into two groups according to SOX10 mutation.The Fisher accuracy test was used to determine statistical difference of inner ear deformation incidence between the two groups. Results: Among all 36 patients, 12 were found to have inner ear abnormality. Most abnormalities were posterior semicircular canal deformations, some accompanied with cochlear deformation and an enlarged vestibule. Among all patients, 9 patients were SOX10 heterozygous mutation carriers, among which six showed bilateral inner ear abnormality. Fisher accuracy test results suggested a significant correlation between the SOX10 mutation and inner ear abnormality in WS patients (P=0.036). Conclusion: This study found that WS patients with the SOX10 mutation are more likely to have deformed inner ears when compared to WS patients without the SOX10 mutation.

Bacterial chondritis complications following ear piercing

BackgroundBody piercing has become widespread and is associated with increased complications. Post-piercing chondritis may lead to severe residual deformity. We aimed to report case patients presenting with post-piercing chondritis in our department and to describe clinical features and treatment. Patients and methodsWe conducted a retrospective study of patients presenting with post-piercing chondritis in the infectious disease department of Tenon Hospital, Paris, France. ResultsWe included 21 patients. Fifteen bacteriological cultures were positive (7 Pseudomonas aeruginosa, 5 Staphylococcus aureus, and three other). Dual intravenous antibiotic therapy was administered to 13 patients for a median duration of six days [2–8], replaced by an oral antibiotic therapy for a median duration of 15 days [7–40]. Eight patients received oral antibiotic monotherapy for 10 days [7–30]. Median duration of antibiotic therapy was 16 days. Earring removal was performed for 18 patients. No ear deformity or general complication was reported. ConclusionTranscartilaginous ear piercing may lead to infectious complications or deformity. In case of chondritis, early administration of an antibiotic therapy active against P. aeruginosa and S. aureus is recommended. Specific guidelines are needed.

Abstract: Impact of Observer Cultural Background On the Visual Processing of Cleft Lip and Other Forms of Facial Difference Facial Deformities

INTRODUCTION: Facial difference affects quality of life, and evidence suggests that social bias and stigmatization often persist even after the provision of appropriate facial reconstruction.1 In order to investigate the impact of observer cultural background on the visual processing of cleft lip and other facial deformities, we employed eye-tracking technology.2,3 PURPOSE: To measure the impact of culture on observer eye-tracking patterns of faces with cleft lip and other deformities. This information may better inform surgeons’ conversations with their patients by improving understanding of how faces are reflexively interpreted by others. This knowledge may also help focus surgical reconstructive priorities. METHODS: 59 experimental and 59 control facial images were obtained from the senior author’s practice. Experimental images included the following diagnoses (15 cleft lip, 15 facial aging, 12 ear deformity, 7 facial lesion, 6 HIV lipodystrophy, 3 facial asymmetry, 2 nasal deformity). Twenty standardized lookzone regions were mapped onto each facial image. 170 adult subject observers were recruited in two locations (107 in USA and 63 in Thailand) and asked to observe a slideshow of images while a digital infrared eye-tracking camera continuously recorded their eye movements. OUTCOMES MEASURED: The total number of eye fixations within the different lookzone regions was recorded. Factorial ANOVA analysis was performed to determine significance of gaze pattern differences between groups. RESULTS: The following observations were statistically significant at p<0.01 level. Compared to when looking at age-matched control images: (i) subjects in both Thailand and the USA preferentially fixated on the periorbital regions of the face (ii) Thai subjects fixated relatively more on lower facial regions while American subjects fixated preferentially on upper facial regions (iii) Both Thai and the USA subjects paid significantly greater attention to the regions of the affected upper and lower lip of images with cleft deformity, and the auricular region of images with ear deformity. (iv) Within this sample, statistically significant differences in gaze pattern were not detected for the other facial deformities considered. CONCLUSIONS: Western and Southeast Asian populations preferentially inspect the periorbital region during early visual processing of a face, and are similarly drawn to regions of difference when observing cleft lip or ear deformity. Southeast Asians focus greater attention on the lower facial region while Westerners focus more on the upper/periorbital facial region. DISCLOSURE/FINANCIAL SUPPORT:No financial support. None of the authors have any financial interest in any of the products, devices, or drugs mentioned in this manuscript. REFERENCES: 1. Berger Z, Dalton L. Coping with a cleft: Psychosocial adjustment of adolescents with a cleft lip and palate and their parents. Cleft Palate Craniofacial J. 48:435–443 Dec 2009 2. Blais C, Jack RE, Scheepers C, Fiset D, Caldara R Culture Shapes How We Look at Faces. PLoS ONE 3(8): e3022 2008 3. Eyetellect GazeTracker™, Charlottesville, VA. EyeTech TM4 Digital System, Mesa, AZ.

Preventing Suture Extrusion and Recurrence in Mustarde and Furnas Otoplasties by Using Laterally Based Postauricular Dermal Flap, Long-Term Results.

Prominent ear deformity (PD) is an unacceptable condition of pinna that affects 5% of the population and is associated with emotional stress, behavioral disturbances, and social restrictions in relationships. Conchal hypertrphy, inadequate formation of antihelical fold, earlobe placement ahead than it should be, or various combinations of these changes are main characteristics of PD. Many surgical techniques have been described for the PD.The authors' aim was to present laterally based postauricular dermal flap combination with cartilage-sparing methods and effectiveness of this technique in suture extrusion prevention and reducing the rate of recurrence with long-term results. Forty-one patients had bilateral and 6 patients had unilateral PD, a total of 47 patients with a mean age of 14.48 were operated by using this combined procedure. A laterally based supraperichondrial dermal flap was prepared from a deepithelized elliptical postauricular incision. Mustarde and Furnas suture techniques were used solely for PD correction. The dissected laterally based dermal flap was fixed to the mastoid bone with sutures in stretched position after reshaping the auricular cartilage with sutures. The average helix-mastoid distance was (mm) 16.28 ± 2.36, concha-mastoid angle was 25.71 ± 0.96° on 12-month measurements. The helix-mastoid distance showed an increase of 1 to 3 mm, in the concha-mastoid angle measurements of 1° to 2°. Statistically significant changes were observed between the average preoperative, postoperative 1. month, postoperative 12. month helix-mastoid distances (mm), and month concha-mastoid angle (°) measurements (P = 0.0001). The laterally based postauricular dermal flap technique is an effective method to prevent suture extrusion and recurrence which are the most important complications of otoplasty procedure and easy to apply.

Abstract: Impact of Observer Age and Gender On the Visual Processing of Faces

DISCLOSURE/FINANCIAL SUPPORT: No financial support. None of the authors have any financial interest in any of the products, devices, or drugs mentioned in this manuscript. INTRODUCTION: Our research is fundamentally interested in the factors leading to the differential perception of patients with congenital or acquired facial difference. The scientific literature has provided little information regarding the impact of observer age and gender on the early stages of visual processing of the human face.1–2 In order to investigate the impact of those factors, we employed eye-tracking technology. PURPOSE: Our goal is to better understand how faces are perceived with the knowledge that early perception may have long-term implications on relationship development.3–5 Elucidation of early visual processing of faces may better inform surgeons’ conversations with their patients by improving understanding of how faces are reflexively interpreted by others. This knowledge may also help focus surgical reconstructive priorities. METHODS: 118 experimental and 79 control facial images were obtained from the senior author’s practice. Experimental images included: 29 cleft lip, 22 facial aging, 18 facial lesion, 16 ear deformity, 14 HIV lipodystrophy, 11 nasal deformity, 6 dermatochalasis. Control images were age-matched to experimental. Twenty standardized lookzone regions were mapped onto each facial image. 265 subjects were recruited to observe a randomly chosen subset of 40 images (20 experimental/20 control age-matched) while an infrared eye-tracking camera continuously recorded their pupillary response. Factorial ANOVA analysis was performed to determine significance of differences between groups. OUTCOMES MEASURED: The total number of eye fixations within different lookzone regions was recorded. Factorial ANOVA analysis was performed to determine significance of gaze patterns between groups. RESULTS: The following observations were statistically significant at p<0.01 level: (i) women look at the periorbital region more than men do; men look at the middle facial region more than women do (ii) women and men both look at women’s eyes more than at men’s eyes (iii) older observers look at the perioral region more and the periorbital region less than younger observers CONCLUSIONS: By describing the age and gender-related patterns of reflexive facial surveillance, this report offers a more nuanced idea about where and how we inspect human faces than has previously been documented in the literature. A construct emerges from this study suggesting that the gender of both observer and facial object, as well as the age of the observer, influence the visual focus of early impression formation. REFERENCES: 1. Isaacowitz DM, Wadlinger HA, Goren D, Wilson HR Selective preference in visual fixation away from negative images in old age? An eye-tracking study. Psychol Aging, 21(1):40–48 Mar 2006 2. Cantoni V, Galdi C, Nappi M, Porta M, Riccio D. GANT: Gaze analysis technique for human identification. Pattern Recogn 48:1027–1038, Mar 2015 3. Human LJ, Sandstrom GM, Biesanz JC, Dunn, EW Accurate First Impressions Leave a Lasting Impression: The Long-Term Effects of Distinctive Self-Other Agreement on Relationship Development Soc Psych Pers Sci 4(4): 395–402 May 2013 4. Human LJ, Biesanz JC Targeting the Good Target: An Integrative Review of the Characteristics and Consequences of Being Accurately Perceived Pers SOc Psych Rev 17(3)248–272 2013Aug 5. Selfhout M, Denissen J, Branje S, Meeus W In the eye of the beholder: Perceived, actual, and peer-rated similarity in personality, communication, and friendship intensity during the acquaintanceship process. J Personality Soc Psych 96: 1152–1165 Jun 2009

A Simplified Nonsurgical Method for the Correction of Neonatal Deformational Auricular Anomalies.

Despite reported success of early nonsurgical splinting of congenital ear deformities, the technique has not been widely utilized due to difficulty with application and positional maintenance of these devices. Delay in treatment can result in unnecessary surgery for the child later in life. In response to this need, we developed a simplified system consisting of Velcro, conformers, and polysiloxane gel that can be applied in 3 steps. Before and after photos after application of the device were graded by a plastic surgeon independent of the study. A total of 33 ear deformities were treated. In all, 92.3% of ears achieved significant improvement and normalization of their ears after therapy. This device allows for a more straightforward and individualized application than current products available. Our hope is that practitioners involved early in the infant's care will utilize this technology resulting in improved outcomes and avoiding unnecessary surgery.

Modified Rhytidectomythat Produces a More Natural Look: Experience with 110 Cases.

Recognition of the effects of aging on the ear and the mechanisms leading to ear deformity associated with facelift procedures aid in achieving improved aesthetic results. In 2009, the author developed a novel rhytidectomy technique to provide more natural-looking results than those achieved through other facelift procedures, which often result in facial and ear distortion/deformity. This technique is designed to optimize aesthetic outcomes by employing incisions hidden within the ear, autologous fat transfer to restore normally lost facial volume, and absorbable bidirectional sutures, all of which allow less skin removal and shorter, more concealable scars within the inside perimeter of the ear, and thus less-distorted facial contours. In this retrospective study, the author added one important modification to this previously described approach for preventing ear deformity. The author will show that this modified rhytidectomy technique has many benefits over a traditional rhytidectomy, and it results in a natural-looking facelift. The author modified the original technique to secure the ears in a way that prevents inferior drifting. The modified technique involves the placement of two parallel strands of 3-0 Monocryl sutures under the scalp and over the skull and running from one side of the head to the other side using a 6-inch blunt needle. The absorbable strands are passed from the inferior part of each earlobe-one in front of the ear and the other in back of the ear. The strands are tied with knots under moderate tension under each earlobe, securing the ear back in the anatomical preoperative position. This secures the bottom of the ears and prevents caudal drifting. The use of 360° round-block, inside-the-ear incisions is advantageous. These incisions have much less lymphatic derangement of the skin, because the overall cut is shorter and the skin is not cut as extensively as in other methods that use longer incisions to get rid of more excess skin in facelifts. This modified rhytidectomy technique has many benefits over a traditional rhytidectomy: the incisions are hidden inside the ears, so there are almost no visible external incisions, and there is no deformity of the ears and earlobes, because the ears do not drift downward. The ear canal is not distorted, there is no hairline distortion, and most importantly, it results in a natural-looking facelift without the commonly seen deformity of any noticeable pulling. This modified approach to rhytidectomy achieves natural looking, aesthetically pleasing results. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Challenges During Baha Surgery: Our Experience.

Baha has proven performance and advantages for patients with aural atresia or chronic ear drainage. Being a per cutaneous osseo integrated implant the skin around the fixture is in contact with a foreign body that leads to chronic inflammatory reaction and complications such as skin irritation and overgrowth occur frequently. Challenges that are faced during Baha surgery include those during candidate selection, work up, anesthesia related as well as intra-operative and post operative complications. Ours was a retrospective and observational study where case records of 10 patients who underwent Baha surgery in the Department of E.N.T during the time period from January 2010 to June 2013 were reviewed. Here, the candidates were advised Baha either for congenital external ear deformity or single sided deafness. Out of 10 patients, who underwent Baha implantation, 8 underwent single staged Baha implant and two patients had two staged implant owing to bone thickness <3mm behind temporo-parietal suture line on HRCT Temporal bone. The complications observed were skin infection (Holgers grade 2) around the site of implant in two patients, skin overgrowth due to more thickness of scalp (Holgers grade 4) in one of the patient. The patient had to undergo revision surgery to replace the abutment. And one of the patients underwent failure of osseointegration and was re-implanted later. Proper surgical technique and post operative wound care play an important role in avoiding complications.

An original technique for the correction of congenital inverted conchal bowl deformity in an adult

Common congenital deformities of the ear include varying degrees of prominent ears and of microtia. Inverted conchal bowl is a very rare congenital deformity. In this condition, the anterior concavity of the concha is replaced by convexity, resulting in an abnormal appearance, as well as functional problems in the of use earpiece devices. This condition has been reported only once in a series of four paediatric cases, wherein a cartilage scoring technique, suitable for pliable cartilage in that age group, is described. No cases have been reported in an adult. We describe a simple and effective technique of managing this rare deformity in an adult, for the first time. The principle of the technique is the use an autologous cartilage graft. Level of Evidence: Level V, therapeutic study.

A New Approach for the Correction of Prominent Ear Deformity: The Distally Based Perichondrio-Adipo-Dermal Flap Technique.

Otoplasty techniques are generally divided into 2 categories as cartilage-cutting and cartilage-sparing. The cartilage-cutting techniques have been criticized because of their high risk of hematoma, skin necrosis, and ear deformity. As a result, suture-based cartilage-sparing methods like Mustardé and Furnas-type suture techniques have become increasingly popular. However, with these techniques postauricular suture extrusion may be seen and recurrence rates of up to 25% have been reported. In this study, cartilage-sparing otoplasty is redefined by introduction of the distally based perichondrio-adipo-dermal flap which is elevated from the postauricular region. Thirty-seven ears (17 bilateral and 3 unilateral) in 20 patients (14 females and 6 males) have been operated with the defined technique by the same surgeon. The distally based perichondrio-adipo-dermal flap is advanced posteriorly to correct the deformity, also acting as a strong postauricular support to prevent recurrence. In addition to the resultant natural-looking antihelical fold, the posterior advancement of the flap corrects both the otherwise wide conchoscaphal and conchomastoid angles. The operative technique is explained in detail with results and the literature is reviewed. There were no hematomas. After an average follow-up of 8.3 months (2-16 months), recurrence was seen in only 1 patient who requested no further surgery. No patients developed suture extrusion or granuloma. The authors introduce a simple and safe procedure to correct prominent ears with benefits including a resultant natural-looking antihelical fold and less tissue trauma. The distally based perichondrio-adipo-dermal flap seems to prevent suture extrusion and may also help to reduce recurrence rates. By forming neochondrogenesis which is stimulated by elevation of the perichondrium, this flap gives the promise of longer durability of the newly formed antihelical fold.

Technical refinement of Stenström otoplasty procedure

Surgical correction of prominent ears is a common aesthetic procedure in young children. Stenström technique is widely performed in France. We present some technical refinements that may be associated to this technique in order to allow for a simple correction of the majority of deformations. The first step of the Stenström technique is the treatment of the unfolded antihelix if necessary. Our first modification consists in introducing the rasp by an anterior approach, hidden under the upper plication of the helix, allowing for a better control. A second modification consists in a resection of the concha by a posterior approach in case of conchal hypertrophy. A third modification is the burying of the concha by suture to the mastoid periosteum after posterior auricular muscle resection in case of obtuse conchoscaphal angle. These refinements can be performed either separately or in combination according to the deformities to be corrected. The technical refinements presented may correct almost all the ear deformities. The suture-less technique allows for a natural aspect of the antihelix plication.

A Novel Method for Correction of the Hypoplastic Pixie Earlobe Deformity: V-Y Advancement Flap and Dermofat Graft.

Pixie ear deformity is a condition in which the inferior edge of the helix of the ear is attached to the cheek without a convolutional notch at the ear lobule-cheek junction. Numerous surgical techniques have been proposed to correct pixie earlobe deformities. However, several of these techniques result in anterior or inferior scars of the ear lobules or dog-ear deformities. Such visible scarring detracts from the esthetics of the ear lobule.We report a novel method for the correction of pixie ear deformities in patients with small ear lobules. A hypoplastic ear lobule was expanded by a V-Y advancement flap designed on the posterior aspect of the ear lobule, and a dermofat graft was placed in the subcutaneous layer under the advanced flap. As a result, the pixie ear lobe deformity was camouflaged by the expanded ear lobule. Moreover, no scars appeared on the anterior or inferior sides of the ear lobule, and a natural appearance of the ear lobe was achieved.We conclude that this method is a feasible alternative surgical option for hypoplastic pixie ear lobe deformities to avoid visible scarring in the anterior or inferior aspects of the ear lobe.

Total ear reconstruction: The role of bilateral triangular post-auricular flaps for creation of the cephaloauricular sulcus

IntroductionAuricular reconstruction of congenital or acquired ear defects can provide a realistic good-looking ear and functional cephaloauricular sulcus especially for those who wear eyeglasses. Over the past few years, refinements in the techniques of elevating the buried ear framework in the second stage of ear reconstruction have shifted from simple skin grafting to the use of flaps and cartilage blocks for creation of the cephaloauricular sulcus. ObjectiveThe aim of the study was to describe useful simple modification using bilateral triangular flaps and full thickness skin graft to create adequately functional cephalo-auricular sulcus especially for patients wearing eyeglasses during the second stage ear reconstruction. The study designThe described technique was carried out between June 2010 and January 2014, for 37 patients (24 patients with congenital microtia grade III, 7 patients with post-burn ear deformity, and 6 patients with post-traumatic ear defects). During the second stage of total ear reconstruction, the ear framework is separated substantially from the side of the head and positioned at the desired angle by means of a block of cartilage covered with a fascial flap. Then, two local triangular flaps from the adjacent non-hairy skin are created (one is superiorly based and the other is inferiorly based) and inset into the created cephaloauricular sulcus. The rest of the post-auricular defect is covered with a full thickness graft. ResultsThe technique was simple and effective with no post-operative complication regarding flaps viability. Patients requiring glasses have worn frames soon after the tie-over was removed and no sulcus problems have resulted.

“Intra Scaphal Opposing Sutures” for Stahl’s ear correction

Stahl’s ear deformity is a rare congenital abnormality and is characterized with the presence of an abnormal third crus in the upper pole of the auricle. Although various techniques are advised, there is no standard surgical correction option. In this study, we have tried to show a new suture method to able to correct Stahl’s ear deformity as a more practical and less invasive way. This study includes 4 patients and 4 ears having Stahl ear deformity that was corrected by “Intra Scaphal Opposing Sutures”. The patients were followed up for 12 months with clinical examination and photography. Patient satisfaction was good with favorable results. Suturing techniques are common procedure for Stahl’s ear correction. They can be used alone or in combination with excision, scoring and/or reshaping techniques. The main advantages of our technique are: using a smaller posterior incision, limited dissection and less destruction without performing any excision. Stahl’s ear correction with Intra Scaphal Opposing Sutures may offer a practical and stable solution in selected cases, especially with minor presence of aberrant third crus.

Cochlear Implantation in Children with Cochlear Malformation.

Cochlear implantation (CI) has proven to be an effective treatment for severe bilateral sensorineural hearing loss (SNHL). Inner ear malformation is a rare anomaly and occurs in approximately 20% of cases with congenital SNHL. In cases with cochlear malformation, CI can be successfully performed in nearly all patients, the exceptions being those with complete labyrinthine and cochlear aplasia. It is important to evaluate the severity of inner ear deformity and other associated anomalies during the preimplantation radiological assessment in order to identify any complication that may potentially occur during the surgery and subsequent patient management.

A Simple Modified Flip-Flop Flap for the Reconstruction of Antihelix and Triangular Fossa Defects.

A Simple Modified Flip-Flop Flap for the Reconstruction of Antihelix and Triangular Fossa Defects.

Clinical Outcomes of Osseointegrated Prosthetic Auricular Reconstruction in Patients With a Compromised Ipsilateral Temporoparietal Fascial Flap.

Patients with major ear deformities and associated compromise of the superficial temporal artery are poor candidates for autogenous ear reconstruction because of a tenuous ipsilateral temporoparietal fascial flap (TPFF). Osseointegrated prosthetic auricular reconstruction (OPAR) is an alternative to contralateral free TPFF microsurgical and autogenous reconstruction, but data on clinical outcomes are limited. The records of patients with ear loss or major deformity and a compromised ipsilateral TPFF who underwent OPAR from 1989 to 2013 were reviewed. Satisfaction was assessed using a questionnaire based on a 5 point Likert scale. Thirty-two patients (8 women, 24 men) with mean age 43.0 years (range, 10-70 years) underwent OPAR. The ipsilateral TPFF was compromised due to major trauma (13 patients), cancer extirpation (9), burn injury (4), previous harvest (4), arteriovenous malformation (1), or infection (1). All but 2 patients had an associated craniofacial defect, such as soft tissue deformity (87.5%), hearing loss (46.9%), or bony deformity (31.3%). The overall implant success rate was 88.6% at mean follow-up time of 7.6 years post-OPAR. Prosthesis wear averaged 12.2 hours/day and 6.6 days/week (80.5 hours/week). All 5 patients who experienced implant failures had received prior head and neck irradiation. With their prosthesis, 76.2% (16 patients) stated that their self-consciousness and self-esteem were "better" or "much better," whereas 85.7% (18 patients) stated that their self-image was "better" or "much better." All patients declared that they would undergo the treatment again. Osseointegrated prosthetic auricular reconstruction is a reliable option in this challenging population with high patient satisfaction. Patients with prior radiotherapy may have a higher chance of implant failure and would benefit from extended annual follow-up.

Milestones in the History of Ear Reconstruction.

The reconstruction of ear deformities has been challenging plastic surgeons since centuries. However, it is only in the 19th century that reports on partial and total ear reconstruction start increasing. In the quest for an aesthetically pleasing and natural-looking result, surgeons worked on the perfect framework and skin coverage. Different materials and flap techniques have evolved. Some were abandoned out of frustration, while others kept evolving over the years. In this article, we discuss the milestones in ear reconstruction-from ancient times to early attempts in Western civilization to the key chapters of ear reconstruction in the 20th century leading to the current techniques.

Injury Patterns and Reconstruction in Acquired Ear Deformities

Reconstruction following ear trauma presents a heterogeneous group of abnormalities with significantly more variation in presentation. The aim of the study was to analyze our experience and expound some broad principles of auricular reconstruction in acquired ear deformities. A total of 117 patients with human, animal bites and revision otoplasty presented to our clinic. Demographic data were extracted from medical records and photographs. Management options included no reconstruction, external silicone prosthesis, or autologous reconstruction. Fifty percent of patients with human bite injuries and 62% with animal bite injuries opted for autologous ear reconstruction. A flap with either a costal cartilage framework (37/39; 95%) or conchal cartilage (2/39; 5%) was used. In revision otoplasty group, 12% required autologous reconstruction either with conchal or costal cartilage. We discuss our indications, techniques, complications, and predictable pattern of injuries in human bites. Autologous auricular reconstruction of traumatic injuries is a safe procedure associated with aesthetically pleasing outcome and improved quality of life despite physical and psychosocial comorbidities. Elderly patients are more likely to opt for prosthetic camouflage.