2-staged Reimplantation of an Amputated Pinna - Doing it the Old-Fashioned Way

Abstract

Reimplantation of amputated pinna has been a complicated issue for otorhinolaryngologists and plastic surgeons. Many techniques have been describes which include microvascular reconstruction and non microvascular reconstruction which come with their own advantages and disadvantages. Some surgeons have described totally removing the skin and burying the cartilage in a subcutaneous pocket in the abdomen (1). Mladick et al. in 1971 describe the technique of post auricular pocket which is used in our case to achieve the reimplantation of the segment (2, 3). Pennington et al. pioneered the technique of microvascular anastomosis which was later carried forward by Kind et al. (4) Although isolated traumatic ear amputation is a rare occurrence and often happens alongside severe systemic or head injuries, which typically rule out re-implantation attempts. In the rare cases where reimplantation is pursued, microvascular ear reimplantation poses significant challenges due to the small size of the vessels and the common presence of an avulsion injury. The old techniques of implantation are favorable for specific cases for example where the procedure needs to be quick, where prolonged anticoagulation is contraindicated, where the chances of failure of microvascular surgery is high for example in smokers. Thus in the era of microvascular surgery the old fashioned way of post auricular skin pocket still posses useful and can be in the armamentarium of otorhinolaryngologists.

Keywords: Pinna amputation; Pinna reconstruction; Post auricular pocket.