A new method in the treatment of ear amputation: experimental and clinical study.
There have been plenty of reconstruction methods for ear amputation, and replantation preserves its importance. In situations where replantation is not feasible, various methods were proposed. We indicate an alternative technique for the ear amputation without replantation indication. The method of replacing of a vascular structure into the tunnel formed on the posterior side of the amputated ear was used instead of replacing the ear cartilage into a vascular area that was described in the literature of ear prefabrication. The dorsal fascial flaps which were prepared from the back of 10 New Zealand rabbits were placed into the amputated ear. The 2 groups, control and the experimental, were consequently the ear that was adapted as a composite graft and the ear with the flap inserted. The ears were examined macroscopically and photographed on postoperative days 3, 7, 14, and 21. On the 21st day, the nourishment pattern of the ear, the dorsal fascia, and the dorsal fascia adapted ear were investigated with digital subtraction angiography (DSA). The group that received applied dorsal fascia possessed increased vascularity. The viability was evaluated with the biopsies taken from the control group and the group that received applied dorsal fascial flap on the 21st day. The cartilage and the connective tissue were viable in the flap-applied group, whereas there was necrosis in the control group. The reflection of the experimental study was performed on 2 subtotal and 1 total ear amputation cases, with the utilization of the superficial temporal artery. The nourishment of the flaps was evaluated with postoperative photographs, angiography, and bone scintigraphy.
Alagöz
M Sahin
MS
Department of Plastic and Reconstructive Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey. sahinalagoz@hotmail.com
Uysal
A Cağr
AC
Işgören
Serkan
S
Erdoğan
Cüneyt
C
Işken
Tonguç
T
Sen
Cenk
C
Tüccar
Eray
E
Sabuncuoğlu
Bizden Tavl
BT
Sensöz
Omer
O
D000328:Adult; D000671:Amputation, Surgical; D000673:Amputation, Traumatic / Q000601:surgery*; D015901:Angiography, Digital Subtraction; D000818:Animals; D004431:Ear, External / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000379:methods; D012092:Replantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D014022:Tissue Survival