Salvage of suboptimal results in a reconstructed ear: nonsurgical reshaping with triamcinolone.
BACKGROUND
Ear reconstruction with autologous tissues and creating a natural-appearing ear is a difficult, multistage surgical procedure. Problems, such as a thick skin or an inadequate cartilage-flap relationship, may cause obliteration of the framework details. A nonsurgical technique to improve auricular definition is described.


METHODS
Twenty-six patients with reconstructed ears due to inadequate auricular definition were enrolled in the study. To achieve a better auricular shape, triamcinolone acetonide injections up to 4 sessions were applied. Results of injections were evaluated by improvement of ear contours, quality of detail, frequency of injections, and complications. In addition, histopathologic studies were carried out in 8 patients.


RESULTS
The results were satisfactory. Significant recovery was observed in auricular definition in all patients. There were no major complications observed as a result of the use of steroids during the long follow-up period, suggesting that our technique was safe.


CONCLUSIONS
The solution to unfavorable results of a primary auricular reconstruction generally requires extremely difficult and challenging procedures. In selected patients, triamcinolone injections may be a remedy and may be helpful in avoiding complex surgical procedures.
Misirlioglu
Aykut
A
Department of Plastic, Reconstructive and Aesthetic Surgery, Dr Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey. aykmisf@hotmail.com
Karanfil
Huseyin
H
Akoz
Tayfun
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000673:Amputation, Traumatic / Q000601:surgery; D002648:Child; D054644:Ear Auricle / Q000187:drug effects*; D004426:Ear Deformities, Acquired / Q000601:surgery; D004428:Ear Neoplasms / Q000601:surgery; D004431:Ear, External / Q000002:abnormalities / Q000293:injuries / Q000601:surgery*; D004487:Edema / Q000139:chemically induced; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced; D007279:Injections, Subcutaneous; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D016879:Salvage Therapy; D013524:Surgical Flaps; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
D005938:Glucocorticoids; D014221:Triamcinolone