Ear Replantation Using Superficial Temperoparietal Fascia Flap Without Microvascular Surgery: A Case Report

Öz

Ear amputation is still a serious problem and leads significant deformities. Successful microvascular replantation of total ear amputations is rare in the literature and often ends with venous congestion. We present a case with ear amputation, which had no appropriate vessel for microvascular anastomosis. The skin of the posterior aspect of the auricle was excised and anterior aspect preserved. To enhance the survival of the skin of anterior aspect of the auricle some fenestrations were performed on the cartilage. The composite auricle was transplanted under the superficial temperoparietal fascia flap. After three weeks, the auricle was successfully transferred to its anatomic location using superficial temporal artery flap. Key words: Ear amputation, Superficial temporoparietal fascia, Ear replantation without microsurgery

Anahtar Kelimeler

• Ear amputation, Superficial temporoparietal fascia, Ear replantation without microsurgery

Superfisial Temporoparietal Fasia Flebiyle Mikrovasküler Olmayan Kulak Replantasyonu: Olgu Sunumu

Öz

Kulak amputasyonu halen ciddi bir sorundur ve aşırı deformitelere yol açar. Başarılı mikrovasküler kulak replantasyonu literatürde oldukça nadir bildirilmiştir ve çoğu zaman venöz konjesyonla sonuçlanır. Biz bu çalışmamızda, kulak amputasyonuyla acil servise başvuran ve replantasyon için uygun damar bulamadığımız olgumuzu sunuyoruz. Ampute kulağın posterior derisini eksize ettik, ön taraf deriyi koruduk. Ön taraf derinin beslenmesini sağlamak için kartilaja fenestrasyonlar açtık. Aynı taraf superfisial temporoparietal fasia (STS) flebinin altına kompozit olarak transplante ettik. Üç hafta sonra superfisial temporal arter (STA) bazlı fleple birlikte kulağı anatomik pozisyonuna transfer ederek başarılı rekonstrüksiyon gerçekleştirdik. Anahtar kelimeler: Kulak amputasyonu, Süperfisyel temporoparietal fasia, Mikrovasküler olmayan kulak replantasyonu.

Anahtar Kelimeler

• Kulak amputasyonu, Süperfisyel temporoparietal fasia, Mikrovasküler olmayan kulak replantasyonu.

Kaynakça

1. Veselý J, Hrbatý J, Výška T, Stupka I, Hyža P. Replantation of totally amputated ears. Eur J Plast Surg 2002; 25: 263-66.
2. Funk GB, Bauman NM, Rinehart RJ, Mankarious LA. Microvascular replantation of a traumatically amputated ear. Arch Otolaryngol Head Neck Surg 1996; 122:184–86
3. Jeng SF, Wei FC, Noordhooff MS. Replantation of amputated facial tissues with Microvascular anastomosis. Microsurgery 1994; 15:327–33
4. Kind GM, Placik OJ, Jansen DA, D’Amore T, Buncke HJ Jr. Total ear replantation. Plast Reconstr Surg 1997; 99:1858–1867
5. Safak T, Ozcan G, Kecik A, Gursu G. Microvascular ear replantation with no vein anastomosis. Plast Reconstr Surg 1993; 92(5):945-8
6. Elsahy NI. Ear replantation. Clin Plast Surg. 2002; 29:221-31.
7. Mc Dowell F. Successful replantation of a severed half ear. Plast Reconstr Surg 1971; 48: 281-85
8. Templer J, Renner GJ. Injuries of the external ear. Otolaryngol Clin North Am. 1990; 23:1003-18.

9. Musgrave RH, Garrett WS. Management of avulsion injuries of the external ear. . Plast Reconstr Surg 1967; 40: 534-39.
10. Pribaz JJ, Crespo LD, Orgill DP, Pousti TJ, Bartlett RA. Ear replantation without microsurgery. Plast Reconstr Surg. 1997; 99:1868-72.
11. Jenkins AM, Finucan T. Primary nonmicrosurgical reconstruction following ear avulsion using the temporoparietal fascial island flap. Plast Reconstr Surg. 1989; 83: 148-52.
12. Mladick, R. A., Horton, C. E., Adamson, J. E., and Cohen, B. I. The pocket principle: A new technique for the reattachment of a severed ear part. Plast. Reconstr. Surg. 48: 219, 1971
13. Mladick, R. A., and Carraway, J. H. Ear reattachment by the modified pocket principle. Plast. Reconstr. Surg. 51: 584, 1973.
14. Brent B, Upton J, Acland RD, Shaw WW, Finseth FJ, Rogers C, Pearl RM, Hentz VR. Experience with the temporoparietal fascial free flap. Plast Reconstr Surg. 1985; 76(2):177-88.
15. Nagata S. Secondary reconstruction for unfavorable microtia results utilizing temporoparietal and innominate fascia flaps. Plast Reconstr Surg. 1994; 94: 254-65.
16. Chun JK, Sterry TP, Margoles SL, Silver L. Salvage of ear replantation using the temporoparietal fascia flap. Ann Plast Surg. 2000; 44:435-9.
17. Brent B, Byrd HS. Secondary ear reconstruction with cartilage grafts covered by axial, random, and free flaps of temporoparietal fascia. Plast Reconstr Surg. 1983; 72(2):141-52.
18. Sucur D, Ninkovic M, Markovic S, Babovic S. Reconstruction of an avulsed ear by constructing a composite free flap. Br J Plast Surg. 1991; 44:153-4.
19. Carstens MH, Greco RJ, Hurwitz DJ, Tolhurst DE. Clinical applications of the subgaleal fascia. Plast Reconstr Surg. 1991; 87:615-26.