J Reconstr Microsurg 2013; 29(03): 181-188
DOI: 10.1055/s-0032-1331150
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Review of Microvascular Ear Replantation

Sung Won Jung
1   Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang-si, Republic of Korea
,
Junsang Lee
1   Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang-si, Republic of Korea
,
Suk Joon Oh
1   Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang-si, Republic of Korea
,
Sung Hoon Koh
1   Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang-si, Republic of Korea
,
Chul Hoon Chung
2   Department of Plastic and Reconstructive Surgery, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea
,
Jong Wook Lee
3   Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea
› Author Affiliations
Further Information

Publication History

29 July 2012

07 September 2012

Publication Date:
31 December 2012 (online)

Abstract

Microvascular ear replantation is a significant challenge because of the small size of the vessels and the fact that traumatic amputations are frequently avulsed. The zone of trauma is therefore extended and the primary repair of the injured vessel is rendered unlikely. The purpose of this study is to review the literature of ear replantation. A review of the relevant literature that has been published since 1980 revealed 47 cases reported in 37 publications. We present 5 cases from our own experience and analyze a total 52 cases of microvascular ear replantation. The patient's age, sex, degree of amputation, cause of injury, ischemic time, method of arterial and venous anastomosis, complications, any additional outflow used, postoperative medications, the requirement for transfusions, and the number of hospital admission days are described. Successful microvascular ear replantations require anastomosis of the vessels if possible. Rather than a vein graft, primary repair of the vessels, or at least pedicled repair of the artery, should be considered to ensure flap survival. In addition, vein repair should be considered if possible to ensure the secure drainage of blood from the replant. With secure circulation, the replant can survive, resulting in a very satisfactory outcome.

 
  • References

  • 1 Buncke Jr HJ, Schulz WP. Total ear reimplantation in the rabbit utilising microminiature vascular anastomoses. Br J Plast Surg 1966; 19: 15-22
  • 2 Pennington DG, Lai MF, Pelly AD. Successful replantation of a completely avulsed ear by microvascular anastomosis. Plast Reconstr Surg 1980; 65: 820-823
  • 3 Juri J, Irigaray A, Juri C, Grilli D, Blanco CM, Vazquez GD. Ear replantation. Plast Reconstr Surg 1987; 80: 431-435
  • 4 Mutimer KL, Banis JC, Upton J. Microsurgical reattachment of totally amputated ears. Plast Reconstr Surg 1987; 79: 535-541
  • 5 Turpin IM. Ear replantation: a case report. J Reconstr Microsurg 1987; 4: 39-41
  • 6 Van Beek AL. Invited comment on Turpin IM, et al: Salvage of the severely injured ear. Ann Plast Surg 1988; 21: 178-179
  • 7 Katsaros J, Tan E, Sheen R. Microvascular ear replantation. Br J Plast Surg 1988; 41: 496-499
  • 8 Anthony JP, Lineaweaver WC, Davis Jr JW, Buncke HJ. Quantitative fluorimetric effects of leeching on a replanted ear. Microsurgery 1989; 10: 167-169
  • 9 Tanaka Y, Tajima S. Completely successful replantation of an amputated ear by microvascular anastomosis. Plast Reconstr Surg 1989; 84: 665-668
  • 10 Sadove RC. Successful replantation of a totally amputated ear. Ann Plast Surg 1990; 24: 366-370
  • 11 Rapaport DP, Breitbart AS, Karp NS, Siebert JW. Successful microvascular replantation of a completely amputated ear. Microsurgery 1993; 14: 312-314
  • 12 Safak T, Ozcan G, Keçik A, Gürsu G. Microvascular ear replantation with no vein anastomosis. Plast Reconstr Surg 1993; 92: 945-948 , discussion 949–950
  • 13 Jeng SF, Wei FC, Noordhoff MS. Replantation of amputated facial tissues with microvascular anastomosis. Microsurgery 1994; 15: 327-333
  • 14 de Chalain T, Jones G. Replantation of the avulsed pinna: 100 percent survival with a single arterial anastomosis and substitution of leeches for a venous anastomosis. Plast Reconstr Surg 1995; 95: 1275-1279
  • 15 Funk GF, Bauman NM, Rinehart RJ, Mankarious LA. Microvascular replantation of a traumatically amputated ear. Arch Otolaryngol Head Neck Surg 1996; 122: 184-186
  • 16 Kind GM, Buncke GM, Placik OJ, Jansen DA, D'Amore T, Buncke Jr HJ. Total ear replantation. Plast Reconstr Surg 1997; 99: 1858-1867
  • 17 Kayikçioğlu A, Ozlüoğlu L, Kizilay A. Prolonged arterial spasm in an ear replantation without venous anastomosis. J Reconstr Microsurg 1997; 13: 313-316
  • 18 Concannon MJ, Puckett CL. Microsurgical replantation of an ear in a child without venous repair. Plast Reconstr Surg 1998; 102: 2088-2093 , discussion 2094–2096
  • 19 Nath RK, Kraemer BA, Azizzadeh A. Complete ear replantation without venous anastomosis. Microsurgery 1998; 18: 282-285
  • 20 Finical SJ, Keller KM, Lovett JE. Postoperative ramifications of total ear replantation. Ann Plast Surg 1998; 41: 667-670
  • 21 Zamboni WA, Lozano DD, Vitkus K , et al. Single-vessel arteriovenous revascularization of the amputated ear. J Reconstr Microsurg 1999; 15: 9-13
  • 22 Cho BH, Ahn HB. Microsurgical replantation of a partial ear, with leech therapy. Ann Plast Surg 1999; 43: 427-429
  • 23 Shelley OP, Villafane O, Watson SB. Successful partial ear replantation after prolonged ischaemia time. Br J Plast Surg 2000; 53: 76-77
  • 24 Akyürek M, Safak T, Keçik A. Microsurgical ear replantation without venous repair: failure of development of venous channels despite patency of arterial anastomosis for 14 days. Ann Plast Surg 2001; 46: 439-442 , discussion 442–443
  • 25 Talbi M, Stussi JD, Meley M. Microsurgical replantation of a totally amputated ear without venous repair. J Reconstr Microsurg 2001; 17: 417-420
  • 26 Cavadas PC. Supramicrosurgical ear replantation: case report. J Reconstr Microsurg 2002; 18: 393-395
  • 27 Veselý J, Hrbatý J, Výška T. Replantation of totally amputated ears. Eur J Plast Surg 2002; 25: 263-266
  • 28 Liang Y, Li X, Gu L , et al. Successful auricle replantation via microvascular anastomosis 10 h after complete avulsion. Acta Otolaryngol 2004; 124: 645-648
  • 29 Schonauer F, Blair JW, Moloney DM, Teo TC, Pickford MA. Three cases of successful microvascular ear replantation after bite avulsion injury. Scand J Plast Reconstr Surg Hand Surg 2004; 38: 177-182
  • 30 Shen XQ, Wang C, Xu JH, Wu SC. Successful microsurgical replantation of a child's completely amputated ear. J Plast Reconstr Aesthet Surg 2008; 61: e19-e22
  • 31 O'Toole G, Bhatti K, Masood S. Replantation of an avulsed ear, using a single arterial anastamosis. J Plast Reconstr Aesthet Surg 2008; 61: 326-329
  • 32 Trovato MJ, Agarwal JP. Successful replantation of the ear as a venous flap. Ann Plast Surg 2008; 61: 164-168
  • 33 Jung SN, Yoon S, Kwon H, Yim YM. Successful replantation of an amputated earlobe by microvascular anastomosis. J Craniofac Surg 2009; 20: 822-824
  • 34 Kim KS, Kim ES, Hwang JH, Lee SY. Microsurgical replantation of a partial helix of the ear. Microsurgery 2009; 29: 548-551
  • 35 Hussey AJ, Kelly JI. Microsurgical replantation of an ear with no venous repair. Scand J Plast Reconstr Surg Hand Surg 2010; 44: 64-65
  • 36 Wong W, Wilson P, Savundra J. Total ear replantation using the distal radial artery perforator. J Plast Reconstr Aesthet Surg 2011; 64: 677-679
  • 37 Steffen A, Katzbach R, Klaiber S. A comparison of ear reattachment methods: a review of 25 years since Pennington. Plast Reconstr Surg 2006; 118: 1358-1364
  • 38 Park C, Lineaweaver WC, Rumly TO, Buncke HJ. Arterial supply of the anterior ear. Plast Reconstr Surg 1992; 90: 38-44
  • 39 Kind GM. Microvascular ear replantation. Clin Plast Surg 2002; 29: 233-248 , vii