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Atypical replantation and reconstruction of frozen ear: A case report.
Medicine (Baltimore). 2020 May; 99(20):e20068.M

Abstract

RATIONALE

The first successful ear replantation was performed by Pennigton in 1980 in Sydney. At least 84 ear replantations have been described in the literature over a period of 37 years since the first case. The authors have not found any previous case of frozen ear replantation in the literature.

PATIENT CONCERNS

We report the case of a 38-year-old man, who had an injury to the head while working with a machine.

DIAGNOSIS

The patient suffered total traumatic avulsion of the left ear. The ear was wrapped in moistened, sterile gauze and was transported on dry ice. At the time of admission to our department, the amputated ear was frozen to stiff, solid nonelastic matter.

INTERVENTIONS

We attempted replantation. Despite repeated arterial thrombosis during surgery, the ear was successfully replanted with arterial and venous anastomosis.

OUTCOMES

Venous congestion occurred within 9 h of surgery and was treated using leeches. Freezing cold injury developed during reattachment. The radix and proximal parts of the helix exhibited necrosis and so were reconstructed by contralateral conchal cartilage graft, which was wrapped with a local subauricular skin flap. On completion of treatment, a satisfactory shape was achieved, although the replanted and reconstructed left auricle slightly was smaller than the contralateral auricle.

LESSONS LEARNED

Our report confirms that the replantation of a frozen, amputated ear is possible, and we suggest that ear replantation should be the method of choice for the treatment of ear loss even under these conditions.

Authors+Show Affiliations

Department of Plastic and Aesthetic Surgery, St. Anne's University Hospital. Faculty of Medicine, Masaryk University, Brno, Czech Republic.Department of Plastic and Aesthetic Surgery, St. Anne's University Hospital.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

32443314

Citation

Dvořák, Zdeněk, and Igor Stupka. "Atypical Replantation and Reconstruction of Frozen Ear: a Case Report." Medicine, vol. 99, no. 20, 2020, pp. e20068.
Dvořák Z, Stupka I. Atypical replantation and reconstruction of frozen ear: A case report. Medicine (Baltimore). 2020;99(20):e20068.
Dvořák, Z., & Stupka, I. (2020). Atypical replantation and reconstruction of frozen ear: A case report. Medicine, 99(20), e20068. https://doi.org/10.1097/MD.0000000000020068
Dvořák Z, Stupka I. Atypical Replantation and Reconstruction of Frozen Ear: a Case Report. Medicine (Baltimore). 2020;99(20):e20068. PubMed PMID: 32443314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atypical replantation and reconstruction of frozen ear: A case report. AU - Dvořák,Zdeněk, AU - Stupka,Igor, PY - 2020/5/24/entrez PY - 2020/5/24/pubmed PY - 2020/5/24/medline SP - e20068 EP - e20068 JF - Medicine JO - Medicine (Baltimore) VL - 99 IS - 20 N2 - RATIONALE: The first successful ear replantation was performed by Pennigton in 1980 in Sydney. At least 84 ear replantations have been described in the literature over a period of 37 years since the first case. The authors have not found any previous case of frozen ear replantation in the literature. PATIENT CONCERNS: We report the case of a 38-year-old man, who had an injury to the head while working with a machine. DIAGNOSIS: The patient suffered total traumatic avulsion of the left ear. The ear was wrapped in moistened, sterile gauze and was transported on dry ice. At the time of admission to our department, the amputated ear was frozen to stiff, solid nonelastic matter. INTERVENTIONS: We attempted replantation. Despite repeated arterial thrombosis during surgery, the ear was successfully replanted with arterial and venous anastomosis. OUTCOMES: Venous congestion occurred within 9 h of surgery and was treated using leeches. Freezing cold injury developed during reattachment. The radix and proximal parts of the helix exhibited necrosis and so were reconstructed by contralateral conchal cartilage graft, which was wrapped with a local subauricular skin flap. On completion of treatment, a satisfactory shape was achieved, although the replanted and reconstructed left auricle slightly was smaller than the contralateral auricle. LESSONS LEARNED: Our report confirms that the replantation of a frozen, amputated ear is possible, and we suggest that ear replantation should be the method of choice for the treatment of ear loss even under these conditions. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/32443314/Atypical_replantation_and_reconstruction_of_frozen_ear:_A_case_report L2 - https://doi.org/10.1097/MD.0000000000020068 DB - PRIME DP - Unbound Medicine ER -