Ear Reconstruction
Ear Reconstruction
Ear reconstruction can be subcategorized into repair for congenital defects, traumatic defects, or cancer defects. Cosmetic auricle surgery is termed Otoplasty and is discussed separately under the cosmetic procedures.
Microtia Repair / Repair of a Congenitally Missing Ear:
Microtia is the medical term for a missing or under developed auricle. This deformity can be isolated, or occur in combination with under developed ear canal and inner ear. Dr Khosh creates a new auricle by taking cartilage from the rib. During surgery, the rib cartilage is shaved and folded to resemble an ear. Typically, smaller secondary procedures are necessary to achieve the best results. Dr Khosh does not use man-made implants for auricle reconstruction since they entail greater risk of infection or extrusion.
The following patient is a representative case for repair of microtia.
Repair of Cauliflower Ear / Repair of Wrestler Ear Deformity:
Trauma from contact sports such as boxing, wrestling, or martial arts can result in bleeding in a tissue plane between the skin and cartilage of the ear. If not relieved, the ear can become permanently deformed, assuming a shrunken thickened shape. Dr Khosh treats acute ear trauma to release any accumulated blood. Patients with late stage deformity can be helped through techniques of cartilage grafting and cartilage shaving.
The following case shows acute ear trauma causing swelling due to blood collection under the skin. The blood was drained and incision was closed.
Skin Cancer Reconstruction:
The majority of skin cancers affecting the ear involve the helical fold (the outer most rim of the external ear). Typically, the adjacent helical rim can be advanced to repair the defect. This technique reduces the size of the ear by necessity. However, since both ears are never seen simultaneously, the size discrepancy will have no significance.
The following case represents a lady who had undergone excision of a basal cell cancer from the upper pole of the ear. She sought consultation with Dr Khosh for delayed repair of her ear. Following the repair, she was no longer self conscious about exposing her ear.
When the defects involve more than 40% of the circumference of the ear, helical rim flaps cannot be used as a reconstructive alternative. In such cases, skin from the scalp behind the ear can be moved unto the ear to cover the defect. This two-staged procedure has one shortcoming: it cannot fully recreate the subtle curves of the helical rim.
The following case is an example of such repair.
Ear Reconstruction: 212-223-1333
