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Classification system for traumatic partial ear defects yields majority satisfaction

The method of classifying traumatic ear defects by size and contiguous skin condition yields satisfied patient outcomes following procedure with few complications, according to study results published in Plastic and Reconstructive Surgery.

The study included 60 patients who were treated at the researchers’ center between 2008 and 2015. There were 37 men and 23 women. Mean age was 31 years (range, 20-53 years). The researchers compared their methods with the more common system of classifying solely by location of upper, middle or lower ear regions.

Their classification system includes type I, type II, type III and type IV defects with a method developed to correspond with each type.

Methods I and II are single stage reconstructions. Method I uses a conchal cartilage framework and can be used if the neighboring postauricular skin is uninjured and the defect length is less than the length of the conchal bowl. Method II uses a costal cartilage framework and can be used if the neighboring postauricular skin is good quality, but the defect is larger than a type I defect. A tongue-shaped skin flap is used in Method I, while a tunnel skin flap is used for Method II.

Method III is a two-stage reconstruction using a costal cartilage framework and local skin flap. This method is chosen when there is limited skin flap mobilization and if the defect involves the antihelix and conchal bowl, the superior crus and inferior crus, or more than half of the earlobe.

Method IV is a single-stage reconstruction using a costal cartilage framework and temporoparietal fascial flap. This method is chosen if the adjacent postauricular skin is of poor quality and has significant scarring.

Of the 60 patients, 55 had successful aesthetic outcomes and reported satisfaction with results. Patients who were unsatisfied included two who reported an unnatural-appearing junction between the graft framework and residual ear stump, one who reported reduced width of the reconstruction ear compared with original size, and one who developed minor framework exposure, which was treated. – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.