F Firmin1, A Marchac. 1. Clinique Bizet, 21, rue Georges-Bizet, 75116, Paris, France. francoisefirmin@damma.org
Abstract
BACKGROUND: The external ear is a complex, delicate structure and treatment of burned ears should not be neglected. We will detail the different scenarios a surgeon can encounter and present a therapeutic algorithm. PATIENTS AND METHODS: From 1984 to 2011, we operated 134 patients for ear deformities secondary to burns, of which 90 cases were unilateral (67%) and 44 cases bilateral (32%), accounting for 178 ear in total. Our two-stage technique is based on an autologous cartilage framework, covered by mastoid skin, superficial temporal fascia (STF) or indirect skin expansion, and later by elevation of the construct. RESULTS: Costal cartilage is the ideal support when loss of substance is greater than one quarter of the ear pavilion and/or two plans. Mastoid skin integrity is the best factor of prognosis when planning an ear reconstruction. If injured, the STF can be used. If the STF has been injured as well, indirect expansion represents the last option before placement of prosthesis. Free contralateral STF is rarely an option in these patients, although it should be considered. CONCLUSION: Reconstruction of one or both ears is often the last step in a rehabilitation process after burns. It is ideally performed after wound healing has been achieved, and by a team well trained in microtia treatment and post-traumatic reconstruction. Copyright Â
BACKGROUND: The external ear is a complex, delicate structure and treatment of burned ears should not be neglected. We will detail the different scenarios a surgeon can encounter and present a therapeutic algorithm. PATIENTS AND METHODS: From 1984 to 2011, we operated 134 patients for ear deformities secondary to burns, of which 90 cases were unilateral (67%) and 44 cases bilateral (32%), accounting for 178 ear in total. Our two-stage technique is based on an autologous cartilage framework, covered by mastoid skin, superficial temporal fascia (STF) or indirect skin expansion, and later by elevation of the construct. RESULTS:Costal cartilage is the ideal support when loss of substance is greater than one quarter of the ear pavilion and/or two plans. Mastoid skin integrity is the best factor of prognosis when planning an ear reconstruction. If injured, the STF can be used. If the STF has been injured as well, indirect expansion represents the last option before placement of prosthesis. Free contralateral STF is rarely an option in these patients, although it should be considered. CONCLUSION: Reconstruction of one or both ears is often the last step in a rehabilitation process after burns. It is ideally performed after wound healing has been achieved, and by a team well trained in microtia treatment and post-traumatic reconstruction. Copyright Â