[Reconstruction of traumatic auricular defect]

Auricle is liable to be injured, owing to its position and structural conditions. Since 1977, 48 cases (52 ears) with traumatic auricular defect have been reconstructed by the use of different operative techniques. The results have been satisfactory for most of them. Loss of a major portion of the auricle or the entire ear itself can be reconstructed by use of framework of costal cartilage graft (autologous or homologous). The joint between remaining auricle and framework must be smooth and secure. Helical defect can be repaired by the use of advancement of auricular skin and cartilage, composite graft, free skin graft with subdermal vascular plexus or tube flap according to specific conditions. Unnecessary injury to tissue should be avoided during the operation. Earlobe defect can be repaired by the use of double subcutaneous pedicle skin flaps. The retroauricular subcutaneous pedicle composite flap including conchal cartilage and the pretragus subcutaneous skin flap are formed. They pass through respective subcutaneous tunnels to reach the defect area. The two flaps and remained auricular fresh edge are sutured together. A flat, new earlobe is reconstructed. The earlobe reconstructed by the use of this technique overcomes the unsightly "spherical earlobe". This technique is an ideal operative method. In brief, there are many forms of traumatic auricular defects. According to the size and extent of defect, careful planning is essential before the actual surgery takes place.