Single-Artery Human Ear Graft Procurement: A Simplified Approach

Area of Science:

• Microsurgery
• Vascularized Composite Tissue Allotransplantation (VCA)
• Anatomy

Background:

• Facial vascularized composite tissue allotransplantation (VCA) research has utilized auricular subunit models.
• Clinical replantation cases suggest single artery perfusion of auricular flaps is possible.

Purpose of the Study:

• To investigate single-pedicle auricular allotransplantation techniques.
• To assess arterial perfusion and venous drainage in auricular grafts.
• To enhance replantation versatility.

Main Methods:

• Harvested 11 auricular grafts on single or double artery pedicles (superficial temporal and/or posterior auricular arteries).
• Utilized selective barium injections, micro-computed tomography, and 3D reconstruction for arterial perfusion analysis.
• Investigated venous drainage via dissection after latex injection in eight hemifaces.

Main Results:

• Homogenous perfusion of the entire auricle was observed across all arterial pedicle variants.
• Intra-auricular anastomoses between superficial temporal and posterior auricular arteries support single-artery perfusion.
• Venous drainage patterns were highly variable, with no consistent dominant pathway.

Conclusions:

• Auricular VCA can be performed using a single artery due to robust intra-arterial anastomoses.
• This vascular versatility simplifies flap harvest and allows flexible pedicle selection.
• Inconstant venous drainage presents a major challenge for successful auricular transplantation.