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Auricular avulsion injuries: Literature review and management algorithm.

Mohamed A Al-Ali1,2, Fikri M Abu-Zidan1

  • 1Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates.

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|May 9, 2022
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Summary

Direct re-attachment (DR) offers good cosmetic outcomes for traumatic ear avulsion (TEA) injuries, especially when microsurgical facilities are unavailable. This technique provides a viable non-microsurgical option for managing ear avulsions.

Keywords:
Direct attachmentear amputationear avulsioninjuryreviewsurgery

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Area of Science:

  • Plastic Surgery
  • Trauma Surgery
  • Otolaryngology

Background:

  • Traumatic ear avulsion (TEA) presents significant psychological distress.
  • Lack of clear surgical guidelines for TEA, particularly in resource-limited settings.
  • Microsurgical facilities are often unavailable for managing these injuries.

Purpose of the Study:

  • To review literature on surgical management of TEA.
  • To focus on direct re-attachment (DR) as a non-microsurgical technique.
  • To develop a management algorithm for TEA in the absence of microsurgery.

Main Methods:

  • Extensive literature review of English papers indexed in PubMed.
  • Analysis of 28 cases of TEA repaired with DR from 18 publications.
  • Focus on studies without time restriction.

Main Results:

  • Direct re-attachment (DR) yields good esthetic results for auricular avulsion injuries.
  • DR is superior to other non-microsurgical techniques in acute settings without microvascular expertise.
  • Particularly effective for incomplete and small-segment auricular avulsions.

Conclusions:

  • DR is an accepted surgical approach for traumatic ear avulsions.
  • It achieves favorable cosmetic outcomes.
  • Preserves the auricular area for potential future reconstruction if initial re-attachment fails.