Complete replantation of a small tissue segment at the auricular apex: A case report

This study reports a rare case of complete replantation of a small avulsed tissue segment at the auricular apex. The patient, a 30-year-old male, sustained a complete amputation of the left ear apex due to a traffic accident. The avulsed tissue had been ischemic for approximately 4 h prior to surgery. Using supermicrosurgical techniques under 30 × magnification, three vessels-one artery and two presumed veins, each with a diameter of approximately 0.2-0.4 mm-were successfully anastomosed. Postoperatively, the patient developed venous congestion, which was effectively managed through regular acupuncture bleeding, leading to restored venous outflow. The tissue survived completely, and during a 3- to 6-month follow-up, the patient showed no significant hearing loss, with good auricular contour and near-normal sensory function. This case suggests that, under appropriate microsurgical conditions, even small tissue segments at the ear apex may be considered for vascular replantation. Accurate intraoperative vessel identification and active management of postoperative venous crisis are critical to success.