Salvage of an amputated ear temporarily lodged in a forearm

After amputation of an ear, the best results are attained through the use of microvascular replantation. The literature reports very few examples of the successful replantation of a whole ear when compared with the vast number of attempts. We report the case of a 17-year-old boy with a recurrence of a voluminous arteriovenous malformation in the right temporoparietal area. Since radical excision was impossible without removing the ear, the cartilage with the perichondrium was inserted into the distal third of the left forearm. Six months later a composite free flap formed by a radial forearm flap including the cartilage was transferred to the permanent site. In the following months, the edema of the flap obscured the outline of the ear, forcing us to remove the skin and subcutaneous layer of the flap and cover the anterior face of the ear with a split-thickness skin graft. The indications and advantages of such a procedure are also discussed.