Use of a platysma myocutaneous flap for the reimplantation of a severed ear
experience with five cases
Keywords:
Platysma flap, Myocutaneous flap, Severed earAbstract
CONTEXT: The traumatic loss of an ear greatly affects the patient because of the severe aesthetic deformity it entails. The characteristic format of the ear, with a fine skin covering a thin and elastic cartilage, is not found anywhere else in the human body. Thus, to reconstruct an ear, the surgeon may try to imitate it by sculpting cartilage and covering it with skin. OBJECTIVE: To use a platysma myocutaneous flap for the reimplantation of a severed ear in humans. DESIGN: Case report. SETTING: Emergency unit of the university hospital, Faculty of Medicine, Ribeirão Preto - USP. CASE REPORT: Five cases are reported, with whole ear reimplantation in 3 of them and only segments in 2 cases. The surgical technique used was original and was based on the principle of auricular cartilage revascularization using the platysma muscle. We implanted traumatically severed auricular cartilage into the platysma muscle. The prefabricated ear was later transferred to its original site in the form of a myocutaneous-cartilaginous flap. Of the 5 cases treated using this technique, 4 were successful. In these 4 cases the reimplanted ears showed no short- or long-term problems, with an aesthetic result quite close to natural appearance. In one case there was necrosis of the entire flap, with total loss of the ear. The surgical technique described is simple and utilizes the severed ear of the patient. Its application is excellent for skin losses in the auricular region or for the ear itself, thus obviating the need for microsurgery or the use of protheses or grafts.
Downloads
References
Gilford GH Jr. Replantation of severed part of an ear. Plast Reconstr Surg 1972; 49:202-2.
Lewis EC II, Fowler JR. Two replantations of severed ear parts. Plast Reconstr Surg 1979; 64:703-5.
Salyapongse A, Maun LP, Suthunyarat, P. Successful replantation of a totally severed ear. Plast Reconstr Surg 1979; 64:706-8.
Hurwitz DJ, Robson JA, Futrell JW. The anatomic basis for the platysma skin flap. Plast Reconstr Surg 1983; 72:302-14.
Pennington DG, Pelly AD. Successful replantation of a completely avulsed ear by microvascular anastomosis. Plast Reconstr Surg 1980; 65:820-3.
Sucur S, Ninkovic M, Markovic S, et al. Reconstruction of an avulsed ear by constructing a composite free flap. Br J Plast Sur 1991; 44:153-4.
Wilkes GH, Wolfaardt JE. Osseointegrated alloplastic versus autogenous ear reconstruction: criteria for treatment selection. Plast Reconstr Surg 1994; 93:967-79.
Mladick RA, Horton CE, Adamson JE, et al. The pocket principle? A new technique for the reattachment of a severed ear part. Plast Reconstr Surg 1971; 48:219-23.
Mello-Filho FV, Mamede RCM, Velludo MASL. Tracheal neovascularization: a method involving mobilization of a complete tracheal neovascularization segment using a sternohyoid muscle flap. Laryngoscope 1996; 106:81-5.
Futrell JW, Johns ME, Edgerton MT, et al. Platysma myocutaneous flap for intraoral reconstruction. Am J Surg 1978; 136:504-7.
Mello-Filho FV, Mamede RCM. Reconstruction of the lower lip with a platysma myocutaneous flap. Acta Oncol Bras 1992; 12:119-22.
Mello-Filho FV, Mamede RCM, Sader AA, et al. Use of the platysma myocutaneous flap for cervical tracheal reconstruction: an experimental study in dogs. Laryngoscope 1993; 103:1161-7.
Arian S, Chicarelli ZN. Replantation of a totally amputated ear by means of a platysma musculocutaneous "sandwich" flap. Plast Reconstr Surg 1986; 78:385-9.
Brent B, Byrd SS. Secondary ear reconstruction with cartilage grafts covered by axial, random and free flaps of tempoparietal fascia. Plast Reconstr Surg 1983; 72:41-51.
