How Can My Ear Be Reconstructed To Hold Up My Glasses?

Q: Dr. Eppley,  I an a 45 year old female with a total avulsion of my left ear with skin graphing to cover the skin loss.  My car accident was twenty years ago and the ear was found at the accident, however it was macerated and nonusable, as well as the tissue behind the ear.  As I am getting older I am having numerous eye issues with severe dry eye syndrome and having to wear glasses and this is quite difficult with missing an ear.  Unlike the lady in this segment, I do not have an ear lobe and no extra skin.  I would even be happy with some sort of way to hold up my glasses.  I wanted to know if there was anything that could be done to help me function normally to wear my glasses.  Look forward to your response.  Thank You.

A: I think there are two approaches to your ear reconstruction depending upon exactly what you want the final outcome to be. The skin graft in place precludes any attempt at making and inserting a cartilage framework through a traditional microtia reconstruction approach. This requires supple skin that can either be elevated or tissue expanded. The standard approach would be the insertion of endosseous implants followed by the attachment of a prosthetic ear. This provides good prosthetic retention and should easily hold up a pair of glasses. A secondary approach would be to create a shelf of cartilage above the skin graft or at its edge onto which glasses could rest. This will not create an ear but more like just the upper ¼ or 1/3 of it. Whether this is possible will require reviewing a picture of what the ear site looks like and the exact location of the skin graft.
Dr. Barry Eppley
Indianapolis, Indiana