Q: Dr. Eppley, I am interested in ear reconstruction. I lost my right ear several years ago in a car accident. I have attached a couple of pictures so you can see the extent of the ear loss. How can my ear be fixed?
A: A complete ear avulsion represents the most complex type of ear reconstruction. The obvious injury seen in the pictures you sent is a traumatic avulsion of the complete external ear. In dealing with such ear injuries, there are two methods of reconstruction which are dramatically different. The first method is known as the autologous or natural tissue reconstruction method using the patient’s own tissues. The framework of an ear can be fabricated from one’s own cartilage since the ear (minus the earlobe) is cartilage covered by skin. To create the necessary skin, an initial tissue expander must be placed to stretch out (expand) the skin around the ear hole. (external auditory meatus) Once enough skin is created, the tissue expander can be replaced with an ear framework fabricated and carved out of rib cartilage. Somke minor touchups are needed later to make the earlobe and a crease or sulcus on the back of the ear. The other approach is to make a prosthetic ear which is held into placed by end osseous (dental) implants. Three implants are initially placed around the ear hole and allowed to heal. They are eventually uncovered and then used as magnetic retention posts onto which a prosthetic ear can be attached.
There are advantages and disadvantages with either approach. (autologous = multiple reconstructive surgeries, prosthetic = need to continuously remake new ear prostheses)
Dr. Barry Eppley