Traumatic ear loss can occur as a result of various injuries such as car accidents, dog bites, sports injuries, burns, and acid victims. Loss of the external ear in an adult causes significant psychological distress. This often has a great impact on social interaction, career, and personal relationships. But the good news is that it is possible to get a complete, normal-looking ear through ear reconstruction surgery.
Dr. Parag Telang, the most preferred cosmetic and plastic surgeon performs ear surgery in Mumbai. In this blog, he has provided a detailed description of how the procedure of traumatic ear loss is carried out to help patients understand it better and not fret about the surgery.
Markings
Whenever we need to plan a patient for ear reconstruction, the surgery begins with the initial clinical photographs and marking. The exact dimensions of the opposite normal ear are replicated on a dressing paper. On the basis of these markings, the marking for the future ear is marked on the skin.
Removing Rib Cartilage
The surgery begins with the patient in the supine position. Initially, we dissect the skin and the muscle to expose the rib cartilage. We use rib cartilage from the same side as the ear to be reconstructed. Normally, sixth, seventh, and eighth rib cartilages are removed. The dissection is done it takes around 40 to 45 minutes to remove these rib cartilage. After the rib cartilage has been removed, the chest incision is closed in layers.
Designing Cartilage Framework
After rib cartilage is harvested, there are special carving instruments that are used to carve out different components of an ear. All the different components of the ear are first replicated on the cartilage framework. These different components are then joined together to form a complete three-dimensional structure of the ear framework, using ultra-thin stainless steel wires.
Dissecting Temporal Fascia
Once the complete ear cartilage framework has been made, then we move on to the dissection of the temporal fascia. Dissection of the temporal fascia also has to be done very meticulously because the blood supply to the temporal fascia is by an artery that is very thin. Extra care has to be taken to preserve this artery so that the fascia maintains its blood supply.
Inserting the Framework
After the temporal fascia has been deserted, the framework is inserted in the correct location on the scalp and then the fascia is used to cover this framework. There are suction drains that are applied to suck any blood or lymph which may collect under the framework and to also ensure that the temporal fascia fits over the cartilage framework.
Applying Skin Graft
After the suction drains have been applied and the fascia gets sucked into the different components of the cartilage framework, an ultra-thin skin graft from the thigh is harvested. This skin graft is then applied to the ear framework. It is very important that no blood should accumulate between the fascia and the cartilage framework.
Dressing
Once the cartilage framework has been covered with the fascia and skin graft, all the crevices of the ear are covered using gauze and then a gentle dressing is applied on top of the scalp and ear.
Post Procedure Check Up
The patient is shifted to the recovery room. Normally this surgery takes around 4 to 5 hours. After the second day, the scalp dressing is opened and the viability of the vascularity of the fascia is checked. We make sure that there is no hematoma inside and that the suction drains are functioning properly. On the third day, the dressing is changed, both the suction drains are removed and a new dressing is applied to the ear and the scalp. The patient is mobilized on the third day and once the patient is pain-free, and comfortably walking, he gets discharged from the hospital.
How long does it take to recover?
Normally patients require a week before they can resume walking or gently jogging. Rigorous exercises or weight training, normally begin four to six weeks after the surgery.
How long does it take for results to be visible?
When we use the temporal fascia to recreate an ear, it is important to understand that it takes three to six months before the internal contours and intricacies of the ear can be seen. Therefore, it is important to have patience before we can see the different dimensions of the ear. Ear reconstruction using temporal fascia is a technically very demanding surgery. But with proper due care and proper training, it is definitely possible to achieve satisfactory results using this technique.
Dr. Parag Telang is a world-renowned surgeon for microtia ear and ear deformities. He is considered to be the best ear surgeon in India. He is an expert in ear reconstruction surgery for children who are born with missing or partial ears and children/adults who have had a traumatic loss of an ear.
