Ear Anatomy, Embryo, Congenital, Recon

Question 1

What is cauliflower ear and how do you manage it?

Answer 1

= subperichondrial hematoma caused by blunt trauma shearing force separating cartilage from perichondrium

• Early (7days): Excise fibroneocartilage and bolster 7days

Question 2

What is suppurative chondritis and how do you manage it?

Answer 2

= infection of cartilage, (Pseudomonas>Staph) same as chondritis but with FLUCTUANCE and induration, occurs 2’ burned ear.

• leave eschar as biologic dressing and apply sulfamylon cream BID to prevent suppurative chondritis
• If present, INCISION AND DRAINAGE, treat with cephalosporin/penicillin + ciprofloxacin IV

Question 3

What are the options for reconstructing Helical rim?

Answer 3

1- Antia-Buch: Rim<2cm defect. Incision along helical sulcus through anterior skin and cartilage, leaving intact posterior auricular skin. May get more advancement with V-Y at helical crus

2- Auricular cartilage graft + local skin advancement or flap

3- Tubed flap (2stage)

Question 4

What are the options for reconstructing Upper 1/3?

Answer 4

1- Ortichea Conchal chondrocutaneous rotation flap

2- Antia-Buch

3- Post-auricular skin flap and rib cartilage or contralat concha

4- Pre-auricular banner flap and cartilage graft

Question 5

What are the options for reconstructing Middle 1/3?

Answer 5

1- Dieffenbach: retro-auricular skin advancement to cover cartilage graft and at 2nd stage divided to recreate tube + sulcus. Donor gets FTSG

2- Converse Tunnel procedure: defect line drawn on mastoid skin, and incised along defect margin, graft placed within mastoid skin and sutured to auricle. Divide after 8-12wks and donor gets FTSG

3- Antia-Buch

4- Direct excision with crescents and wedges (Tanzer)

5- Tubed flap

Question 6

What are the options for reconstructing Lobule?

Answer 6

1- Neolobule

2- Pardue technique