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Cited by 91Reconstructive Facial Surgery TechniquesReconstructive Surgery and Microvascular TechniquesFacial Trauma and Fracture Management

A Comparison of Ear Reattachment Methods: A Review of 25 Years since Pennington

Steffen, Armin, Katzbach, Ralf, Klaiber, Susanne·2006·Plastic and Reconstructive Surgery
DOI 10.1097/01.prs.0000239539.98956.b0
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Abstract

BACKGROUND: A failed ear reattachment tends to complicate subsequent reconstruction with autogenous rib cartilage. The various reattachment methods differ in technical demand, in the secondary damage of periauricular tissue, and in aesthetic outcome. In the past 25 years, the microsurgical method has proven to be especially successful. The aim of this work was to assess case reports of auricular trauma since the first microsurgical ear replantation by Pennington. METHODS: An extensive review of the literature of acute ear trauma published between 1980 and 2004 was performed. For a better comparison, the type of damage, the reattachment technique, and the final outcome were categorized. Representative cases of traumatic auricular lesions, which were reconstructed with rib or conchal cartilage at the authors' hospital, were included. RESULTS: Seventy-four cases in 56 publications were analyzed. The microsurgical replantation showed excellent aesthetic results but demanded an intensive perioperative and postoperative treatment. Pocket methods were used mainly in partial amputations. Repairs with periauricular tissue flaps made a quite inconsistent impression. Direct reattachments, such as composite grafts, were indicated only in extended lacerations. CONCLUSIONS: To replant an avulsed auricle is still a challenge for surgeons. Microsurgically reanastomosed ear replantation appears to be the best method because a superior outcome can be achieved without jeopardizing a subsequent ear reconstruction with rib cartilage in case of failure. The pocket method and periauricular skin or fascia flaps should be abandoned. They rarely achieve such a consistently good aesthetic outcome as a secondary reconstruction with rib cartilage.

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43 of 43 references verified0 citation errors · 0 not checkable

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  • In Steffen et al's study, segments larger than one-third of the ear had a poor outcome.

    “In Steffen et al's study, segments larger than one‐third of the ear had a poor outcome.6”

    From Auricular avulsion injuries and reattachment techniques: A systematic review (2020) · cites this paper as [6]

  • In Steffen et al's review, microvascular repair was reported to offer superior cosmetic results compared to all other repair methods.

    “In Steffen et al's review, microvascular repair was reported to offer superior cosmetic results, when compared to all other repair methods.6”

    From Auricular avulsion injuries and reattachment techniques: A systematic review (2020) · cites this paper as [6]

  • A failed ear reattachment complicates subsequent reconstruction with autogenous rib cartilage.

    “A failed ear reattachment complicates subsequent reconstruction with autogenous rib cartilage,6 emphasizing the importance of maximizing successful reattachment rates in the acute care of these injuries, while ensuring maximal preservation of tissue critical to any salvage repair.”

    From Auricular avulsion injuries and reattachment techniques: A systematic review (2020) · cites this paper as [6]

  • Steffen et al. described loss of cartilage complexity and stability even in cases where the pocket principle was successfully employed.

    “Steffen et al described “loss of cartilage complexity and stability,”6 even in cases where the pocket principle was successfully employed.”

    From Auricular avulsion injuries and reattachment techniques: A systematic review (2020) · cites this paper as [6]

  • Larger segments are more likely to fail, leading to necrosis and resulting in a large residual defect.

    “Larger segments are more likely to fail, leading to necrosis and resulting in a large residual defect.”

    From Auricular avulsion injuries and reattachment techniques: A systematic review (2020) · cites this paper as [6]

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Authors
Steffen, A., Katzbach, R., & Klaiber, S.
Affiliations
University of Lübeck (DE)
ORCID
Steffen, Armin
Venue
Plastic and Reconstructive Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2006-11
Volume
118
Issue
6
Pages
1358-1364
ISSN
0032-1052 (ISSN-L)
DOI
10.1097/01.prs.0000239539.98956.b0
OpenAlex
W2062501780
Cited by
91
References
43
Citations by year
2026: 3 · 2025: 10 · 2024: 5 · 2023: 6 · 2022: 6 · 2021: 5 · 2020: 6 · 2019: 3 · 2018: 5 · 2017: 3 · 2016: 3 · 2015: 2 · 2014: 6 · 2013: 6 · 2012: 3
FWCI
3.05
Type
journal article
Language
en
Open access
closed
Locations
  • Plastic & Reconstructive Surgery (publishedVersion)
  • PubMed (publishedVersion)
Funders
Dartmouth College
Topics
  • Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
  • Health Sciences › Medicine › Surgery › Reconstructive Surgery and Microvascular Techniques
  • Health Sciences › Medicine › Surgery › Facial Trauma and Fracture Management
Keywords
ear replantation, ear trauma, ear amputation, composite graft, ear reconstruction, cosmetic outcome
MeSH terms
Adolescent, Adult, Amputation, Traumatic, Cartilage, Child, Child, Preschool, Ear Cartilage, Ear Deformities, Acquired, Ear, External, Female, Humans, Infant, Male, Microsurgery, Middle Aged, Replantation, Retrospective Studies, Ribs, Transplantation, Autologous, Treatment Outcome, Plastic Surgery Procedures

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