RECONSTRUCTION OF THE AURICLE IN TRAUMATIC DEFECTS WITH RIB CARTILAGE AUTOGRAFT
DOI:
https://doi.org/10.11603/2414-4533.2025.1.15185Keywords:
auricle, trauma, defect, reconstruction, rib cartilage autograftAbstract
The aim of the work: to specify the indications and to develop a method of replacing large defects of the auricle with a costal cartilage autograft.
Materials and Methods. Within 5 years (2000–2024), two male patients aged 22 and 43 years were operated on at the Yuriy Lypa Lviv Regional Hospital for War Veterans and Repressed Persons with defects of the upper and middle thirds of the auricle due to a knife wound and a dog bite. The diagnosis was made based on the examination of the patients. Wound contamination was noted for one of the hospitalized patients, which required intensive wound washing and sparing surgical treatment. All patients admitted to the clinic were hemodynamically stable. After routine laboratory tests, in each case, the auricle was photographed before surgery for legal and tactical reasons. Patients were operated on the day of hospitalization; the method of choice for anesthesia was endotracheal anesthesia. The duration of the operation was 1 hr. 25 minutes - 2 hours. 10 minutes. Cartilage autografts were harvested from 7-8 ribs, considering the chondroarchitectonics of the rib arch. Pneumothorax did not occur in any case.
Results. An ear shell framework was formed for the patients from their own rib cartilage, which was used to restore the shape and size of the auricle. The cartilage frame was covered with temporal fascia on the vascular pedicle. A split autograft was transplanted onto the fascia. With an injury to the middle part of the auricle, it was necessary to restore the lost soft covering tissues and cartilage defect. A two-stage plastic surgery was performed: first, the soft tissue defect was repaired, and the next step was to repair the cartilage defect with the patient’s own rib cartilage. There were no complications with satisfactory cosmetic result.
Conclusions. Large-sized traumatic defects of the upper and middle thirds of the auricle require the use of transplants. The method of choice for closing large defects of the upper and middle thirds of the auricle is prosthetics with a cartilaginous rib auto-graft.
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