Pinna repair is proposed after a trauma, tumor resections, and in congenital malformations. Surgical techniques are similar in each cases. Reconstructions may be more or less complete depending on the pinna defect .
Dr. Carles is a student of Dr Françoise Firmin, who is world famous in ear reconstruction, and uses most of her surgical principles .
– Sequelae of injuries : burns, bites, car accidents.
– Birth Defects : minor anomalies ( cup-ear, cryptotia, Stahl’s ear ) and major anomalies , mainly microties ( ear aplasia ). These may be isolated or associated with other malformations as in Franceschetti syndrome (Treacher – Collins syndrome ), oto -mandibular syndrome and Goldenhar syndrome .
– Secondary cases : patients’ear already rebuilt with an unsatisfactory cosmetic result. A new reconstruction in this case is sometimes possible, but with significant post -operative risks.
PARTIAL EAR RECONSTRUCTION
The restorative intervention is based on the realization of a template enabling a comparison to the contralateral ear. The cartilage is usualy directly shaped. In cases where a support is needed, it is possible to use ear ( conchal ) or costal cartilage. Skin cover is usually sufficient and the procedure is performed most often at the same time .
TOTAL EAR RECONSTRUCTION
Reconstruction is possible from the age of 9. A framework of assembled rib cartilage is carved reproducing complex reliefs of the future ear. This framework is placed under the skin behind the ear for a minimum period of 6 months. The ear is elevated during a second operation .
Dr. Carles may need to create a resin template of the future ear by stereolithography, based on a CT scan of the contralateral ear . This model allows an improvement of the final result and facilitating the realization of a symmetry between the two ears. The prosthesis is not designed to be implanted.
The first procedure requires hospitalization for 3 days and a recovery of 15 days. This procedure can be responsible for significative chest pain for a few days. Painkillers are given directly in the operated site. The appearance is after a few weeks a normal ear without a retroauricular sulcus. This is an intervention with frequent postoperative scarring difficulties, requiring a careful monitoring .
The second operation will be performed at least 6 months after. The ear is elevated from the head with the implementation of a skin graft on its rear face . The graft is taken from the scalp. Hair shaving is required around the ear, which will grow back quickly. This procedure is not painful and requires a hospital stay of 3 days.
In the frequent case of a malformation with abnormal bones and a possible lack of ear canal, it is possible to provide a hearing aid. The earing prosthesis are provided by Dr DUMON .
In case of impossibility of reconstruction , which is rare, it is possible to propose a removable prosthesis, called ” epithesis .”
EAR RECONSTRUCTION FOR MICROTIA
Photos before and one year after the 1st step of reconstruction.
EAR RECONSTRUCTION FOR MICROTIA
Photos before and 3 months after the 2nd step of reconstruction.
EAR RECONSTRUCTION AFTER AMPUTATION
EAR RECONSTRUCTION AFTER TRAUMATIC AMPUTATION