Ear Reconstruction: About Outer Ear Reconstruction Procedure

Outer ear reconstruction may be required for a variety of reasons

. Anomalies may result from congenital or traumatic causes. Developmental malformations and deformations are not uncommon and may require early implantation of a hearing aid if both ears are affected. Trauma, such as a dog bite or a burn, can be catastrophic, both physically and psychologically. The purpose of outer ear reconstruction is to rebuild an external ear (auricle and pinna) that looks completely normal upon quick glance by the casual observer.

It is important to note that outer reconstruction does not improve hearing. Congenital malformations may require surgical correction of the external canal or eardrum if bilateral hearing loss is present. Implantation of a hearing aid is usually recommended within the first few months of life in order to promote normal speech progression in infants.

Instead, outer ear reconstruction is designed to psychologically support those with facial deformity. It can also be useful for those who wear glasses. This type of surgery is intensive and often involves 2 or more trips to the operating room. It is essential for patients to understand the process and complexities involved.

In the first operation for outer ear reconstruction, cartilage is removed from the patient's own rib cage. It is essential to wait until a child is 8 or 10 years old to ensure enough cartilage can be removed to make a framework that resembles their normal pinna and auricle. Use of living tissue from a patient means there is less chance of rejection and the cartilage will grow with the patient. After the framework is created, it is inserted underneath a flap of skin. The shape of the new pinna can now be seen lying flat against the head.

The second operation normally takes place at least 4 months after the initial operation. This amount of time ensures good blood flow and supply to the transplanted cartilage. During the second operation for outer reconstruction, the groove behind the pinna is deepened and skin grafts cover the back of the cartilage.

At this point, the new pinna and auricle will feel stiff. It is important to remember that the skin will eventually warm with increased blood supply and gain some feeling. Since there are many complications involved in transplant graft surgery, there are options available to patients interested in an alternative. Prosthetics can be created using the normal ear as a template, but still require surgery to implant titanium screws and a metal frame.

by: Abigail Aaronson

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