How to deal with ear injury? What to do if the defect is serious? Click to learn more →

Author: Yang Qinghua, Chief Physician, Plastic Surgery Hospital, Chinese Academy of Medical Sciences

Reviewer: Fan Jufeng, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

In recent years, with the development of my country's industrialization process and the gradual improvement of modern transportation infrastructure, our travel has become more and more convenient. But at the same time, there are more and more patients with auricular trauma, especially in the emergency room, where many such patients are encountered.

Therefore, it is particularly important to understand some scientific knowledge related to auricle trauma.

1. How to deal with emergency after ear injury?

There are two types of ear injuries:

One situation is that the auricle is simply injured and the auricle tissue is not completely separated from the body. In this case, go to the hospital in time for simple debridement and suturing.

Another situation is that after the auricle is injured, the auricle tissue is completely or almost completely separated from the body, or the entire auricle falls off. In this case, a clean container is needed to store the auricle tissue, or the auricle is wrapped with a clean cloth and taken to the hospital for treatment in time. If the width of the severed auricle tissue is less than 2cm and the wound is relatively neat, it can be sutured back directly. It can survive and basically will not lose the appearance of the auricle.

Here we need to remind everyone that some patients may think that putting the severed auricle tissue in alcohol can be disinfected, or directly putting it in ice water can better preserve it, but in fact these are wrong practices. When storing, never do this to avoid secondary damage to the severed auricle tissue.

Figure 1 Original copyright image, no permission to reprint

If it is placed in ice, it should be wrapped with something waterproof to prevent it from getting wet. Go to the hospital in time and the doctor will replant it according to the damage to the auricle tissue.

2. What should I do if the auricle defect caused by trauma is serious?

If the auricle is damaged in large part or in its entirety, auricle reconstruction can be performed using skin expansion about half a year after the wound has healed and the scar has stabilized.

The expansion method is what ordinary people call buried water bag. Because auricle reconstruction requires a lot of hairless skin, and the area of ​​hairless skin behind the ear is far from enough, so we need to make some extra skin in advance for auricle reconstruction, which is called skin expansion method auricle reconstruction.

The specific expansion method is to embed a water bag in advance, and then inject water into it about twice a week. As the water bag gradually grows, the skin outside the water bag will also gradually grow, thus meeting the needs of auricle reconstruction.

This type of skin expansion method for auricular reconstruction is relatively safe. However, any surgery has its complications. For example, during auricular reconstruction by skin expansion, the expander capsule may not expand, or may leak or seep water, or the expander may be punctured due to external force.

Figure 2 Original copyright image, no permission to reprint

However, there are ways to remedy these situations by simply replacing an expander, so the safety of expansion-based auricle reconstruction surgery is guaranteed.

3. How is the auricle reconstruction surgery performed using skin expansion method?

Skin expansion auricle reconstruction surgery is divided into three stages:

The first stage of surgery is to implant the expander, which is to make a small incision about four or five centimeters long in the scalp behind the ear, and implant the expander capsule under the skin. The stitches will be removed after about 10 days, and then water injection treatment will begin, usually twice a week. After about 10 injections, the expander is basically ready.

After the expander is filled with water, there is a static skin-nurturing period. The principle of the skin-nurturing period is like blowing a balloon. If you blow up a balloon and immediately let the air out, the balloon will shrink back quickly. However, if you leave the balloon for a week and then deflate it, the shrinkage rate will be smaller. Therefore, after the expander is filled with water, there will be a one-month skin-nurturing period, which is to keep the grown skin in this state and minimize shrinkage. Therefore, the entire first stage of the operation will take about two months.

The second stage of surgery is auricle reconstruction, which includes the collection of rib cartilage, carving of auricle support, taking out the expander, and then implanting the ear support, so that the ear shape is established. Generally, after the second stage of auricle reconstruction, the drainage tube is removed and the patient can be discharged from the hospital 3-5 days later. Then, the patient will come back to remove the stitches in about a week, and can go home after the stitches are removed.

After the first two surgeries, the auricle will have a recovery period, which usually takes six months to a year. After six months to a year, the third surgery is performed to repair the reconstructed auricle. After all, the reconstructed auricle is connected to the original ear, and there may be some uneven joints, which need to be repaired to make it smoother.

Of course, everything is not over after the operation. Each patient has different injuries and physical conditions, and the recovery after the operation is also different. Therefore, after the operation, you should follow the doctor's advice for regular checkups to detect certain abnormal problems in time and deal with them in time.