Salvage of the severely injured ear

We present three cases of severe external ear injuries and their management. The first patient's ear, amputated in an automobile accident, was revascularized microsurgically. Replantation, when possible, offers the ultimate result. However, disadvantages include the length of the operation and prolonged hospitalization. The second patient sustained a human bite ear amputation. Salvage consisted of immediate coverage with a vascularized temporoparietal fascial flap and split-thickness skin graft. Revision of the external auditory meatus and postauricular sulcus was required. This technique is relatively simple and reliable when microvascular revascularization is not possible. In the third case the patient's ear suffered a full-thickness burn as part of a larger scalding injury to the patient's body, face and scalp. Acute salvage was accomplished in one stage with a technique similar to that used for the second patient. Secondarily, skin was regrafted to achieve an improved color match and cartilage contour.