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Salvage ear reconstruction after an infection and exposure

This is a young boy with a history of right Microtia who had an alloplastic ear reconstruction in another institution who presented to my clinic with a severe ear infection and exposure of the ear implant.

I would like to discuss few things in this blog.

  • Infections, as with implant fractures and exposures, can happen to any patient and any surgeon, with any type of implant. Infection is a complication that is rare, but when it happens it is important to take care of it quickly by your plastic and reconstructive surgeon.
  • The management of an infected reconstructed ear varies depending if the reconstruction was a cartilage (autologous) reconstruction or a polyethylene (alloplastic) reconstruction.
  • When faced with an infection, it is very important that your ear surgeon is involved in the care. One common mistake is to go see another physician who will treat the infection by removing the implant, washing the pocket and letting it heal. This will cause the pocket to close up completely and will prevent for salvaging the reconstruction. The temporal parietal fascia flap will contract completely and the pocket will collapse and scar down. This will preclude a reconstruction using the flap. To recreate a new ear, the patient will require an occipital flap and a reconstruction from scratch.

In the case of this nice boy, I opened the ear and removed the old implant that was placed previously. I cleaned well the pocket and removed all unhealthy tissue. The area that was exposed was behind the lobule. I cleaned it and closed it from inside-out in multiple layers and using a local flap.

After irrigating well, and debriding well the pocket, I applied a new implant. As you can see from the picture, he healed well and his ear definition improved quickly.

Ear reconstructions are challenging surgeries. Complications can happen to anyone. It is important that you choose a surgeon who performs ear reconstructions very regularly. In our office, we perform ear reconstructions on a daily / weekly basis. We are very experienced with this procedure. Moreover, we are very experienced with managing complications that could happen after alloplastic ear reconstructions.

Feel free to contact Dr. Tahiri if you would like to have more information.

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