Temporoparietal Fascia Sandwich Technique in the Immediate Reconstruction of Human Bite Ear Amputation

Abstract

Background: Traumatic ear amputation is a rare injury. Ear replantation is the gold standard in dealing with amputated ears. However, this is not always feasible. In this case series, the authors discuss the immediate reconstruction of traumatic ear amputation using temporoparietal fascia with the same skin from the amputated ear, which provided a high esthetic result and patient satisfaction. Patients and Methods: The authors present a case series of 3 patients from July 2018 to May 2020 who suffered from traumatic ear amputation due to a human bite and were successfully reconstructed using temporoparietal fascia and the same skin from the amputated ear as FTSG. The cartilage was sutured back, the temporoparietal fascia was raised and flipped over the exposed cartilage, and the FTSG previously harvested from the same amputated ear was put on the fascia. Quilting sutures were taken to ensure proper inset of the graft on the fascia. The authors measured the patient-reported outcome using an Ear-Q validated questionnaire. Results: All patients were males, with a mean age of 30.6 years. They were all smokers, and none of them had any comorbidities. No major complications occurred. However, partial graft loss occurred in one patient and healed properly with secondary intention. All patients had high satisfaction scores of more than 70 in the EAR-Q questionnaires. Conclusion: Traumatic human bite ear amputations can be reconstructed with good esthetic outcomes by using single-stage temporoparietal fascia and the same skin of the amputated ear as a full-thickness skin graft whenever replantation is not feasible.