Complications During and After Ear Reconstruction

Abstract

Complications after ear reconstruction may occur in 3–8 % of patients. They are more frequent after secondary reconstruction as well as on reconstruction after traumatic amputation with complex laceration of soft tissues. So before performing this reconstruction it is important to examine adequately and find out about the previous operations. Complications may be classified as: during operation, immediate (up to 2 weeks after surgery), middle-term (from 2 weeks until 2 months), and long-term. The most dangerous complication during surgery is definitely to pierce the pleura. In my opinion as long as the perichondrium is preserved on the posterior aspect of the costal cartilage it is possible to safeguard the pleura. After performing more than 1,000 operations for removing rib cartilage to excavate the new auricular framework, I have never had damage to the pleura.

Immediate complications with skin necrosis are the most frequent and the treatment is to remove the exposed cartilage. Also, it is possible to re-cover the exposed cartilage with the fascial flap followed by skin graft. Long-term complications that may occur are deviation of the auricular framework and absorption of the cartilage. Most of those circumstances may occur because of some technical failure during surgery, such as the skin covering putting too much pressure on the cartilaginous auricular framework.