Subcutaneous preservation of an amputated auricle: Morphologic changes.

Background: Microsurgical replantation of an avulsed auricle remains a chal lenge in reconstructive surgery. Secondary reconstruction of a traumatic lo st auricle is usually performed using a costal cartilage framework accordin g to well documented techniqes or with a prosthesis. In order to minimize d onor-site morbidity, various efforts can be undertaken to preserve the ampu tated auricle by implanting the deepithelialized cartilage framework in a s ubcutaneous pocket on the surface of the mastoid. Where preservation is suc cessful, this original cartilage could be used for reconstructive treatment . Patient and Results: This study describes the histologic and immunohistol ogic changes in a complete traumatic avulsion of the auricle with subsequen t cartilage conservation for eight months within a skin pocket. Trauma, pre paration and preservation were accompanied by morphologic changes that incl uded generation of local ossification centers and infiltration of fibrous t issue. We compared the macroscopic and microscopic morphology of the amputa ted part to native elastic cartilage following maximal denutrition and temp orary heterotopic implantation in conjunction with atypical tension and pre ssure properties of the retroauricular pocket. Conclusion: In this case, th e limited success of cartilage conservation in the subcutaneous pocket requ ired conventional auricle reconstruction with autologous costal cartilage.