Atypical replantation and reconstruction of frozen ear: A case report
Dvořák Z, Stupka I (2020) · Medicine (Baltimore) · n=1
RCT evidence detailTrial reference
Study Profile
- Design
- single-patient case report (38-year-old man, occupational ear avulsion transported on dry ice, St. Anne's University Hospital Brno, Czech Republic)
- Sample size (n)
- 1
- Intervention
- Replantation of frozen ear (transported on dry ice) with arterial and venous anastomosis; postoperative venous congestion managed with leech therapy
- Comparator
- Conventional replantation of fresh amputated ear
- Primary endpoint
- Ear replantation feasibility from frozen state with leech adjunct
- Primary result
- Successful replantation despite frozen storage; venous congestion at 9 hours managed with leech therapy; freezing cold injury required radix/proximal helix reconstruction with conchal cartilage graft wrapped in subauricular flap
- Follow-up duration
- Postoperative reconstruction phase
- PMID
- 32443314
Key Findings
- First reported successful frozen ear replantation
- Dry ice transport of amputated ear
- Venous congestion at 9 hours postoperatively managed with leeches
- Freezing cold injury required staged reconstruction
- Satisfactory final aesthetic outcome
Limitations
- Single case - extreme storage condition not generalizable
- Inevitable freezing tissue damage limits outcomes
- Cannot quantify leech contribution to overall salvage
- Long-term cosmetic outcomes limited
- Storage conditions unique to specific occupational setting
Clinical Implications
Dvořák 2020 expands the boundary of acceptable amputated ear storage conditions to include frozen state with dry ice transport. For US clinicians under K040187, the case demonstrates leech therapy's role as enabling technology in pushing surgical boundaries - here, salvaging an ear that would otherwise be deemed non-viable due to freezing.
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