Using an unconventional perfusion pattern in ear replantation - arterialization of the venous system
Case report published in Microsurgery (2014)
Abstract
Ear amputation is a devastating injury characterized by a conspicuous deformity that is not easily concealed and can result in tremendous psychological trauma in addition to the physical insult. While numerous different approaches have been proposed, microvascular replantation is widely considered to deliver the best esthetic outcome. In this article, the authors report a case in which an unconventional perfusion pattern (i.e., arterialization of the venous system) was chosen, as intraoperative anatomic conditions precluded conventional vascular reconstruction. A 25-year-old male patient sustained a human bite resulting in subtotal amputation of his left ear. In the setting of an adequate arterial donor vessel, that is, branch of the posterior auricular artery, and a single suitable recipient vein (0.4 mm), the decision was made to perform an end-to-end arterio-venous anastomosis without the use of vein grafts. Medicinal leeches were applied postoperatively to provide for venous drainage. The ear survived and the patient was discharged after 14 days. To the best of our knowledge, this is first case of a subtotal ear amputation that was successfully replanted by arterialization of the venous system without the use of vein grafts and with preservation of the superficial temporal vessels.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
A 25-year-old man's subtotal ear amputation from a human bite was replanted by end-to-end arteriovenous anastomosis without vein grafts, with postoperative medicinal leeches providing venous drainage; the ear survived.
Why This Matters for Hirudotherapy
This case report describes subtotal left ear amputation from a human bite in a 25-year-old male, managed with unconventional arterialization of the venous system via end-to-end arteriovenous anastomosis using a posterior auricular artery branch and a 0.4 mm recipient vein. Medicinal leeches were applied postoperatively to provide venous drainage, and the ear survived with discharge at 14 days. The paper illustrates medicinal leech therapy as a postoperative adjunct in microsurgical replantation when conventional venous reconstruction is not feasible. Caveat: This is a single case report with an unusual vascular reconstruction strategy, limiting generalizability; it provides no quantitative data on leech therapy duration or complications.
Citation
Reference (Vancouver style)
Momeni A, Parrett BM, Kuri M. Using an unconventional perfusion pattern in ear replantation - arterialization of the venous system. Microsurgery. 2014;34(8):657-661. doi:10.1002/micr.22308. PMID: 25116223
Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.
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