Artery-Only Ear Replantation in a Child: A Case Report With Daily Photographic Documentation
Mendenhall SD, Sawyer JD, Adkinson JM (2016) · Eplasty · n=1
RCT evidence detailTrial reference
Study Profile
- Design
- single-patient case report with daily photographic documentation (10-year-old boy, Southern Illinois University School of Medicine)
- Sample size (n)
- 1
- Intervention
- Subtotal ear replantation without venous anastomosis with leech therapy for venous congestion management; daily photography
- Comparator
- No control - single case with photographic protocol
- Primary endpoint
- Ear survival, native venous drainage development, and arterial revascularization
- Primary result
- Successful venous congestion management with leech therapy through postoperative day 14; arterial thrombosis at day 4 required take-back and interposition vein graft salvage; partial necrosis required debridement and skin graft
- Follow-up duration
- Postoperative recovery + skin graft healing
- PMID
- 28101290
Key Findings
- Artery-only ear replantation with 14-day leech therapy
- Daily photography as monitoring tool
- Native venous drainage confirmed by skin color change
- Arterial thrombosis at day 4 required take-back
- Long-term aesthetic salvage achieved with multi-stage repair
Limitations
- Single pediatric case - limited generalizability
- Late arterial thrombosis complicates outcome attribution
- Aesthetic outcome judgment subjective
- Skin graft on posterior ear suboptimal aesthetic
- Cannot generalize from school-aged child
Clinical Implications
Mendenhall 2016 establishes a methodological standard for artery-only ear replantation: daily photography as monitoring tool, ~14 days of leech therapy when no venous anastomosis, and readiness to revise if arterial thrombosis develops. For US clinicians under K040187, the photographic documentation protocol enables objective assessment of native venous drainage development and informs leech discontinuation timing.
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