Anterior approach to posterior auricular artery in microvascular anastomosis - a new concept in replanting amputated ears - experience from four successful cases and literature review
Hong Ha N, Thanh Huyen TT (2025) · Acta Chirurgiae Plasticae · n=4
Детали доказательств RCTСсылка на исследование
GRADE Очень низкаяНедостаточно доказательствСостояние: Microsurgical Replantation (Digit / Ear / Scalp) →
Характеристика исследования
- Дизайн
- single-institution case series of 4 successful microsurgical auricular replantations using novel anterior approach (February 2012-July 2022)
- Размер выборки (n)
- 4
- Вмешательство
- Microsurgical ear replantation via supine position and anterior observation of posterior auricular artery (0.4-0.5 mm diameter); leech therapy 10-14 days postoperatively in 2 cases where venous anastomosis could not be achieved
- Компаратор
- Historical posterior approach and venous-anastomosis cases
- Первичная конечная точка
- Ear survival and aesthetic outcomes after microvascular replantation
- Основной результат
- All 4 cases (100%) successful with anterior approach; 2/4 patients required 10-14 days of leech therapy for venous drainage when vein anastomosis impossible; ischemia duration 4-14 hours; blood transfusion 3-4 units
- Длительность наблюдения
- Postoperative + long-term aesthetic assessment
- PMID
- 41996214
Ключевые выводы
- Novel anterior approach for posterior auricular artery exposure
- 100% success rate in 4 cases (2012-2022)
- Extended leech protocol 10-14 days for artery-only cases
- Traffic accidents (3/4) and violence (1/4) as causes
- Posterior auricular artery diameter 0.4-0.5 mm achievable
Ограничения
- Small case series (n=4) over 10 years
- Single institution experience
- Novel approach without comparative cohort
- Limited long-term aesthetic outcome data
- Acta Chirurgiae Plasticae has limited international visibility
Клиническое значение
Hong Ha 2025 contributes a novel anterior surgical approach plus protocol for extended (10-14 day) leech therapy in artery-only auricular replantation. For US clinicians under K040187, this provides duration evidence beyond typical 5-7 day protocols and validates leech adjunct in artery-only scenarios when venous anastomosis is technically impossible.
Связанные исследования
Successful Microsurgical Replantation of Amputated Penis: A Case Report and Review of Literature
Akhoondinasab MR, Farahmand HR, Zahedi A, Saraee A (2023)
Complete penile amputation during ritual neonatal circumcision and successful replantation using postoperative leech therapy
Banihani OI, Fox JA, Gander BH, Grunwaldt LJ, Cannon GM (2014)
Leeches and Caudal Analgesia After Replantation for Glans Amputation During Neonatal Circumcision
Mousa A, Keefe DT, Wong K, Davidge K, Lorenzo AJ, Dos Santos J (2022)
Penile Replantation: A Review of Microsurgical Techniques, Patient Outcomes, and Solutions to Complex Reconstructive Challenges
Arbel EJ, Reese AD, Richards R, Singh S, O'Shea AW, Hennig F, Abramowitz D (2024)