Ear Reconstruction in Hyderabad

The need for ear reconstruction in Hyderabad

A deformed ear requiring the need for ear reconstruction in Hyderabad has a substantial negative effect on a patient’s self-esteem and mental development because the human ear is an essential and distinguishing part of the face. The most typical congenital ear deformity is microtia.

Due to its intricate 3D structure, managing ear abnormalities can be difficult. First, it’s crucial to understand the fundamental anatomy and architecture of the ear to achieve the best possible reconstructive outcomes.

Autogenous cartilage, alloplasts such as silicone and Medpor, and osseointegrated materials are used for ear restoration. An exceptional fusion of science and art is seen in the surgical repair of the ear using autogenous grafts.

Ear reconstruction in Hyderabad refers to surgery to reconstruct or restore the auricle or pinna, which is the outer portion of the ear, is referred to as ear reconstruction. This procedure may be carried out to treat a congenital disability in the outer ear (congenital disability).

Ear reconstruction is also done to repair an ear that has cancer or has been harmed due to trauma, such as a burn. The framework for the ear can be constructed using rib cartilage, or a medical implant could be employed. An artificial (prosthetic) outer ear fixed to the bone may be an option in some circumstances.

The objective of ear reconstruction is to develop an ear shape that is realistic enough that it does not draw attention to itself, even though reconstructed ears might not be as delicate and finely detailed as natural ears.

The procedure is frequently performed between the ages of 6 and 10 for children who require ear reconstruction due to a problem present at birth, although it may be performed at an earlier age in some cases.

Why ear reconstruction is done

Treatment for the following conditions that affect the outer part of the ear usually involves ear reconstruction in Hyderabad–

• A deficient ear (microtia)
• Absent ear (anotia)
• On the side of the head, a portion of one ear is hidden beneath the skin (cryptotia)
• The ear is pointed (Stahl’s ear) and includes more folds of skin.
• An ear has folded itself over (constricted ear)
• A cancer treatment caused the removal or destruction of a portion of an ear.
• An ear burn or other severe injury

Only the outer portion of the ear is involved in ear reconstruction. It has no impact on hearing ability. In some circumstances, this operation may be planned in conjunction with surgery to address hearing issues.

Currently, a variety of techniques are employed for ear reconstruction. These include utilizing an implant (MedPor), a prosthetic implant, or the patient’s own rib cartilage (autologous rib cartilage). Depending on the surgeon and the technique used for ear reconstruction, the timing of the procedure will vary.

Ear treatment centre in Hyderabad

Reconstruction of an ear using rib cartilage at the ear treatment centre in Hyderabad – Autologous ear reconstruction

Reconstruction of an autologous ear at the ear treatment centre in Hyderabad involves several surgical steps. In the first phase, cartilage from the ribs is used to fashion a three-dimensional sculpture that resembles an ordinary ear. The majority of surgeons employ this method, which is commonly carried out on patients between the ages of 6 and 10 years old.

The ribs will provide enough material to build a foundation large enough at this age, as the opposite ear is almost adult size. Then, to match the other ear, the cartilage structure is positioned beneath the skin at the location of the newly implanted ear. Additional cartilage may be stored for future use at the rib donor site or behind the temporal scalp.

To give the area around the framework more definition, suction catheters are inserted under the skin. Within one to two weeks, they are taken out. Children are typically hospitalised for three to five days. The Brent method and the Nagata method are just two of the techniques used for autologous ear reconstruction.

The distinctions between these treatments are found in the number of steps (2 to 4) and the quantity of cartilage required for ear reconstruction. To ensure that there is enough cartilage to remove from the ribs using the Nagata technique, youngsters should be closer to 10 years old.

At the ear treatment centre in Hyderabad, the patient will move on to the subsequent stages of repair once they have fully recovered from the initial one. Usually, this takes at least six months. The new ear framework is raised off the side of the head in the following step of reconstruction to mimic the position of a normal ear.

The elevated framework may need to be covered at this stage using a skin graft or a tissue flap (fascia) taken from the region just below the scalp. The opposite ear, the scalp, and occasionally the area above the collarbone or the groin, are the usual locations for skin grafts.

Although there are multiple stages to the autologous approach of ear reconstruction, one benefit is that using the patient’s own tissue reduces the danger of infection and eliminates the possibility of foreign object rejection.

Surgical anatomy of ear

Before starting a reconstruction, it is essential to comprehend the external auricular anatomy and architecture. The ear consists of several distinct structural components. The ear’s general form is oval, and its posteroinferior aspect is slightly flattened. From its root to the crus helicis, a clear line that delineates the helical rim may be seen.

The concha, which is made up of the tragus and antitragus, is formed by another line. The ear’s final distinguishing feature is the fossa triangularis. The microtia surgeon can use these fundamental parts to recreate the intricate three-dimensional structure if they have a thorough understanding of these structures.

The ear is divided into three sections when seen in the horizontal plane. The helical root at the superior border of the concha cymba marks the end of the superior part, which begins at the top of the helical rim. The midportion extends from the upper aspect of the antitragus to the upper border of the concha cymba.

From the lobule’s tip to the superior border of the antitragus, the lowest part is located. The distance between the ear’s highest point (supra-aural) and its lowest position is referred to as the ear’s length (subaural). Due to variations in each patient’s facial shape and lobule features, this may differ between individuals. For instance, ear lengths range from 55 to 65 mm, with men’s averages being 62.4 mm and women’s averages being 58.4 mm.

The width is about 35.5 mm in men and 33.4 mm in women, or about 55% of the ear length. The auriculocephalic angle, which is another name for the protrusion of the ear, is between 15° and 20°. This is the angle formed by the mastoid skin and the auricle’s back surface.

Once more, this may reflect patient variance. However, both the natural and the rebuilt ears should maintain the same angle. The term “ear inclination” refers to the angle formed by the vertical axis of the face and the longitudinal axis of the ear.

The patient must be placed in the Frankfort horizontal posture for the measurement to be accurate. This is about 24 degrees with the face, but 32 degrees with the nasal dorsum.

Three primary types of ear reconstruction in Hyderabad

Patients can choose from three different ear reconstruction procedures to restore their ears to a normal appearance and function. Each has its own distinct advantages. The brief descriptions of each are provided here so that patients can choose the option that best suits them.

Surgery for Microtia/Anotia

In this treatment, the upper half of the outer ear cartilage is partially reconstructed. The development of a whole external ear is required in more serious situations brought on by modest birth abnormalities.

The most frequently recommended surgical procedure for complete reconstruction entails wrapping a polyethylene plastic frame foundation with the patient’s skin, typically taken from an arm or leg. To treat partial microtia, the patient’s own living cartilage is generally removed and grafted onto the affected area.

Surgery for Otoplasty

To correct large ears, a straightforward, highly personalized surgical treatment is typically carried out as an outpatient procedure. Recovery following this ear reconstruction technique, also known as ear pinning, normally requires approximately one month and involves wearing an elastic headband at night for a brief period while the new cartilage hardens.

Surgery due to Cancer or Trauma

Common car accidents and failed ear surgeries are just a few examples of ear injuries. Deformation may also take place in patients who have had diseases such as melanoma, squamous cell carcinoma, or carcinoma.

The corrected ear reconstruction operation is relatively simple and will resemble those performed for Microtia or Otoplasty if the injury is not caused by cancer or another underlying health issue.

Timing of Ear Reconstruction – Why it is important

Physical development and psychological factors both influence when repairs should be made. By the age of 7, the ears are largely their adult size. Typically, cartilage has grown sufficiently by the age of 6 to provide an ideal foundation.

However, more cartilage is accessible for restoration as a youngster gets older. On the other hand, the psychological and social repercussions of the child’s missing ear must be evaluated against the benefits of waiting for cartilage growth.

According to studies, psychological consequences typically begin to appear around the ages of 7 to 10. However, by the age of 6, the majority of children are aware of the issue and want to see it fixed. The reconstruction technique selected may also affect the timing.

Placement of artificial ear – How it is done

The remainder of the ear is removed during this kind of ear reconstruction. Then, a prosthesis (an artificial ear) is surgically implanted into the patient’s ear bone.

When the ear tissue has been significantly injured, as in the case of a burn, when a substantial portion of the ear has been removed during cancer surgery, or when an earlier attempt at ear reconstruction has failed, this method may be utilized. Instead of youngsters, adults are more likely to go for this method. 

This technique has the benefit of not requiring donor rib cartilage, which reduces discomfort and enables the procedure to be performed at a younger age (as early as 3 years old, though the reconstructed ear is made to the adult projected size). Additionally, this process can be completed in a single step.

Recovery after ear reconstruction

The amount of the reconstruction determines how long a person needs to recuperate. The majority of the time, soft dressings and bandages are applied to the surgical site before the patient leaves the medical facility, and they remain there for a few days.

It is normal to have some minor discomfort, but painkillers that the surgeon suggests or prescribes can assist. Those who normally sleep on their side may experience disturbed sleep patterns because this position must be avoided for two or more weeks. Swimmer-style elastic headbands can help to support the surgery site while the incisions heal.

The type of surgery the concerned patient undergoes also affects how quickly they recover following ear reconstruction. Some ear restoration procedures allow patients to go home the same day, while others may require a hospital stay.

Following surgery, the patient may have the following symptoms

• Pain or swelling
• Bleeding or itching

As prescribed by the surgeon, the patient needs to take painkillers. It is essential to contact the surgeon immediately if the patient is taking pain medication and their pain level increases. The patient is also required to discuss with a member of the medical team what they should do to care for the ear following surgery. For several days, the patient may need to wear a covering over their ear in the area where the ear was rebuilt. It is better to avoid sleeping on one side. Additionally, it is essential to avoid rubbing or applying pressure to the ear.