Reviving the Chondrocutaneous Conchal Transposition Flap for Auricular Reconstruction After Human Bite Injury.

Abstract

Mammalian bites account for 1% of annual emergency room visits and present distinct issues when they involve regions such as the ear. Human bite injuries may cause atypical tissue damage and elevate the risk of infection, thereby compromising ear repair. Diverse surgical methodologies aim to rehabilitate the ear's functionality and appearance. The Orticochea flap, using conchal transposition flaps, is recognized as a prominent single-stage approach for auricular defect reconstruction. A 22-year-old man presented with a human bite injury that led to the total amputation of the upper auricle of the left ear. After the initial reattachment, tissue necrosis necessitated an additional operation. The amputated ear was reconstructed using a conchal chondrocutaneous transposition flap (Orticochea). This treatment reinstated the ear's structural integrity and soft tissue coverage. The flap, tailored to the defect's dimensions, was lifted while preserving its vascular pedicle and rotated to reconstruct the ear. A postauricular full-thickness skin graft was used to cover the donor site and the posterior surface of the flap. Postoperative follow-up indicated exceptional flap viability, satisfactory healing, a natural aesthetic result, and patient satisfaction. Human ear bite injuries are challenging to treat due to their complexity and infection risk. Single-stage reconstruction using the Orticochea flap balances structural integrity and aesthetics. This approach highlights the importance of tailored surgical interventions for optimizing patient satisfaction and functional restoration in auricular reconstructions.