Subtotal ear amputation with a very narrow pedicle: a case report and review of the literature.

Total ear amputation is common, and management can necessitate different procedures, especially microsurgical anastomosis. Partial ear amputations supplied by narrow pedicles, however, have been reported rarely. In a subtotally amputated auricle, the chance of survival depends on the vascularization within the pedicle. In our case, the right ear of a 36-year-old male patient was subtotally amputated following a traffic accident, leaving only a 6-mm skin pedicle on the cranial side. The subtotally amputated segment was bleeding from the wound margins. The ear was reattached with primary suture without using microsurgical techniques after optimal debridement. Postoperatively, we administrated dextran 40 for 5 days to improve the microcirculation and increase blood volume and antibiotic to control the infection. No signs of edema, venous congestion or arterial insufficiency were observed immediately after the operation or subsequently. The replanted auricle healed completely with 100% survival, resulting in an essentially normal contour and appearance. This successful result without microvascular anastomoses also points out the anatomical features of the auricular vascular networks.