Ear Nose and eyelid reconstructions are almost exclusively dealt with by plastic surgeons. These are usually complex reconstructions involving the transfer of tissues from other body parts or the use of implants. Often multiple stages are needed for such reconstructions.
These defects may be present since birth or may happen due to some accident or some cancer. Since these are complex 3-dimensional structures, a lot of planning is required to accomplish these reconstructions.
Ear Reconstructions: Most commonly patients either have absent/ deformed ears since birth or have lost the ear in some type of trauma. The absent ear since birth is usually reconstructed around 9 years of age, Chest Cartilage is used to make a new ear, and 3-4 stages are needed for surgery.
For traumatic ear loss or loss due to cancer is reconstructed with cartilage either from another ear or chest. Occasionally medpore implants are used. Helix defects are made with skin tubes that give excellent results. Antia buch technique used selective patients with rim loss gives excellent results.
Nose reconstructions: Most common cause of Nose loss is trauma followed by cancers. Small defects are usually covered with local tissue rearrangement. For larger defects, we use forehead flaps (this technique is inspired by ancient Indian techniques of Sushruta) which give excellent results when executed properly.
For total loss of nose free radial forearm flaps are used for reconstructions. This may need further revisions depending on case to case.
Eyelid reconstructions: Eyelid loss is mostly due to trauma followed by cancer and by birth defects. Eyelids are every unique multilayered structure. Due to its complex structure, most reconstructions are at least 2 staged especially in cancer cases. Trauma cases mostly can be repaired primarily or with local advancement flaps. Since tear forming and drainage systems are closely associated with eyelids they need to be kept in consideration while planning any procedure.