Management of Post-traumatic Ear Reconstruction in a Tertiary Care Center: A Retrospective Study

Background The external ear, due to its prominent anatomical position and complex three-dimensional (3D) cartilaginous framework, is particularly susceptible to traumatic injuries. There has been a rising incidence of partial and total auricular deformities resulting from road traffic accidents, assaults, human and animal bites, burns, and accidental falls. These injuries are often aesthetically conspicuous and psychologically distressing. Reconstruction of post-traumatic auricular defects poses significant challenges because of the need to restore bilateral symmetry, the limited availability of adjacent skin, and the presence of the external auditory canal. Although various reconstructive techniques have been described, including the Baudet method, pocket principle, microvascular reattachment, local flaps, composite grafting, and emerging modalities such as 3D printing, no standardized treatment guidelines currently exist. Methodology This retrospective study analyzed 25 patients treated for acquired auricular deformities at a tertiary care center for a period of two years, from 2023 to 2025, and included all patients with acquired ear deformity and injuries. Data were collected regarding patient demographics, mechanism of injury, anatomical location and zone of defect, reconstructive technique employed, number of surgical stages, and postoperative complications. The study aimed to identify the most suitable reconstructive approach based on defect characteristics and to evaluate the advantages and limitations of different techniques. Results Road traffic accidents were the most common cause of injury (56%), followed by assault (24%), bite injuries (8%), self-falls (4%), and burns (4%). The upper third of the auricle was the most frequently affected region (36%), followed by the middle third (12%), combined upper and middle thirds (12%), lower third (4%), and total ear involvement (4%). Costal cartilage grafting was required in 8% of cases. Postauricular skin flaps were the most commonly utilized method for soft tissue coverage (20%). The findings align with existing literature, confirming road traffic accidents as the predominant cause of auricular trauma and the upper third as the most commonly involved region. The protocol suggested in our study is easy to practice and can be performed by newly graduated plastic surgeons, resulting in better results. Conclusions Post-traumatic auricular reconstruction requires individualized planning based on defect location, extent of tissue loss, and condition of surrounding skin. Despite the availability of multiple reconstructive techniques, no single method is universally applicable. A tailored approach yields satisfactory functional and aesthetic outcomes. Further studies are required to establish standardized management guidelines for auricular avulsion injuries.