Autologous cartilage in the shape of an ear growing in a patient’s forearm is shown as part of cutting-edge total ear reconstruction performed on a 21-year-old Soldier at William Beaumont Army Medical Center, the first of its kind at WBAMC. Recently the cartilage was successfully transplanted on the Soldier, who suffered the total loss of the left ear after a single-vehicle accident in 2016. (U.S. Army photo courtesy of Lt. Col. Owen Johnson III)
Plastic surgeons at William Beaumont Army Medical Center successfully transplanted a new ear on a Soldier who lost her left ear due to a single-vehicle accident.
The total ear reconstruction, the first of its kind in the Army, involved harvesting cartilage from the Soldier’s ribs to carve a new ear out of the cartilage, which was then placed under the skin of the forearm to allow the ear to grow.
“The whole goal is by the time she’s done with all this, it looks good, it’s sensate, and in five years if somebody doesn’t know her they won’t notice,” said Lt. Col. Owen Johnson III, chief, Plastic and Reconstructive Surgery, WBAMC. “As a young active-duty Soldier, they deserve the best reconstruction they can get.”
The revolutionary surgery has been over a year in the making for Clarksdale, Mississippi native, Pvt. Shamika Burrage, a supply clerk with 1st Battalion, 35th Armored Regiment, 2nd Brigade Combat Team, 1st Armored Division.
In 2016, while returning to Fort Bliss, Texas, after visiting family in Mississippi, a tire blowout changed Burrage’s life in an instant.
“I was coming back from leave and we were around Odessa, Texas,” said Burrage, who was travelling with her cousin. “We were driving and my front tire blew, which sent the car off road and I hit the brake. I remember looking at my cousin who was in the passenger seat, I looked back at the road as I hit the brakes. I just remember the first flip and that was it.”
The vehicle skidded for 700 feet before flipping several times and ejecting the Soldier. Burrage’s cousin, who was eight-months pregnant at the time, managed to only suffer minor injuries while Burrage herself suffered head injuries, compression fractures in the spine, road rash and the total loss of her left ear.
“I was on the ground, I just looked up and (her cousin) was right there. Then I remember people walking up to us, asking if we were okay and then I blacked out,” said Burrage, whose next memory was waking up in a hospital.
She was later told by doctors if she would not have received medical attention for 30 more minutes, she would have bled to death. After several months of rehabilitation, Burrage began to seek counseling due to emotions caused by the accident and its effects on her appearance.
“I didn’t feel comfortable with the way I looked so the provider referred me to plastic surgery,” said Burrage.
“She was 19 and healthy and had her whole life ahead of her,” said Johnson. “Why should she have to deal with having an artificial ear for the rest of her life?”
When explained her options for reconstruction, Burrage was shocked and initially resistant to go through with the total ear reconstruction.
“I didn’t want to do (the reconstruction) but gave it some thought and came to the conclusion that it could be a good thing. I was going to go with the prosthetic, to avoid more scarring but I wanted a real ear,” said Burrage, who is now 21. “I was just scared at first but wanted to see what he could do.”
In order to avoid any more visible scarring, Johnson selected prelaminated forearm free flap, which involved placing the autologous cartilage into the patient’s forearm to allow for neovascularization, or the formation of new blood vessels. This technique will allow Burrage to have feeling in her ear once the rehabilitation process is complete.
“(The ear) will have fresh arteries fresh veins and even a fresh nerve so she’ll be able to feel it,” said Johnson.
In addition to the transplant, epidermis from the forearm, while attached to the ear, will cover up scar tissue in the area immediately around Burrage’s left jawline.
“I didn’t lose any hearing and (Johnson) opened the canal back up,” said Burrage, whose left ear canal had closed up due to the severity of the trauma.
“The whole field of plastic surgery has its roots in battlefield trauma,” said Johnson. “Every major advance in plastic surgery has happened with war. This was trauma related.”
With only two more surgeries left, Burrage states she is feeling more optimistic and excited to finish the reconstruction.
“It’s been a long process for everything, but I’m back,” said Burrage.
Author: Marcy Sanchez – WBAMC/US Army