Ear reconstruction

This is a pencil and ink illustration by Mollie Lentaigne of a procedure to reconstruct a traumatically deformed ear, and undertaken by Archibald McIndoe himself at the Queen Victoria Hospital, East Grinstead on 3^rd September 1941.

It depicts the partial reconstruction of a scarred right ear. It is not clear what has injured the external ear (auricle), but there is a scar contracture behind it, closing off the gap between it and the head (the post auricular sulcus). The upper pole of the auricle is also partially folded forward. The aim of this procedure is to release the ear from the scar, increasing its prominence and creating a sulcus behind so that, for instance, spectacles may be used more easily.

Here McIndoe appears to have incised around an area of un-scarred skin behind the ear before undermining it. The auricle may then be pulled forward releasing it from the side of the head. In so doing, McIndoe has generated a thin flap of skin sufficient to fold under and resurface the back of the auricle. This also makes a new, shallow sulcus. Further skin is then undermined and pulled forward to close the raw area created. In reality, this technique probably only created a partial release and shallow sulcus.

Lentaigne’s illustrations are often more diagrammatic, and perhaps more informative than by comparison to some of her peers. She usually sketched quickly in theatre, dodging around the surgeons in order to see what they were doing. Later, she would have gone back over the lines, enhancing the drawing using inks and watercolour before adding annotations. This would have both formed part of the patient’s operative record and acted as a teaching resource for other surgeons.

This illustration is reproduced by kind permission of the East Grinstead Museum who hold the complete archive of Mollie Lentaigne’s works at the Queen Victoria Hospital.