Limits...
Reconstruction of auricular conchal defects with local flaps

View Article: PubMed Central - PubMed

ABSTRACT

Reconstruction of the auricular conchal cavity is relatively difficult because of its unique structure, shape, and location. We compared different methods of repair of the auricular concha to determine the method that would cause the least injury to the donor site.

The method selected was based on the location and size of the defect. If the defect was located in the upper part of the concha, or if the defect was >15 mm in diameter, we used a post-auricular subcutaneous pedicle island flap that was pulled through a post-auricular sulcus tunnel to cover the wound. If the defect was located in the lower part of the concha and was <15 mm in diameter, we used a pre-auricular translocation flap that was passed through the intertragic notch to cover the wound. The donor site was closed primarily. All flaps survived well and any scars associated with the surgery were unnoticeable. No tumor relapse or metastasis was observed over a mean follow-up period of 35 months. All patients were satisfied with the outcome.

The periauricular flap technique chosen for reconstruction of skin defects in the auricular concha depends on the size and location of the defect. With appropriate flap selection, excellent functional, and aesthetic outcomes are achieved.

No MeSH data available.


Related in: MedlinePlus

(A) Design of postauricular island pedicle flap. (a) Island flap; (b) subcutaneous pedicle. (B) Before surgery; (C) 2 months after surgery; (D) Intraoperative: (D-1) removal of tumor; (D-2) frontal view immediately after surgery; (D-3) postauricular view immediately after surgery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5120910&req=5

Figure 1: (A) Design of postauricular island pedicle flap. (a) Island flap; (b) subcutaneous pedicle. (B) Before surgery; (C) 2 months after surgery; (D) Intraoperative: (D-1) removal of tumor; (D-2) frontal view immediately after surgery; (D-3) postauricular view immediately after surgery.

Mentions: The postauricular subcutaneous pedicle island flap (PASPI) was used for repair of defects located in the upper part of the concha, or for defects that were >15 mm in diameter. The vertical axis of the flap was created along the sulcus auriculae posterior. The subcutaneous pedicle was created in the lower third of the ear. The tissue of the postauricular subcutaneous pedicle island flaps was created to be slightly larger than the area of the defect, ranging from 1.5 cm × 1.5 cm to 2.5 cm × 3.0 cm. The length of the pedicle was approximately 1 cm to 1.5 cm. A spindle-shaped skin incision was made, taking care to preserve a portion of the skin over the pedicle (Fig. 1). The flap was tongue shaped, with a length to width ratio ranging from 2:1 to 5:1. A slit was created along the postauricular sulcus by resecting part of the cartilage. The flap was pulled through the slit onto the anterior surface of the concha. The slit was created to be wide enough to allow the flap to pass without resistance, reducing the risk of ischemia. The postauricular donor site was closed through primary skin closure, using an interrupted suture pattern (Fig. 1). The sutures were removed after 1 week.


Reconstruction of auricular conchal defects with local flaps
(A) Design of postauricular island pedicle flap. (a) Island flap; (b) subcutaneous pedicle. (B) Before surgery; (C) 2 months after surgery; (D) Intraoperative: (D-1) removal of tumor; (D-2) frontal view immediately after surgery; (D-3) postauricular view immediately after surgery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120910&req=5

Figure 1: (A) Design of postauricular island pedicle flap. (a) Island flap; (b) subcutaneous pedicle. (B) Before surgery; (C) 2 months after surgery; (D) Intraoperative: (D-1) removal of tumor; (D-2) frontal view immediately after surgery; (D-3) postauricular view immediately after surgery.
Mentions: The postauricular subcutaneous pedicle island flap (PASPI) was used for repair of defects located in the upper part of the concha, or for defects that were >15 mm in diameter. The vertical axis of the flap was created along the sulcus auriculae posterior. The subcutaneous pedicle was created in the lower third of the ear. The tissue of the postauricular subcutaneous pedicle island flaps was created to be slightly larger than the area of the defect, ranging from 1.5 cm × 1.5 cm to 2.5 cm × 3.0 cm. The length of the pedicle was approximately 1 cm to 1.5 cm. A spindle-shaped skin incision was made, taking care to preserve a portion of the skin over the pedicle (Fig. 1). The flap was tongue shaped, with a length to width ratio ranging from 2:1 to 5:1. A slit was created along the postauricular sulcus by resecting part of the cartilage. The flap was pulled through the slit onto the anterior surface of the concha. The slit was created to be wide enough to allow the flap to pass without resistance, reducing the risk of ischemia. The postauricular donor site was closed through primary skin closure, using an interrupted suture pattern (Fig. 1). The sutures were removed after 1 week.

View Article: PubMed Central - PubMed

ABSTRACT

Reconstruction of the auricular conchal cavity is relatively difficult because of its unique structure, shape, and location. We compared different methods of repair of the auricular concha to determine the method that would cause the least injury to the donor site.

The method selected was based on the location and size of the defect. If the defect was located in the upper part of the concha, or if the defect was >15 mm in diameter, we used a post-auricular subcutaneous pedicle island flap that was pulled through a post-auricular sulcus tunnel to cover the wound. If the defect was located in the lower part of the concha and was <15 mm in diameter, we used a pre-auricular translocation flap that was passed through the intertragic notch to cover the wound. The donor site was closed primarily. All flaps survived well and any scars associated with the surgery were unnoticeable. No tumor relapse or metastasis was observed over a mean follow-up period of 35 months. All patients were satisfied with the outcome.

The periauricular flap technique chosen for reconstruction of skin defects in the auricular concha depends on the size and location of the defect. With appropriate flap selection, excellent functional, and aesthetic outcomes are achieved.

No MeSH data available.


Related in: MedlinePlus