title: Versatility of the bilobed cervical skin flap for total ear reconstruction in the unfavorable temporoauriculomastoid region.
abstract: BACKGROUND
  The unfavorable temporoauriculomastoid region is a serious clinical problem that makes total ear reconstruction a real challenge. In patients who have it, all local flap solutions to provide skin coverage to the cartilage frame are precluded because of loss and/or severe scarring of the regional skin in association with loss of the axial vascularity of the region. In the current literature, all available techniques for these patients are lengthy and risky free flap procedures that can provide a poor quality of skin coverage with no aesthetic harmony at best. In this article, the authors describe the use of the bilobed cervical flap as a new technique for providing skin coverage in total ear reconstruction for patients with an unfavorable temporoauriculomastoid region.
  
  
  METHODS
  Over a period of 6 years, the technique was used in seven patients between the ages of 19 and 52 years. In all patients, the entire skin of the temporoauriculomastoid region was either lost or badly scarred. Moreover, use of the ipsilateral temporoparietal fascia was not possible because of impaired axial vascularity of the region.
  
  
  RESULTS
  Except for mild venous congestion at the distal part of the primary flap, the flaps healed uneventfully in all patients. The patients were followed up for 1 to 4 years. The results were excellent in all patients.
  
  
  CONCLUSIONS
  Providing a thin, pliable, hairless, and well-vascularized skin cover with a perfect color match, the bilobed cervical flap seems to be a useful solution to overcome the skin coverage dilemma in patients with an unfavorable temporoauriculomastoid region.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Gaziantep School of Medicine, Turkey. doctormutaf@yahoo.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Mutaf
authors.forename: Daghan
authors.initials: D
authors.lastname: Isk
authors.forename: Bekir
authors.initials: B
authors.lastname: Atik
authors.forename: Omer
authors.initials: O
authors.lastname: Bulut
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D000818:Animals; D001733:Bites and Stings / Q000601:surgery; D002056:Burns / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002648:Child; D002921:Cicatrix / Q000601:surgery*; D004285:Dogs; D004428:Ear Neoplasms / Q000601:surgery; D004431:Ear, External / Q000293:injuries / Q000601:surgery*; D005151:Facial Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D016896:Treatment Outcome