Reconstruction of nonhelical auricular defects with local flaps.
BACKGROUND
The integrity of each of the components of the auricle is important for its overall aesthetic appearance. Cartilage-exposing nonhelical defects that are too large to be closed primarily without distorting the auricle may be reconstructed with local flaps.


OBJECTIVE
The objective was to present our experience with the reconstruction of nonhelical medium-sized defects using a variety of simple, one-stage local flaps.


METHODS
Eighteen patients who underwent reconstruction of nonhelical auricular defects with local flaps at our center from 2003 to 2006. Defect size ranged from about 10 to 20 mm. Various methods were used for reconstruction as follows: conchal defect (n=11)--pull-through postauricular flap or cutaneous rotation flap from the concha itself; triangular fossa defect (n=3)--transposition-rotation flap from the concha or cutaneous periauricular pull-through flap via the root of the helix; antihelical defect (n=2)--V-Y advancement flap from the skin of the antihelix; and tragus defect (n=2)--periauricular cutaneous flap.


RESULTS
All flaps survived. Transient congestion was noted in four patients. The aesthetic results were good, with no auricular deformation.


CONCLUSIONS
It is important that reconstructive surgeons be familiar with a variety of basic flaps for reconstruction of nonhelical defects. An algorithm for nonhelical flap reconstruction is suggested.
Adler
Neta
N
Department of Plastic Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqwa and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. amosad@gmail.com
Ad-El
Dean
D
Azaria
Ron
R
D002277:Carcinoma / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D054644:Ear Auricle; D004426:Ear Deformities, Acquired / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D004428:Ear Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D019651:Plastic Surgery Procedures; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery; D013524:Surgical Flaps; D013536:Suture Techniques