Inferiorly based postauricular periosteofascial flap for reconstruction of intractable small postauricular defects.
BACKGROUND
Small postauricular defects are a common problem after treatment of chronic otitis media and after excision surgery for small skin cancers. Blood supply to the postauricular area is poor, and bone exposure is common. Grafts involving alloplastic materials, cartilage, and bone often yield unsatisfactory results. A standard surgical procedure for successfully treating such defects has yet to be established. The present study examined the use of postauricular fascial free flaps for the reconstruction of small intractable postauricular defects.


METHODS
From August 2006 to August 2007, 3 patients (2 with chronic otitis media and 1 patient with squamous cell carcinoma) with postauricular defects underwent mastoid flap surgery. The inferiorly based postauricular fascial flap included the periosteum and the sternocleidomastoid muscle. The flaps measured 2 to 4 x 2.0 to 3.5 cm, and the mean follow-up period was 11.5 months.


RESULTS
There were no serious complications, such as fistula recurrence, infection, or flap necrosis during the follow-up period.


CONCLUSIONS
Current methods for repairing small postauricular defects often fail. Although free flap surgery is generally considered inappropriate for such defects, the postauricular flap method applied here appeared to be successful.
Choi
Jong Woo
JW
Department of Plastic and Reconstructive Surgery, Seoul Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Poongnap2-dong, 388-1, Seoul 138-736, Korea. pschoi@amc.seoul.kr
Oh
Tae Suk
TS
Lee
Taik Jong
TJ
Kim
Tae Gon
TG
D000328:Adult; D002908:Chronic Disease; D054644:Ear Auricle / Q000601:surgery*; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D010035:Otitis Media, Suppurative / Q000150:complications* / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation; D013524:Surgical Flaps