title: Paraumbilical perforator flap for reconstruction of the external auditory meatus: A case report.
abstract: We herein present a technique of using the umbilical stalk for reconstruction of the external auditory meatus. A 49-year-old female presented with locally aggressive melanoma affecting her mastoid region. She underwent radical excision including the skin and soft tissues around the external ear with simultaneous lymph node clearance. The resultant defect measured 15 cm × 8 cm in diameter and was 2.5 cm deep. This was reconstructed with a similarly sized microvascular paraumbilical perforator flap that included the umbilical stalk. In the post-operative course there was complete flap survival but a prolonged wound dehiscence near the auditory meatus that required revision surgery. At 15-months follow-up, the patient was melanoma-free and the auditory meatus was patent. Hearing was also preserved. The umbilical stalk is one of the few skin covered tubed structures in the human body that may be used without major donor morbidity to "replace like with like," the auditory channel.
authors.affiliation: Department of Plastic Surgery, Töölö Hospital, Helsinki University Hospital, Helsinki, Finland.|University of Helsinki, Faculty of Medicine, Helsinki, Finland.
authors.forename: Patrik
authors.initials: P
authors.lastname: Lassus
authors.affiliation: Department of Plastic Surgery, Töölö Hospital, Helsinki University Hospital, Helsinki, Finland.|University of Helsinki, Faculty of Medicine, Helsinki, Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: De Leo
authors.affiliation: Department of Plastic Surgery, Töölö Hospital, Helsinki University Hospital, Helsinki, Finland.|University of Helsinki, Faculty of Medicine, Helsinki, Finland.
authors.forename: Islam Hazem
authors.initials: IH
authors.lastname: Moussa
authors.affiliation: Department of Plastic Surgery, Töölö Hospital, Helsinki University Hospital, Helsinki, Finland.|University of Helsinki, Faculty of Medicine, Helsinki, Finland.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lindford
mesh_terms: D004424:Ear Canal / Q000601:surgery*; D004428:Ear Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D061525:Perforator Flap; D019651:Plastic Surgery Procedures / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery*; D014472:Umbilicus / Q000637:transplantation*