The reverse auricular flap: a new flap for nose reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Otorhinolaryngology

Background:

• Nose reconstruction presents challenges for composite defects.
• Existing methods may have limitations in achieving optimal aesthetic and functional results.
• Vascular anatomy of the ear helix is crucial for flap viability.

Observation:

• Anatomic studies reveal helix vascularization primarily relies on superficial temporal vessels.
• Vascular communications exist between the superficial temporal artery and supraorbital/supratrochlear arteries.
• A chondrocutaneous island flap can be designed from the ear helix.

Findings:

• A new chondrocutaneous island flap from the ear helix was developed for nose reconstruction.
• The flap utilizes reverse vascular flow, supported by superficial temporal and associated arterial systems.
• Successful reconstruction of composite nasal tip and ala defects was achieved in seven patients.
• Donor site defects were managed with a helical rim flap, yielding inconspicuous scars and acceptable cosmetic results.

Implications:

• This ear helix flap offers a viable option for complex nasal reconstruction.
• The technique provides a good balance between reconstructive efficacy and donor site aesthetics.
• Further research can explore variations and long-term outcomes of this reconstructive approach.