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Retroauricular flap: its clinical application and safety
T Yotsuyanagi1, Y Watanabe, K Yamashita
1Department of Plastic and Reconstructive Surgery, Hirosaki University School of Medicine, Hirosaki, Japan.
British Journal of Plastic Surgery
|December 21, 2000
Summary
The retroauricular flap shows variable safety and aesthetic outcomes depending on its application site and vascular pedicle. While safe for auricular reconstruction, remote applications risk flap necrosis and patient dissatisfaction due to color mismatch.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Head and Neck Surgery
Background:
- The retroauricular flap is a reconstructive option for head and neck defects.
- Its application and safety profile require detailed evaluation across various anatomical sites.
Observation:
- The study analyzed 38 cases utilizing the retroauricular flap for diverse reconstructions.
- Reconstructions included anterior auricular, peri-auricular, preauricular sideburn, malar, eyelid, and intraorbital regions.
Findings:
- Flaps pedicled by postauricular or superficial temporal vessels demonstrated safe circulation and good aesthetics for auricular/peri-auricular reconstructions.
- Remote reconstructions using superficial temporal vessel pedicles (subcutaneous or free) showed unstable circulation, leading to flap necrosis.
- Free flaps with postauricular vessel pedicles had satisfactory circulation, though vessel accessibility was challenging; superficial temporal vessels were sometimes substituted.
- Malar region reconstructions, particularly in younger women, resulted in patient dissatisfaction due to the flap's reddish hue.
Implications:
- Vascular pedicle selection is critical for retroauricular flap success, with postauricular vessels preferred for auricular reconstructions.
- Careful patient selection and counseling are necessary for remote reconstructions, especially in the malar region, to manage aesthetic expectations.
- Further research into optimizing vascularity and aesthetic outcomes for remote retroauricular flap applications is warranted.