Retroauricular skin: a flaps bank for ear reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Otolaryngology

Background:

• Retroauricular skin is ideal for ear reconstruction due to rich vascularization, concealment, and similarity to facial skin.
• An algorithm using different Retroauricular Island Flaps (RIFs) is proposed for anterior auricle defects.
• The study covers 16 years of experience with 216 consecutive cases.

Purpose of the Study:

• To present an algorithm for reconstructing anterior auricle defects using various Retroauricular Island Flaps (RIFs).
• To evaluate the efficacy and outcomes of RIFs in ear reconstruction over a 16-year period.

Main Methods:

• A retrospective analysis of 216 patients undergoing ear reconstruction with RIFs from 1999 to 2006.
• Utilized Superior Pedicle RIF (SP-RIF) for upper half defects (52 cases).
• Employed Perforator RIF (P-RIF) for conchal reconstruction (68 cases) and Inferior Pedicle RIF (IP-RIF) for non-marginal/superficial marginal defects (96 cases).

Main Results:

• No flap failures were recorded in any of the 216 cases.
• Excellent morphological reconstruction was achieved with no donor site sequelae.
• Minor issues like flattened sulcus (P-RIFs) or temporary venous stasis (SP-RIFs) were observed but did not impact function or spectacle wear.

Conclusions:

• Retroauricular skin serves as a valuable source for diverse island flaps for ear reconstruction.
• RIFs offer safe vascularization, matching skin color/texture, and can be harvested under local anesthesia with low morbidity.
• The choice of RIF type depends on the location and size of the ear defect.