Salvage of cartilage framework exposure in microtia reconstruction using a mastoid fascial flap

One of the common complications of microtia reconstruction with cartilage grafting is exposure of the framework. Recently, we used a mastoid fascial flap for salvage operations in two microtia patients, who had partial skin necrosis with resultant exposure of the cartilage framework. Following the excision of the necrotic skin, the anteriorly based mastoid fascial flap was elevated and transferred as a hinge flap on to the portion of the exposed framework. Split-thickness skin grafts were applied over the mastoid fascial flap. Each skin graft took well and the relief of the reconstructed ear was preserved in both cases. This salvage method has a large advantage of not leaving any visible scars on the temporal region and the reliability of its rich blood supply.