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Revision meatoplasty: management emphasizing de-epithelialized postauricular flaps.

F J Stucker1, G Y Shaw

  • 1Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Medical Center, Shreveport 71130.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 1, 1991
PubMed
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Revision meatoplasty can be challenging due to scarring. A new technique uses vascularized postauricular skin flaps to reconstruct the ear canal, preventing stenosis and improving outcomes.

Area of Science:

  • Otolaryngology
  • Plastic Surgery
  • Reconstructive Surgery

Background:

  • Revision meatoplasty addresses external ear canal and conchal stenosis, often caused by inflammation and scarring.
  • Previous reconstructive attempts using skin grafts can lead to circumferential scarring, worsening stenosis.

Observation:

  • Scarring compromises the use of existing ear canal and conchal skin for reconstruction.
  • A novel technique utilizes vascularized postauricular skin flaps rotated into the ear canal.

Findings:

  • The postauricular flap provides healthy skin for resurfacing the canal and meatus.
  • Flap placement from a posterior direction uses scar contracture to maintain meatal patency.
  • CO2 laser facilitates precise de-epithelialization of the flap segment beneath the auricle.

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Implications:

  • This technique offers a viable solution for revision meatoplasty, successfully managing 32 cases of stenosis.
  • It contrasts with traditional methods, preventing the compounding stenosis associated with skin grafts.
  • The flap design is adaptable based on pre-existing postauricular scarring.