Pearls for perfecting the mastoid interpolation flap

Area of Science:

• Otolaryngology
• Plastic Surgery
• Dermatologic Surgery

Background:

• Reconstructing helical rim ear defects presents a significant challenge for Mohs surgeons.
• Traditional methods like wedge excision or helical rim advancement flaps can lead to undesirable cosmetic outcomes, including ear anteversion and reduced size.
• Alternative techniques are needed to achieve aesthetically pleasing and functional ear reconstructions.

Purpose of the Study:

• To present a detailed technique for mastoid interpolation flaps (retroauricular to auricular flaps) for helical rim ear defect reconstruction.
• To provide guidance on optimizing results, avoiding potential pitfalls, and managing postoperative care.
• To offer a valuable alternative for surgeons and patients seeking to maintain ear size and form.

Main Methods:

• The study details the surgical procedure for mastoid interpolation flaps, emphasizing a two-stage approach.
• Techniques for donor site selection (hidden retroauricular area) and flap design are described.
• The manuscript includes step-by-step videos illustrating the reconstruction process.

Main Results:

• Mastoid interpolation flaps allow for aesthetically superior reconstructions, preserving the ear's natural size and shape.
• The technique utilizes concealed donor skin, leading to minimal visible scarring and complications.
• This method is particularly suitable for patients amenable to a two-stage surgical process.

Conclusions:

• Mastoid interpolation flaps are a reliable and effective method for reconstructing helical rim ear defects.
• This technique offers significant advantages over traditional methods, particularly in maintaining aesthetic outcomes.
• Proper surgical planning and execution are key to achieving optimal results and patient satisfaction.