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Updated: Apr 21, 2026

Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Chondrocutaneous helix rim advancement flap: two classical and two new modifications for very large defects of the
E M Valesky1, R Kaufmann1, M Meissner1
1Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
Background:
The plastic reconstruction of the ear after microscopically controlled tumor surgery is a particular challenge. The chondrocutaneous helix rim advancement flap (CHRAF) is perfectly suited for the repair of different defects of the helix and even defects beyond.
Objective:
Here, we describe two known and two new modifications of the CHRAF that enlarge the scope of application in tumor surgery of the ear.
Methods:
We demonstrate the different techniques and practical application of the repair and evaluate the benefits and limitations.
Results:
The CHRAF and its modifications is an excellent method for repair of various defects of the helical region of the ear.
Conclusion:
The CHRAF and its modifications proves to be an good alternative to other methods of closure by preserving the anatomical contour and mechanical and acoustic functions in a single-staged procedure with excellent aesthetic results. The two new modifications we introduced here, enlarge the known armentarium for very large defects of the upper pole and the mid-helix of the ear.

