The Occipital Artery-Based Fascial Flap for Ear Reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Otolaryngology

Background:

• The temporoparietal fascia flap is a common choice for ear reconstruction.
• Limited options exist for salvage reconstruction when this flap is not viable.
• The occipital artery fascia flap presents an alternative for soft-tissue coverage.

Purpose of the Study:

• To describe the utility of the occipital artery fascia flap for ear reconstruction.
• To evaluate its use in conjunction with porous polyethylene frameworks.
• To present a salvage option for auricular reconstruction.

Main Methods:

• Retrospective review of patients undergoing occipital artery fascia flap surgery with a porous polyethylene framework.
• Data collected from 1992 to 2017 by the primary author.
• Inclusion criteria focused on patients with contraindications for temporoparietal fascia flap use.

Main Results:

• Eighty-three patients received the occipital artery fascia flap for primary (24) or revision (59) ear reconstruction.
• Contraindications for temporoparietal fascia flap use included prior surgery, trauma, or inadequate perfusion.
• Complications (infection, necrosis) occurred in 12% of patients, requiring further revision.

Conclusions:

• The occipital artery fascia flap is a versatile option for auricular reconstruction, especially in salvage or revision cases.
• It remains a valuable technique when conventional flaps are contraindicated or unavailable.
• This flap can be utilized with both alloplastic and autologous frameworks.