Helical Rim Reconstruction With Chondrocutaneous Hatchet Flap-Z Plasty

Helical rim reconstruction is relatively difficult because of the unique anatomical structure of the ear. The aesthetic and functional characteristics of the ear make such reconstruction even more important. This article presents the newly defined chondrocutaneous hatchet flap-Z plasty (HFZP) method in helical rim defects and evaluates the results.

This study retrospectively evaluates 14 patients who were operated on using the chondrocutaneous HFZP method after a tumor excision located on the helical rim. The etiologies of the patients were basal cell carcinoma (n = 7), squamous cell carcinoma (n = 2), and actinic keratosis (n = 5). All patients were operated on under local anesthesia. The patients were evaluated regarding age, sex, etiology, defect location, and aesthetic outcomes.

Five patients were female, and 9 were male. The mean age of the patients was 72.2 years. Nine tumors were localized in the upper one-third of the helical rim, and 5 were localized in the middle one-third. The average duration of operation was 24 minutes. The aesthetic results were 11 patients (78.59%) who recovered with excellent outcome, 2 patients (14.2%) with good outcome, and 1 patient(7.1%) with poor outcome. There were no postoperative complications, such as flap necrosis, infection, suture detachment hemorrhage, or hematoma.

The chondrocutaneous HFZP method is a simple, single-stage method that uses local tissues without color mismatch. In addition to the method's geometric gain, there is no removal of healthy skin or cartilage, resulting in minimal decreases in the vertical and horizontal diameters of the ear.