The application of a retrograde postauricular island flap in reconstructing periorbital region defects

Reconstruction of periorbital region defects is thought to be one of the most challenging areas in reconstructive plastic surgery. This paper describes our experiences with the application of retrograde postauricular island flaps in reconstructing periorbital region defects.

Between November 2008 and June 2019, 16 patients with periorbital region defects underwent treatment using a retrograde postauricular island flap. The flap is designed with two portions: 1) the pedicle segment only with the superficial temporal fascia and 2) the flap segment in the posterior auricular region with non-hair-bearing full-thickness tissue. Intraoperatively, the vascular networks between the postauricular and the superficial temporal vessels were preserved. The flap was then transferred to the receipt area after passing through a subcutaneous tunnel. The donor site was directly closed in the postauricular sulcus by advancing the posterior scalp flap.

All the periorbital region defects were reconstructed in one-stage surgery. All the flaps survived without venous congestion. The size of the harvested flaps varied from 5.0 × 2.5 cm to 7.5 × 5 cm. The colour of the transferred flaps matched the surroundings of the receipt region, and the eyelids functioned well.

A retrograde postauricular island flap is a good choice for the reconstruction of periorbital region defects. The flap can be useful for the reconstruction of the periorbital region, since it uses similar colours and textures. In addition, it permits a "one-stage" reconstruction with less conspicuous donor site scars behind the auricle.