Chondrocutaneous Advancement Flap and Postauricular Skin Flap: An Effective Combination for Large Helical Rim Defect...

Defects of the ear helix are a frequent challenge in plastic surgery, with more than 5% of all skin cancers occurring in this region. The Antia-Buch flap is a single-stage reconstruction technique utilizing chondrocutaneous flaps for helix repair. However, for defects exceeding 2 cm, it can lead to auricular distortion. To address this limitation, we propose a modified Antia-Buch technique combining chondrocutaneous advancement with a postauricular skin flap to optimize outcomes.

A retrospective review was conducted of 15 patients who underwent our modified Antia-Buch flap procedure between 2019 and 2022. This approach incorporated chondrocutaneous advancement for primary defect closure and a postauricular skin flap for improved contouring. Functional and aesthetic outcomes were assessed using a questionnaire developed in collaboration with a clinical psychologist. The questionnaire evaluated surgical satisfaction, cosmetic results, self-image, and social integration postreconstruction.

No complications, including ischemic necrosis or the need for surgical revision, were observed in any case. The technique demonstrated excellent vascularity, with no occurrences of flap failure. Patient-reported outcomes revealed high satisfaction rates, with no evidence of self-image distortion or social barriers. Aesthetic results were rated as superior, with minimal risk of auricular distortion even for larger defects.

The modified Antia-Buch technique is a reliable and effective method for helical rim reconstruction, particularly for defects larger than 2 cm. It offers technical simplicity, low complication rates, patient convenience, and excellent cosmetic outcomes, making it a preferred option for many auricular defect reconstructions.