A Novel Surgical Approach for the Reconstruction of a Large Partial-Thickness Defect of the Helical Rim

The unique anatomy of the ear makes it difficult to reconstruct. In terms of restoring the natural curvature of this anatomic site, repair of large defects involving the helical rim after skin tumor removal presents a unique surgical challenge. We present a case of a patient with a partial-thickness surgical defect involving more than one-third of his right helical rim. The defect was reconstructed using a double transposition flap, with the flap taken from the surrounding skin. There was no need to interpose a cartilage graft, as there was no damage to the patient's own cartilage during the surgery. Both flaps survived with no complications. This single-staged surgical technique was performed under local anesthesia. The immediate and long-term outcomes were satisfactory, and cosmetic results were good. We describe the double transposition flap as an innovative technique for reconstructing specific ear defects. In particular, it is an excellent surgical option for the reconstruction of large surgical defects involving the helical rim. For defects such as the one outlined here, this flap may be considered as an alternative reconstructive option, provided the patient's medical condition allows.