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Three-Stage Prelaminated Radial Forearm Flap for Total Auricular Reconstruction Following Scalp Avulsion Injury
Bo Liang1, Yan Xue1, Wanqiao Zhang1
1Department of Hand and Foot Microsurgery Huabei Petroleum Administration Bureau General Hospital Renqiu Hebei China.
Clinical Case Reports
|February 23, 2026
Summary
This study presents a novel ear reconstruction technique using a prelaminated radial-forearm flap for patients with severe scalp avulsion. The method successfully restored auricular form and function when conventional methods were impossible.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Otolaryngology
Background:
- Complete scalp avulsion and ear amputation present significant reconstructive challenges.
- Loss of local tissues like mastoid skin and temporoparietal fascia precludes standard ear reconstruction methods.
Purpose of the Study:
- To describe a total auricular reconstruction using a remote, prelaminated radial-forearm flap.
- To evaluate the efficacy and outcomes of this technique in a patient with prior scalp avulsion.
Main Methods:
- A two-stage approach involving forearm tissue expansion and subsequent free transfer of a prelaminated radial-forearm flap.
- Autogenous costal cartilage was used for framework construction and inserted into the expanded flap for maturation.
- The flap was transferred to the mastoid area and anastomosed to preserved superficial temporal vessels.
Main Results:
- The reconstructed ear (neo-auricle) demonstrated symmetric contour, good color match, and well-defined anatomical features (helix/anti-helix) at 6 months post-surgery.
- The donor forearm site maintained full wrist function.
- No major complications such as infection, significant exposure, or cartilage resorption were observed.
Conclusions:
- Remote, prelaminated radial-forearm flap auricular reconstruction is a reliable option for ear restoration in complex cases where local tissues are unavailable.
- This technique offers a viable solution for ear restoration when all conventional surgical options have been exhausted.
