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Repair of a Congenital Isolated Alar Defect Using Mutaf Triangular Closure and Composite Ear Cartilage Graft in a
David A Cohen1, John J Sykes2, Jacob Poynter3
1Department of Otolaryngology-Head and Neck Surgery, University of Florida College of Medicine, Gainesville, FL.
The Journal of Craniofacial Surgery
|June 29, 2026
Summary
Congenital isolated alar defects (CIAD) are rare. A 7-year-old boy
Area of Science:
- Plastic Surgery
- Craniofacial Surgery
- Pediatric Surgery
Background:
- Congenital isolated alar defects (CIAD) are rare, occurring in approximately 0.7% of craniofacial clefts.
- The complex three-layered anatomy of the alar region presents significant challenges for reconstruction, particularly in pediatric patients.
Purpose of the Study:
- To present a novel surgical technique for the reconstruction of congenital isolated alar defects in a pediatric patient.
- To evaluate the efficacy of the Mutaf triangular closure flap combined with an auricular composite graft for single-stage alar reconstruction.
Main Methods:
- A 7-year-old boy with a right-sided CIAD underwent surgical repair.
- The reconstruction utilized a Mutaf triangular closure flap.
- An auricular composite graft was incorporated into the repair.
Main Results:
- The surgical repair resulted in excellent alar symmetry.
- Nasal patency was successfully restored.
- The aesthetic contour of the alar region was significantly improved with no postoperative complications.
Conclusions:
- The combined use of the Mutaf flap and auricular composite graft is effective for single-stage reconstruction of full-thickness alar defects in children.
- This technique successfully balances functional preservation and aesthetic outcomes in pediatric CIAD repair.
