Nasal reconstruction with auricular microvascular transplant

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Otolaryngology

Background:

• Complex nasal defects often require advanced reconstructive techniques.
• Previous reconstructions may fail, necessitating alternative surgical options.
• Matching color and contour in nasal reconstruction is challenging.

Purpose of the Study:

• To evaluate the efficacy of an auricular free flap for distal nose reconstruction.
• To assess the vascular supply and reconstructive potential of the ascending helix flap.
• To present this flap as a viable surgical option for complex nasal defects.

Main Methods:

• A free flap was harvested from the ascending helix of the ear.
• Cadaver studies confirmed blood supply from the superficial temporal artery.
• Flaps were used to reconstruct nasal tip, ala, columella, and sill in 6 patients.
• Donor vessels were anastomosed to facial vessels or neck vessels via vein grafts.

Main Results:

• All 6 auricular free flaps survived successfully.
• Excellent color and contour match was achieved in all cases.
• Minor revisions were required in all patients post-reconstruction.
• The auricular donor site was closed with local tissue advancement.

Conclusions:

• The ascending helix auricular free flap is a valuable surgical option for complex distal nasal reconstruction.
• This technique offers predictable outcomes and avoids central facial donor sites.
• It provides superior aesthetic results in terms of color and contour match.