Extended Retroauricular Temporal Flap with Conchal Cartilage for Alar or Columellar Reconstruction

Background: The retroauricular-temporal or Washio flap has been introduced for reconstruction of partial nose and cheek defects, and has many advantages. We decided to evaluate the extended use of this technique in order to repair full thickness nasal defects. Methods: Superficial temporal and retroauricular arteries are identified with Doppler flowmetry. Selection points A, B, C and D are delineated. Point Ais the point around which the entire flap rotates, and is a fixed point in front of the anterior end of the helix and behind the superficial temporal artery. The next step is the selection of point C for the flap to reach the defect.We operated 8 cases utilizing this method to reconstruct alar and columellar defects with chondrum. Results: We found this technique very useful. The advantages of this technique include suitable flap color, good texture, no need for microsurgery experience, donor and recipient sites for surgery are in one field, and the donor site scar is inconspicuous. Conclusion: We find this technique very effective in repairing total subunit (nasal tip) defects. To fully appreciate it, we have to expand the distal part of the flap by including conchal cartilage with it.