A New Skin Flap Method for Total Auricular Reconstruction: Extended Scalp Skin Flap in Continuity With Postauricular Skin Flap and Isolated Conchal Flap: Four Skin Flaps and Temporoparietal Fascia Flap

A sufficient skin envelope of good quality as well as definite auricular framework is a prerequisite for a successful auricular reconstruction. Various surgical techniques, such as recruitment of mastoid skin, skin graft, tissue expansion, and so on, have been used to get the necessary skin for covering of the auricular framework. However, debates about the drawbacks of these techniques have continued. In this article, I report on a new skin flap method for total auricular reconstruction, which is an extended scalp skin flap in continuity with postauricular skin flap and isolated conchal flap. Between January 2009 and March 2010, a total of 20 patients underwent an auricular reconstruction using a Medpor framework (Porex Surgical, Inc, Newnan, GA) and the new skin flap method. Follow-up time range was 4 to 17 months. The reconstructed ear showed no definite true hair growth except for some fine hair, which can be ignored. More favorable results such as a good color matched skin, well-formed ear convolution, no other donor site scars can now be achieved using this new method.

[1]  Chul Park.  Subfascial Expansion and Expanded Two‐Flap Method for Microtia Reconstruction , 2000, Plastic and reconstructive surgery.

[2]  S. Nagata,et al.  A New Method of Total Reconstruction of the Auricle for Microtia , 1993, Plastic and reconstructive surgery.

[3]  S. Kawakami,et al.  Vascular supply of the subcutaneous pedicle of Nagata's method in microtia reconstruction. , 2004, British journal of plastic surgery.

[4]  S. Nagata.  Modification of the Stages in Total Reconstruction of the Auricle: Part I. Grafting the Three‐Dimensional Costal Cartilage Framework for Lobule‐Type Microtia , 1994, Plastic and reconstructive surgery.

[5]  B Brent,et al.  The Correction of Microtia with Autogenous Cartilage Grafts: II. Atypical and Complex Deformities , 1980, Plastic and reconstructive surgery.

[6]  R C Tanzer,et al.  TOTAL RECONSTRUCTION OF THE AURICLE: The Evolution of a Plan of Treatment , 1971, Plastic and reconstructive surgery.

[7]  S. Nagata,et al.  Modification of the Stages in Total Reconstruction of the Auricle: Part III. Grafting the Three‐Dimensional Costal Cartilage Framework for Small Concha‐Type Microtia , 1994, Plastic and reconstructive surgery.

[8]  Yang-Woo Kim,et al.  A Single-Stage Two-Flap Method of Total Ear Reconstruction , 1991, Plastic and reconstructive surgery.

[9]  Yeliang Song,et al.  An Improved One‐Stage Total Ear Reconstruction Procedure , 1983, Plastic and reconstructive surgery.

[10]  S. Nagata.  Modification of the Stages in Total Reconstruction of the Auricle: Part IV. Ear Elevation for the Constructed Auricle , 1994, Plastic and reconstructive surgery.

[11]  B Brent,et al.  The Correction of Microtia with Autogenous Cartilage Grafts: I. The Classic Deformity , 1980, Plastic and reconstructive surgery.

[12]  R. C. Tanzer.  TOTAL RECONSTRUCTION OF THE EXTERNAL EAR , 1959, Plastic and reconstructive surgery and the transplantation bulletin.

[13]  B Brent,et al.  Technical advances in ear reconstruction with autogenous rib cartilage grafts: personal experience with 1200 cases. , 1999, Plastic and reconstructive surgery.

[14]  S. Nagata.  Modification of the Stages in Total Reconstruction of the Auricle: Part II. Grafting the Three‐Dimensional Costal Cartilage Framework for Concha‐Type Microtia , 1994, Plastic and reconstructive surgery.