Comparison Between the Superior Pedicle Retro Auricular Flap and the Masson's Revolving Door Flap for Coverage of Conchal Defects.

Post operative defect of the external ear result mainly from the resection of skin cancers of this region, hence the need for an adequate plasty to avoid any stenosis or deformation, this article compares 2 retroauricular flap covering techniques through 2 cases of patients with conchal basal cell carcinoma the first one was a 65 years old male patient who had for 2 years a basal cell carcinoma of the postero-superior part of the concha of the right ear, a total removal of the tumor was made with a successful covering of the substance loss by a retroauricular flap with superior pedicle. The second patient was a 66 years old female who has for 3 years a basal cell carcinoma of the inferior part of the concha of the right ear, a successful removal of the tumor was and the covering of the substance loss by a Masson's retroauricular revolving door flap. We discuss the different operating times as well as the advantages and disadvantages of each technique, to finally conclude that the retro auricular flap is an excellent technique to cover the postoperative loss of substance of the superior part whereas the Masson's revolving door flap is more adapted for the posterior lesions of the concha.

Retroauricular lymph node flap: An anatomic and surgical feasibility study.

BACKGROUND: The study investigated the anatomy of the retroauricular lymph node (LN) flap and evaluate its surgical feasibility as a new donor site for a free LN flap in lymphedema surgery. METHODS: Twelve adult cadavers were examined. The course and perfusion of the anterior auricular artery (AAA) and the location and sizes of the retroauricular LNs were studied. RESULTS: The AAA was available in 87% and absent in 13% specimens. The AAA's origin had a mean vertical distance of 12.2 ± 6.9 mm and a mean horizontal distance of 19.1 ± 4.2 mm from the superior attachment of the ear. The mean diameter of the AAA was 0.8 ± 0.2 mm. The mean number of LN per region was 7.7 ± 2.3, with an average LN size of 4.1 ± 1.9 × 3.2 ± 1.7 mm. The LN were categorized into anterior (G1) and posterior (G2) groups, with a total of 59 and 10 LN, respectively. In a cluster analysis, three LN clusters could be detected across the anterior group (G1). CONCLUSIONS: The retroauricular LN flap is a delicate but feasible flap with reliable anatomy, containing a mean of 7.7 LNs.

Secondary surgery for the unsatisfactory auricle after auricular reconstruction.

OBJECTIVES: Complications, including framework exposure, infections, and reconstructed auricle deformation, may occur after auricular reconstruction. However, reports on surgical methods for cases with unsatisfactory outcomes after auricular reconstruction using an autologous costal cartilage are insufficient. Herein, we summarized retreatment casesfor poor ear morphology in patients who had undergone auricular reconstruction in our department for 5 years and discussed other techniques. METHODS: Between September 2014 and September 2019, 24 ears of 24 patients with poor morphology, unsatisfactory macroscopic characteristics and anatomical structures, and unsatisfactory outcomes of local repair after auricular reconstructive surgery were treated. Patients were divided into the following three groups: type 1 (9 ears), with intact and sufficient hairless skin in the mastoid region behind the reconstructed ear; type 2 (7 ears), with intact, but insufficient, hairless skin in the mastoid region behind the reconstructed ear; and type 3 (8 ears), with hairless skin in the mastoid region behind the reconstructed ear with impaired skin integrity. RESULTS: Twenty-two (91.6%) patients successfully completed the surgical treatment and recovered well; one experienced delayed wound healing and another developed hypertrophic scarring at the incision site at 3 months postoperatively. All patients were followed for 0.5-4 (mean, 2.8) years. The macrostructure of the reconstructed ear post-revision was stable and significantly improved in terms of morphology and structure. CONCLUSIONS: In patients with unsatisfactory outcomes after auricular reconstruction, the appropriate technique for the revision surgery should consider the local soft tissue conditions of the reconstructed ear to obtain satisfactory results.

[Application on the clinical effect of immediate repair of part helix defect with flap on post aurem and mastoid region].

Objective: To investigate the clinical effect of the flap on post aurem and mastoid region on immediate repair of part helix defect. Method: Fifteen patients with part helix defect were immediately repaired using the flap on post aurem and mastoid region. Firstly, the skin tissue above the defect of the helix was used as the pedicle. The flap was drawn toward the post aurem and mastoid region closing to the auriculocephalic angle. The flap was generally 3-4 cm long and at least 1 cm wide. Secondly, the flap was lifted on the perichondrium, and the structure of the helix was formed by upward rotation of the flap to repair the defect of the helix. Finally, the flap was sutured to repair the helix defect. Result: Fifteen cases were applied with this method to repair immediately the defect in the emergency environment. The sizes of helix contour were satisfactory and the auriculocephalic angles had not changed. The ear shape was stable after 1 to 3 months of followup. Conclusion: The flap on post aurem and mastoid region could immediately repair the part helix defect. It has the advantages of simple operation, high flap survival rate and one-time satisfactory shape..

Natural sideburn reconstruction with retroauricular expanded flap with original hairline / 中华整形外科杂志

Objective@#To introduce a reconstruction procedure of natural sideburn, with combined expanded retroauricular flap and scalp flap.@*Methods@#A retrospective study was produced in Plastic Surgery Hospital, PUMC, from January 2014 to December 2017. Twenty patients (21 sides) underwent sideburn reconstruction with combined expanded retroauricular flap and scalp flap (double pedicled flap, n=3; single pedicled flap, n=17) were included in this study. There were 12 male (12 sides) and 8 female (9 sides), with the mean age of (23.8±3.2) years. The sideburn defect was caused by burn in 19 patients, and it was resulted from hemangioma in 1 patient.@*Results@#The size of flaps ranges from 8 cm×12 cm to 10 cm×16 cm. Venous congestion at the distal end of the flap occurred in 1 patient, which was cured after dressing change, and the sideburn was not affected. The reconstructed sideburns are natural, symmetric, and without obvious scar. The follow-up time was 3-40 months. Fourteen patients were very satisfied with the reconstructed sideburn, and 6 patients were satisfied. No severe complication was observed during follow-up time.@*Conclusions@#The combined retroauricular flap and scalp flap is an alternative method for sideburn reconstruction, which provide natural hair distribution, inconspicuous scars and less complications.

[EFFECTIVENESS OF V-Y ADVANCED RETROAURICULAR FLAP FOR REPAIRING MILD AND MODERATE EARLOBE DEFECTS].

OBJECTIVE: To investigate the effectiveness of the V-Y advanced retroauricular flap for repairing mild and moderate earlobe defect. METHODS: Between September 2014 and July 2015, V-Y advanced retroauricular flap was used to repair earlobe defect in 6 patients. There were 1 male and 5 females, aged 18 to 30 years (mean, 23 years). The left earlobe was involved in 2 cases and the right earlobe in 4 cases, including 2 cases of congenital earlobe defect and 4 cases of secondary earlobe defect; 1 patient had congenital deformity of upper auricle. According to self-made criteria for earlobe defect, 5 cases were rated as mild defect and 1 case as moderate defect. RESULTS: All incisions healed at the first stage, and the flaps survived smoothly. The patients were followed up 3 to 12 months, with an average of 9 months. The reconstructed earlobes had natural size and shape, and smooth curve; the texture and color were close to the adjacent skin. The effectiveness was satisfactory. CONCLUSIONS: The V-Y advanced retroauricular flap for repairing mild and moderate earlobe defect can achieve natural earlobe and aesthetic plastic effectiveness, so it is a safe and ideal earlobe reconstruction method.

A Case Report of Correction of Cryptotia / 대한이비인후과학회지

Cryptotia is a congenital auricular anomaly found more commonly in orientals than whites. It is characterizaed by the invagination of the upper part of the auricle under the temporal skin and deformity of the auricular cartilage. Surgeries to correct cryptotia principally involves addition of skin to the deficient retroauricular sulcus and cartilage plasty. We have developed a surgical method using modified retroauricular flap and have obtained good result without complication. We hereby report a surgical case with discussion and review of literatures.