Upper and middle third auricular reconstruction with a peninsular conchal flap

Abstract

Fikret Eren, Bilge Kagan Aysal, Cenk Melikoglu, Sinan Oksuz

Background: Traumatic or iatrogenic full thickness auricular defects can be reconstructed in many ways. The defects exceeding 2 cm require challenging reconstruction techniques. The reconstruction options for those should include anterior and posterior skin envelope repair with cartilaginous content. Providing color and texture match, while maintaining anatomic landmarks, should be considered. The outcomes of patients in which we used a peninsular conchal axial pattern flap (PCF) to reconstruct the composite defects of the auricle were outlined in this case series. Materials and Methods: Five patients with different etiologies were evaluated and operated with PCF between March 2012 and January 2015. The ages of the patients ranged from 21 to 91 years with a median age of 80. The mean follow-up period was 16.8 months. In PCF, the conchal subpart of the auricle was elevated as an axial pattern composite flap relied on the anastomotic connections between the superficial temporal artery and the posterior auricular artery. Donor sites were left to secondary healing. The statistical assessment was carried out with the Mann-Whitney U test. Results: The median age of the patients was 80 (21-91) years. The median percentage of flap survival was 100,00. The median operation duration was 92,00 minutes. Donor site epithelialization was 21 and 20 days in the first two patients, with a median of 20,5 days. In the latter three patients, a silver-containing dressing material was used prophylactically to suppress contamination by skin bacteria, which led to a decrease of the length of healing time to a median of 11,00 days, with a range of 3,00. Conclusion: PCF offers a one-stage procedure and can be used in the reconstruction of defects of the auricle exceeding 2 cm. The use of axial pattern peninsular conchal flap is recommended to all of our colleagues