Temporoparietal fascial flap in auricular reconstruction

Ear defects

The projection and exposure of the auricle make it particularly susceptible to actinic injury and thus to cutaneous malignancies. Auricular reconstruction is challenging because of its unique surface anatomy and undulating topography. This article organizes auricular defects into different categories based on anatomic location and extent of tissue loss, including skin-only defects, small composite defects, full-thickness defects involving or sparing the upper third of the ear, and total auricular loss. The authors share an algorithm for repair of the array of auricular defects.

Reconstruction of the ear after skin and cartilage loss

Small defects (less than 1.5 cm) of the helix or antihelix of the middle third of the ear can be converted to a wedge-shaped excision and primary repair performed. In some cases, small Burrow's triangles on either side of the wedge must be exised from the scapha or antihelix to allow for closure without distortion or cupping. In addition, the resection may go across the conchal rim and include the bowl to allow for rotation without deformity.

Auricular reconstruction

Auricular defects occur from a variety of different causes and a wide array of reconstructive options are often necessary. This article presents a general algorithm for approaching the reconstruction of auricular defects. The spectrum of problems ranges from simple lacerations to superficial cutaneous defects to total avulsions. There are small tips that can help improve results with adjacent flaps as well as guidelines for total auricular reconstruction.