Modified Antia-Buch repair for full-thickness upper pole auricular defects

Modified Chondrocutaneous Flaps for Middle Helical Rim Defects

This article describes a unique approach for reconstruction of large helical rim defects. By raising bilateral chondrocutaneous flaps of the helical rim while including a semicircular chondrocutaneous excision of the adjacent scapha and antihelix, large defects can be repaired with minimal loss to the overall external ear circumference. This is a technically simple and reliable method that has resulted in excellent cosmetic outcomes and minimal morbidity in our practice.

Helical rim advancement - A technique to avoid keloid recurrence

Introduction

Helical rim keloids occur commonly following ear piercings, trauma and previous surgeries and can be disfiguring. Many techniques have been developed to treated these disfiguring lesions with varying successes, however, individuals prone to developing keloids inadvertently recur despite best efforts.

Objective

To determine whether helical rim advancement flap reconstruction following helical rim keloid excision can reduce recurrences.

Design

Case series followed up to 2 years.

Setting

Single Centre Tertiary Hospital Facial Plastics Service.

Participants

All patients who consented to helical rim advancement reconstruction after keloid excision.

Results

The authors report a series of 7 patients with helical rim keloids ranging from 1.2 cm to 5 cm in widest diameter treated with keloid excision and reconstruction with helical rim advancement flap technique. There were no recurrences within a mean of about 19 months post-operatively. Most patients report satisfaction with the cosmetic end-result.

Discussion

From the authors’ experience, helical rim advancement reconstruction following excision of keloids about 2.5 cm in widest diameter is an excellent tension-free option to avoid recurrence of helical rim keloids. Wound tension is a key risk factor for keloid formation. We hypothesise that the reason why there was no recurrence is because in helical rim advancement flap reconstruction, the underlying helical rim takes all the tension of closure off the dermis, resulting in tension-free skin closure.

Conclusion

Helical rim advancement flap reconstruction is a viable technique to avoid recurrence and minimise cosmetic deformities of the pinna for selected helical rim keloids.

Partial Ear Defects

Reconstruction of partial ear defects represents one of the most challenging areas within reconstructive surgery of the head and neck. Each case of auricular reconstruction is unique and warrants a systematic approach that accounts for defect size and location, the quality of the surrounding skin, patient preference, and operator experience. In this article, the authors outline different reconstructive approaches for defects of the upper-, middle-, and lower-third of the auricle. The relevant anatomy is discussed in detail. Successful outcomes in auricular reconstruction rely on the surgeon's careful analysis of the defect as well as knowledge of the different reconstructive options available.

Reconstructive Surgery of Auricular Defects: An Overview

Context:

Despite the ongoing advances in surgical procedures and promising progress in bioengineering techniques, auricular reconstruction remains a significant challenge in plastic surgery. There are different causes for acquired auricular defects, including trauma, tumor ablation and burns. The management options for upper, middle and lower third auricular defects are briefly reviewed in the current paper.

Evidence Acquisition:

Original research papers investigating the plastic surgeons, otolaryngologists and maxillofacial surgeons in approaching the complicated issue of auricular reconstruction published from January 1995 to December 2014 were aggregated and used in the current study.

Results:

Utilizing autologous stem cell populations to treat craniofacial defects is a promising field of ongoing investigations. Studies show that cartilage stem/progenitor cells (CSPCs) are highly chondrogenic and can produce elastic reconstructive material with long-term tissue restoration.

Conclusions:

Auricular reconstruction surgery is a challenging plastic procedure that requires great expertise and expert knowledge of the various techniques available. Novel techniques in the fields of reconstructive bioengineering and regenerative medicine are promising but further research is required before widespread clinical application.

Single staged, z-plasty supported, wedge excision modification for treatment of auricular lesions under local anesthesia: a technical note

Following wedge-excision of auricular lesions, a triangular-cartilage only-excision is planned at the tip of the wedge. The dimensions and the angles of this cartilage can be modified as much as the required helical rotation. After approximating the cartilage edges a notching deformity may be observed which can be improved using single or multiple z-plasties.

Auricular reconstruction of helical rim defects: wedge resection revisited

Auricular reconstruction of an acquired helical rim defect is a clinical situation commonly encountered by dermatologic surgeons. Wedge resection is a simple but effective method for repairing such helical rim defects. This is a review of the wedge resection, outlining its indications, limitations, surgical technique, postoperative care, and pitfalls.