Retroauricular Advancement Flap In Single Stage Auricular Defect Reconstruction

Auricular defects must be treated early and properly because they may interfere with facial symmetry. Retroauricular skin is an ideal flap source for a non-reduction reconstruction procedure of the upper, middle, and lower auricular defects. Auricular reconstruction aims to achieve good anthropometric and aesthetic ear unit. The purpose of this case report is to present a reconstruction of auricular defects using the rectroauricular flap that results in a favorable aesthetic and normal anthropometric dimensions of the auricular. We report a case of auricular defect caused by post-excision of keloid located in the helical and antithetical area of the middle third of the right auricular, using a retroauricular flap. Normal values of the auricular’s anthropometric measurements were achieved, followed by a complete aesthetic ear unit. Retroauricular flaps are suitable for reconstructing partial auricle defects in the helical rim, temporal area, and conchae. Keywords: auricular defect, retroauricular flap, aesthetic ear unit, auricular anthropometry. Jabir Retroaurikular untuk Rekonstruksi Defek Telinga Abstrak Daun telinga berperan penting pada simetri wajah sehingga defek di daun telinga harus ditangani dengan baik sejak dini. Kulit retroaurikular merupakan sumber jabir ideal untuk rekonstruksi tanpa reduksi pada defek daun telinga bagian atas, tengah, dan bawah. Rekonstruksi daun telinga bertujuan untuk mendapatkan hasil yang baik secara antropometri dan estetika unit telinga. Tujuan laporan kasus ini adalah menunjukkan hasil yang baik berdasarkan unit telinga estetik dan dimensi normal antropometri pada rekonstruksi defek daun telinga menggunakan jabir rektroaurikular. Dilaporkan satu kasus defek telinga pasca-eksisi keloid, di area heliks dan antiheliks sepertiga tengah daun telinga kanan, menggunakan jabir retroaurikular. Didapatkan nilai normal pada pengukuran antropometri telinga dan kelengkapan estetika unit telinga. Jabir retroaurikular baik untuk rekonstruksi defek telinga parsial di lengkung heliks, area temporal, dan konka. Kata kunci: defek aurikular, jabir retroaurikular, unit telinga estetik, antropometri daun telinga.

Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions

Importance: Reconstruction of facial deformity poses a significant surgical challenge due to the psychological, functional, and aesthetic importance of this anatomical area. There is a need to provide not only an excellent colour and contour match for skin defects, but also a durable cartilaginous structural replacement for nasal or auricular defects. The purpose of this review is to describe the history of, and state-of-the-art techniques within, facial cartilaginous surgery, whilst highlighting recent advances and future directions for this continually advancing specialty.Observations: Limitations of synthetic implants for nasal and auricular reconstruction, such as silicone and porous polyethylene, have meant that autologous cartilage tissue for such cases remains the current gold standard. Similarly, tissue engineering approaches using unrelated cells and synthetic scaffolds have shown limited in vivo success. There is increasing recognition that both the intrinsic and extrinsic microenvironment are important for tissue engineering and synthetic scaffolds fail to provide the necessary cues for cartilage matrix secretion.Conclusions and Relevance: We discuss the first-in-man studies in the context of biomimetic and developmental approaches to engineering durable cartilage for clinical translation. Implementation of engineered autologous tissue into clinical practise could eliminate donor site morbidity and represent the next phase of the facial reconstruction evolution.

Reconstruction of an iatrogenic anterior conchal defect with a revolving-door flap

Background Auricular concha has been widely used as a supporting material in rhinoplasty or repairing of auricular defects. However, complications, trauma or iatrogenic excision often result in concha defects which destroy the normal structure of the external ear and further influence daily life. Local flaps are often applied to repair the defects because of their safety and satisfactory functional and aesthetic results. Case presentation We report a 24-year-old female who presented with a concha defect that resulted from a complication of concha cartilage graft for rhinoplasty. The anterior concha defect was covered by a revolving-door (RD) flap as a single-stage procedure. The aesthetic and functional outcomes were satisfactory at 6 months post operation. Conclusion We recommend the RD flap as an excellent choice for conchal defect reconstruction. Satisfactory aesthetic and functional results can be achieved by this easy-to-learn technique in relatively short surgical time.

A clinical study of external ear reconstruction: a study of 20 cases

Background: Auricular defects pose one of the most difficult challenges in reconstructive surgery of the head and neck. The reason is the unique three-dimensional anatomical architecture of the auricle, with its multiple concavities and convolutions of the cartilage and the thin, delicate skin cover. Acquired auricular deformities commonly result from traumatic injuries, burn trauma or tumour extirpation. These vary in severity from simple lacerations to complete auricular avulsions. Congenital ear deformity (microtia) occurs in every 1 out of 6000 live births. The goal of reconstruction is the precise duplication of the missing anatomical part with regard to size, orientation and anatomical landmarks.Methods: Range from healing by secondary intention to complete replacement with autologous rib cartilage and/or auricular prosthesis. Total auricular reconstruction was done by two methods: (1) Nagata and (2) Brent’s method. Nagata’s technique is commonly performed in this study. The present study aimed to evaluate the reconstruction of auricular defects using autologous rib cartilage graft with or without temperoparietal fascia flap covered by split-thickness skin graft.Results: Excellent cosmetic result can be obtained with adequate skills and training in carving the cartilage for auricular framework. This improves confidence and gives psychological support to microtia patients.Conclusions: With training and method, results in ear reconstruction using autologous rib cartilage are excellent and reproducible.