Reconstruction of the external auditory canal using a super-thin superficial circumflex iliac perforator flap after tumour resection.

Abstract

Reconstruction of the external auditory canal (EAC) after resection of carcinoma has become widely performed in combination with tympanoplasty to retain hearing ability, thus improving quality of life. Although skin grafting has been commonly performed, stenosis, infection and delayed wound healing often occur postoperatively. Local flaps can cause less stenosis, but the size and mobility are limited. For preventing stenosis and osteoradionecrosis after postoperative radiation, super-thin as well as durable resurfacing is required. We present two cases of reconstruction of the EAC using a super-thin free superficial circumflex iliac perforator (SCIP) flap. The flap was elevated as a super-thin flap primarily and inset into the defect as a tube. The flap survived completely without stenosis, infection or osteoradionecrosis even after postoperative radiation therapy. As this flap can securely cover the important structures, causes less stenosis and can endure postoperative radiation therapy, we believe that this method could be an option for reconstruction after resection of EAC cancers.