Application of Sandwich Shape Double Bilobed Flap in Auricular Defects.

Abstract

Reconstruction of auricular defects is a challenging surgical procedure because of its complex 3-dimensional structure. Various surgical techniques have been used for the reconstruction of the auricle. However, most of these techniques are not applicable to the reconstruction of marginal and central defects, and the texture and color harmony of the reconstructed parts were not evaluated in detail. Thus, the aim of this study is to present a novel technique, sandwich shape double bilobed flap, which can be used for correcting, both, central and marginal defects of the auricle and to evaluate esthetic outcomes with objective and quantitative parameters. In this study, 24 patients with partial thickness auricular defects were treated with a bilobed flap, and excess tissue in the postauricular sulcus region was transferred to the defective region on the anterior surface. Color compatibility between the flap and surrounding tissues, patient's satisfaction on the final shape and auricular symmetry, as well as anterior scar formation on the auricle were evaluated. The color, texture, and thickness of the flap matched well with the adjacent auricular tissue and there was no perceptible color difference. The original size, projection, and subunits of auricles were maintained. All patients were mostly very satisfied with surgical outcomes (mean satisfaction score, 4.75 ± 0.4). There was only inconspicuous scar on the visible anterior surface of the auricle (mean patients' scores, 2.22 ± 0.3; mean observers' scores, 2.6 ± 0.4). The sandwich shape double bilobed flap technique preserved size and subunits of the auricle. Additionally, this procedure also resulted in inconspicuous scarring as well as similar color, texture, and thickness of the flap with the surrounding tissue, thereby achieving satisfying esthetic outcomes.