Using Preauricular Rotation Flaps to Repair Cartilage Exposure in the Triangular Fossa Area After Ear Reconstruction: Clinical Techniques and Evaluation.

Abstract

Cartilage exposure in the triangular fossa following ear reconstruction is a challenging complication due to the region's concave morphology and limited soft tissue coverage. This study evaluates the efficacy of preauricular rotation flaps for repairing such defects. Twenty-four patients with cartilage exposure in the triangular fossa after ear reconstruction underwent repair using preauricular rotation flaps at the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences (2018-2023). The surgical technique emphasized flap design from the preauricular region, tension-free rotation, and integration with local skin. Outcomes were assessed by flap survival, triangular fossa morphology restoration, donor site scarring, and patient satisfaction. Follow-up averaged 18.5 months (range, 6-36 months). Complete flap survival was achieved in 22 cases (91.7%), whereas 2 cases (8.3%) experienced partial superficial necrosis that healed with conservative treatment. Triangular fossa morphology restoration was rated excellent in 16 cases (66.7%), good in 6 (25.0%), and poor in 2 (8.3%). Donor site scarring was minimal in 20 cases (83.3%) and moderate in 4 (16.7%), with no significant scarring observed. The average patient satisfaction score was 4.3/5. No recurrent cartilage exposure or secondary repairs were required during follow-up. The preauricular rotation flap provides an effective solution for triangular fossa cartilage exposure after ear reconstruction, offering both functional and aesthetic benefits. This technique is straightforward to perform with a short learning curve and achieves high success rates with good patient satisfaction.