The staged retroauricular to auricular direct pedicle (interpolation) flap for helical ear reconstruction.

Abstract

A significant soft-tissue defect involving the helix of the external ear may present a difficult challenge to repair. We describe our experience with the staged retroauricular to auricular pedicle flap for repair of soft-tissue defects with exposed cartilage of the helix of the ear. The staged pedicle flap was used to repair 26 helical ear defects after excision of basal cell carcinoma (n = 16), squamous cell carcinoma (n = 3), and melanoma (n = 7). Defect size ranged from 1 x 2 cm to 4 x 6 cm (average 2.4 x 3.3 cm). Defects involved the superior helix in 12 patients, mid helix in 11, and inferior helix in three. No cases of infection or flap necrosis occurred. The staged retroauricular to auricular pedicle flap consistently provides a good to excellent functional and cosmetic outcome when performed on properly selected helical ear defects.