Ear Reconstruction with Postauricular Flap

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Author: Neil Tanna, MD, MBA, FACS
Published:
Specialties: Plastic Surgery
Schools: Northwell Health
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Basic Info

The post-auricular flap is utilized for larger ear reconstructions.  More commonly, it is reserved for defects that are not amenable to primary closure or helical rim advancement flaps.

DOi#: http://dx.doi.org/10.17797/4k9jzjrexh

Advanced

Procedure

Postauricular flap for ear reconstruction

Indications

The postauriuclar flap is indicated for large ear defects that are not amenable to helical rim advancement flap or skin graft reconstruction

Contraindications

The post auricular flap should not be performed in patients who can
not undergo surgery.

Instrumentation

Setup

The surgery can be done with local anesthesia. Additional sedation is at the surgeon preference.

Preoperative Workup

None.

Anatomy and Landmarks

The flap donor site is identified immediately posterior the postauriclar suclus. The base of the flap is at the harline margin.

Advantages/Disadvantages

Advantages
Better tissue match and color than a skin graft

Disadvantages
Can require 2 stages or skin grafting of the donor site

Complications/Risks

These include bleeding, infection, scarring, asymmetry, wound
disruption, partial flap loss, total flap loss, need for wound care,
sensory disturbance, alopecia, and need for revision.

Disclosure of Conflicts

None.

Acknowledgements

None.

References

Tanna N, Clary MS, Conrad DE, Joshi AS, Lindsey WH. Reliability of the
helical advancement flap for auricular reconstruction. Plast Reconstr
Surg. 2010;125:202e-3e.

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