Helix rim advancement for reconstruction of marginal defects of the pinna

Majumdar, Amitabha; Townend, John

doi:10.1054/bjom.1998.0009

Cited by 32 publications

(25 citation statements)

References 11 publications

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“…Generally, defects up to 2 cm along the lateral helical rim can be repaired in this fashion. Larger defects of the lateral helical rim have also been repaired using bilateral helical chondrocutaneous advancement flaps in which the traditional earlobe‐based helical advancement flap is performed in conjunction with a superior helical chondrocutaneous advancement flap 1,2 . In these examples, however, the flaps were designed to include helical cartilage, which is generally not necessary for superficial defects of the helix.…”

Section: Resultsmentioning

confidence: 99%

Superior Helical Rim Advancement Flap for the Repair of Ear Defects

et al. 2008

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The authors have indicated no significant interest with commercial supporters.S urgical defects of the auricular helix generally require reconstruction to maintain the contiguous border of the helical rim. Whereas the traditional helical advancement flap ( Figure 1A) provides an excellent repair for defects along the lateral helix, this flap is not ideally suited for repair of defects of the superior helix. We report a superior helical advancement flap that utilizes donor skin from the laxity of the superior preauricular area to repair defects of the superior helical rim ( Figure 1B). MethodsSeven patients with Mohs micrographic surgery defects of the superior helix repaired in this fashion by one surgeon (AKA) were included in the study. The flaps were devised by incising along the inferior margin of the helical rim toward the superior border of the tragus (Figure 2). Backcuts were made into the superior portion of the preauricular crease to free the lax preauricular skin and allow advancement of the flap. Dog-ears were removed in the posterior ear. The flaps were undermined superiorly in a subcutaneous plane as well as on the posterior ear above the perichondrium. The flaps were then advanced to cover the surgical defects. Suturing was performed using 5-0 nylon sutures. No subcuticular sutures were used in this flap except when needed to repair the preauricular crease. Sutures were removed 1 week postoperatively. ResultsThe defects measured 2.5 Â 1.0, 2.4 Â 0.9, 2.0 Â 1.5, 2.0 Â 1.2, 1.7 Â 0.9, 1.5 Â 1.0, and 1.3 Â 1.0 cm (mean, 1.9 Â 1.1 cm). Each defect was successfully repaired with this flap with no notable distortion of the ear. Helical rims were maintained in a smooth, contiguous fashion. There was no flap necrosis or trapdooring noted. There was no significant postoperative pain, chondritis, infection, or dehiscence. Postoperative surgical revisions were not required.

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Section: Resultsmentioning

confidence: 99%

Superior Helical Rim Advancement Flap for the Repair of Ear Defects

et al. 2008

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“…It is of primary importance to be able to align the anatomic landmarks for an aesthetically acceptable result. Wedge excision or its modifications 3,7,11,13,14,17 are based on the principle of circumference reduction and require proper surgical design and technique to obtain optimal results. The design of the basic wedge consists of a triangle with its base located peripherally along the helical rim.…”

Section: Discussionmentioning

confidence: 99%

“…The design of the basic wedge consists of a triangle with its base located peripherally along the helical rim. Potential deformities are well described in the literature such as webbing, 'butterfly appearance' with notching of the helix into a bilobed architecture, and cupping of the pinna [13][14][15] . In order to avoid these, a variety of modifications are described 4,,7,15,13 all of which have their own advantages and disadvantages.…”

Section: Discussionmentioning

confidence: 99%

“…7 Methods for reconstruction of auricular rim defects can be divided into techniques for closure of partial-thickness defects (skin or pericondrium, or both) or techniques for closure of full-thickness defects (skin and cartilage). 4,7 Options for closure of full-thickness defects include; simple primary closure, contralateral conchal cartilage composite grafts, preauricular flaps 12 , staged postauricular flaps 10 , various subperichondrial wedge resections of the cartilage 17 , thin tubed mastoid flaps 16 , Banner flaps 6 , Converse's tunnel procedure 5 , advancement of condrocutaneous flaps of adjacent rim tissues 1,2,8,13 , rotation or advancement chondrocutaneous flaps 7 and rotation-advancement of the earlobe tissue 18 for smaller, inferior defects.…”

mentioning

confidence: 99%

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Single staged, z-plasty supported, wedge excision modification for treatment of auricular lesions under local anesthesia: a technical note

Tuncali¹,

Yavuz²,

Aslan³

2005

International Journal of Oral and Maxillofacial Surgery

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“…Finally, the traditional wedge resection may result in ''webbing,'' whereby the helical rim appears depressed owing to the elastic memory of the auricular cartilage and scar contraction. 3 Numerous techniques have been described for reconstruction of helical rim defects. The ideal reconstructive procedure should be simple, 1 stage, with no significant donor site morbidity, and provide acceptable soft tissue cover with regard to color and texture match, ensuring a good aesthetic outcome.…”

Section: Introductionmentioning

confidence: 99%