More than just the helix: A series of free flaps from the ear

Lassus, Patrik; Husso, Annastiina; Vuola, Jyrki; Lindford, Andrew

doi:10.1002/micr.30178

Cited by 13 publications

(9 citation statements)

References 28 publications

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“…Second, raising the flap is straight forward due to the constant and reliable anatomy of the superficial temporal artery. 10,13 Finally, we believe that the helical rim is an ideal donor site as it can reform the alar shape but also has similar color and texture resulting in a good aesthetic and functional outcome.…”

Section: Discussionmentioning

confidence: 94%

“…Parkhouse and Evans 3 described a free composite flap in 1985 for reconstruction of full-thickness alar defects but stated that it is performed with difficulty and hence with unreliable results. Despite reports of readily accessible suitable veins for microsurgical anastomosis in the perinasal area, 9,10,12 there is a general paucity of recipient veins around this region and this contributes to the difficulty of this reconstructive option. This undoubtedly has resulted in the poor popularity of free tissue transfer as an option for the reconstruction of these defects.…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of a Large Full-Thickness Alar Defect Using an Extended Free Composite Flap from the Pinna: A Case Report

Vlachogiorgos

Grecu

Salibi

et al. 2018

J Reconstr Microsurg Open

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Alar reconstruction can pose a challenging task in reconstructive surgery. Herein, we describe a case of a large full-thickness alar defect (involving the full- thickness of the left ala, 50% of the tip of the nose and extending over the left nasal sidewall and cheek) that was reconstructed using a contralateral free composite pinna flap, which extended into the right temple. A 70-year-old man with a squamous cell carcinoma to the left ala underwent surgical excision and immediate reconstruction with an extended contralateral free composite pinna flap based on a branch of the right superficial temporal artery supplying the helical root and the skin paddle of the supra-auricular area. The patient had an uneventful recovery and the result was aesthetically pleasing without compromising the nostril or the external nasal valve. Based on this case, a free composite flap incorporating the contralateral root of helix and adjacent tissue from the temporal region is an option that could be used in a single-staged procedure for reconstruction of large full-thickness alar defects. One of the challenges of performing free flaps in this area is the paucity of suitable recipient veins. This can be reliably addressed with a vein graft.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Reconstruction of a Large Full-Thickness Alar Defect Using an Extended Free Composite Flap from the Pinna: A Case Report

Vlachogiorgos

Grecu

Salibi

et al. 2018

J Reconstr Microsurg Open

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“…The groin flap can be an example, perhaps one of the most ideal donor sites with minimal morbidity but was difficult to use due to the short pedicle and pedicle with short diameter, now by using supermicrosurgery technique, superficial circumflex iliac artery perforator (SCIP) flap is ideal for soft tissue reconstruction that requires thin flaps . Small boutique flaps with small perforator and short pedicle can now be used without hesitation to reconstruct various defects of the hand, nose, toes, small facial defects (Figure ) . The classical flaps such as anterolateral thigh flap, deep inferior epigastric artery perforator flap, and others do not need a lengthy pedicle but only a short segment reducing the harvest time and proficiency of reconstruction.…”

Section: The Applicationsmentioning

confidence: 99%

Supermicrosurgery: Principles and applications

Hong

Song

Suh

2018

Journal of Surgical Oncology

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Supermicrosurgery is defined as microsurgery in less than 0.8 mm vessels. It is an evolved form of microsurgery but with the same principle: (1) enhanced working environment including microscopes and finer instruments; (2) detailed preoperative evaluation and planning; (3) supermicrosurgical technique; and (4) postoperative care.Supermicrosurgery now provides reconstructive solutions to address lymphedema, distal finger amputations, allows minimal invasive reconstruction using a perforator to perforator approach, and will eventually allow targeted customized reconstruction.application of supermicrosurgery, lymphedema, oncologic reconstruction, perforator to perforator supermicrosurgery, supermicrosurgery

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“…The temporal artery posterior auricular skin (TAPAS) flap, recently described by Lassus et al, 13,14 is a fasciocutaneous island flap harvested from the posterior auricular region and is based on the superior auricular branch of the superficial temporal artery crossing the superior aspect of the helix. The superior auricular branch of the superficial temporal artery was first described by Song et al 15 as taking a trajectory along the superior auriculo‐cephalic angle before terminating on the posterior surface of the auricle to anastomose with the posterior auricular arterial network.…”

Section: Introductionmentioning

confidence: 99%

“…The superior auricular branch of the superficial temporal artery was first described by Song et al 15 as taking a trajectory along the superior auriculo‐cephalic angle before terminating on the posterior surface of the auricle to anastomose with the posterior auricular arterial network. The TAPAS flap was originally described by Lassus et al 13,14 as a free flap used to restore small‐ to medium‐sized defects of the face and oral cavity. It was reported as having a safe skin paddle size of 70 × 40 mm 2 and a maximum pedicle length of 60 mm, without any venous congestion 13 .…”

Section: Introductionmentioning

confidence: 99%

Revisiting the temporal artery posterior auricular skin flap with an anatomical basis stepwise pedicle dissection for use in targeted facial subunit reconstruction

Ganry¹,

Ettinger

Rougier

et al. 2020

Head & Neck

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Background: This study demonstrates the anatomy of the pedicled temporal artery posterior auricular skin (TAPAS) flap, its variable arc of rotation based on stepwise dissection, and case reports demonstrating clinical use. This flap provides excellent color match and ultrathin tissue for targeted reconstruction of small-to medium-sized facial subunit defects. Methods: Twenty-six cadaver dissections were performed. The authors measured the reach and rotation limits of the flap in a pedicled fashion depending on a stepwise approach for vascular pedicle dissection. Two clinical cases demonstrating maximum arc of rotation are seen. Results: The pedicled TAPAS flap maximal rotation limits allow for reconstruction of facial subunits encompassing nearly the entire ipsilateral face. No venous congestion, wound complications, or partial/total flap loss were encountered with extreme clinical applications. Conclusion: The pedicled TAPAS flap has extensive versatility for reconstruction of a variety of facial subunit defects. The flap also has, in theory, multiple applications for intraoral reconstruction. K E Y W O R D S facial flap, facial reconstruction, head and neck, pedicle flap, TAPAS flap 1 | BACKGROUND The repair of small-to medium-sized defects of the head and neck can represent a challenging problem for surgeons when local soft tissue flaps do not provide adequate tissue volume or appropriate tissue quality to meet the desired reconstructive needs. In these instances, regional pedicled flaps or free tissue transfers become the reconstructive modalities of choice; however, reliance on distant donor sites can lead to mismatches in tissue color, texture, or bulk, which can lead to suboptimal function and contour of the reconstruction site. 1-3 In light of these considerations, multiple revision procedures are often required to further refine the reconstruction. 2

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More than just the helix: A series of free flaps from the ear

Abstract: As a versatile source of free flap options, the ear can provide more than just the helix.

Cited by 13 publications

References 28 publications

Reconstruction of a Large Full-Thickness Alar Defect Using an Extended Free Composite Flap from the Pinna: A Case Report

Reconstruction of a Large Full-Thickness Alar Defect Using an Extended Free Composite Flap from the Pinna: A Case Report

Supermicrosurgery: Principles and applications

Revisiting the temporal artery posterior auricular skin flap with an anatomical basis stepwise pedicle dissection for use in targeted facial subunit reconstruction

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