Reconstruction of a Helical Rim Defect

Abstract

A 57-year-old Caucasian man presented for treatment of a biopsy-confirmed invasive squamous cell carcinoma on the right ear helix. Two stages of Mohs micrographic surgery were required to extirpate the tumor. The resulting surgical defect measured 2.2 Â 0.8 cm (Figure 1). The patient strongly preferred a single operative reconstruction. How would you reconstruct this defect?

Chondrocutaneous helix rim advancement flap: two classical and two new modifications for very large defects of the ear

“…A comparable modification for a much smaller defect and, therefore, only a one-sided CHRAF, was published by Fangman et al 8 Given that the ear of the patient is not too small, reconstruction of helix rim defects up to the one-half of the ear with our double CHRAF wedge excision flap is possible. Of course, the height reduction is significant but the anatomical contour of the ear and, therefore, the aesthetic outcome and the function, can be mainly preserved.…”

Modified Antia Buch Repair for Full-Thickness Middle Auricular Defect

“…4 With the addition of a Burrow's triangle, greater advancement of the chondrocutaneous flap is achieved. 5 With the addition of an incision in the helical root and closure as a V-Y advancement, additional length can be obtained for closure of the helical rim. We demonstrate that a large defect of the vertical part of the helical rim can be closed using this modified Antia Buch reconstruction.…”

“…Several modifications of this technique have been reported, but these were all upper pole defects . With the addition of a Burrow's triangle, greater advancement of the chondrocutaneous flap is achieved …”

Helical Rim Advancement Flap with an Additional Postauricular Skin Flap: A Case Report

“…Firstly, the V-Y advancement of the superior helical segment was designed [4,7] to allow increased flexibility of the flap. Then the tricone at the base of the inferior flap was excised [8] to prevent a cutaneous dog-ear deformity. Finally, cutaneous flap extensions from the anterior surface were designed to cover the exposed cartilage [9].…”