Full thickness advancement flap to reconstruct large helical rim

Auricular reconstruction of partial ear defects is usually challenging, especially in extended resections or traumas. Helical rim is the most noticeable part of ear with aesthetic significance, which demands detailed procedures. Helical rim advancement is a known procedure to reshape lacerated rim. In the original technique, a chondrocutaneous flap is raised in order to preserve the posterior skin and consequently, the blood supply.

Due to auricle’s rich blood supply, we selected an inferiorly based flap of helical rim, which we incised completely, even the posterior skin, in order to advance the flap more freely to the cephalic side and relaxed cephalically. In five patients with helix tumors, this reconstructive procedure was done without threatening the blood supply and flap ischemia. Moreover, posterior skin traction or subsequent deformity, as one of concerns of reconstructive surgeons, were also eradicated.

It appears that this modification can be noteworthy in auricular reconstruction.