Two-Step-Reconstruction of Non-Marginal Auricular Defects

Abstract Objective Auricular reconstruction is an extensively discussed topic in facial reconstructive surgery and poses an immense challenge to the reconstructive surgeon. In this article we present a two-stage-technique to repair non-marginal, full-thickness defects of the auricle. Method A total of 13 patients were operated after partial to complete loss of auricular concha using an improved and refined method to that described before. Tissue from pre- and retro-auricular regions was used to replace non-helical auricular tissue loss in two surgical steps. All procedures were performed in an ambulatory setting using local anaesthesia. Results All 13 operated patients (age range 37-82; mean age 68; women/men 4/9) had excellent aesthetic outcomes with low surgical morbidity and were satisfied with the achieved results. No flap necrosis was observed. Auricular vertical and horizontal size changed minimally (0-4 mm). A tension free closure of donor site defects could be achieved primarily. Conclusion The method presented uses two separate donor sites to reconstruct centrally located, full-thickness defects of the auricle. It is simple to perform, reduces the surgical steps required, shows excellent outcomes and additionally the donor site can be closed easier due to the distribution of the harvested tissue.