Chondrocutaneous Advancement Flap to The Helical Rim



Chondrocutaneous Advancement Flap to The Helical Rim


N. H. ANTIA





Many acquired defects of the ear involve small segments of the helical margin, usually less than a quarter of the circumference of the ear. Such defects commonly result from the excision of tumors such as basal cell carcinoma or burns. Although small, the defect is very noticeable, especially in men. The chondrocutaneous advancement flap is a relatively simple and safe single-staged operative procedure that provides an almost normal contour to the ear (1, 2).




FLAP DESIGN AND DIMENSIONS

The principle underlying this procedure is that of advancement of the adjacent intact helical margin as a chondrocutaneous flap based on a wide postauricular skin pedicle. The ear lobule, which can be quite variable in size, is also advanced upward with this procedure.

If the defect is large, involving 3 to 4 cm of the helix, a double chondrocutaneous advancement of the helix can be performed by including the intact cephalic segment of the helix as a second flap (Fig. 83.1). It is important to extend the triangular tail of this flap right into the depth of the concha so that even after advancement the pleasing question mark shape of the helix is preserved. When such a large defect is closed by this technique (as shown in Fig. 83.2), it is often necessary to reduce the size of the contralateral ear to provide earlobe symmetry.

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Jun 26, 2016 | Posted by in General Surgery | Comments Off on Chondrocutaneous Advancement Flap to The Helical Rim
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