Nasal Alar Reconstruction With An Ear Helix Free Flap

EDITORIAL COMMENT

This procedure provides a very elegant reconstruction of the nasal alar region; however, the surgeon must be expert in microvascular techniques.

A vascularized chondrocutaneous free flap from the root of the auricular helix can serve as a solution to the problem of alar reconstruction. It is unlike local flaps that may result in additional facial scarring and bulky alae that require multiple thinning revisions. This flap produces satisfactory symmetry between the two alae and a good color match. The donor defect can be concealed with hair in female patients (1, 2, 3, 4, 5, 6, 7, 8, 9, 10).

INDICATIONS

The structural similarities between the alae and the auricular helices have allowed the use of free helical composite grafts to repair small nasal defects of less than 2.0 cm (11, 12, 13, 14, 15, 16). More recent delineation of the vascular territories of the ear has allowed the use of vascularized helical free flaps in the repair of large alar defects. With a chondrocutaneous microsurgical free flap from the root of the auricular helix, a successful reconstruction of a 3.2 × 3.0 cm full-thickness alar defect is possible.

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