External auditory canal reconstruction following subtotal auricular resection with a tragal lobule wrap flap

Abstract

Different etiologies may lead to total auricular and external auditory canal wall ablation. These include burns, tumors, trauma, and malformations. Reconstruction of the canal wall and maintaining its patency pose as a great challenge in plastic surgery. Inability to do so may lead to a serious hearing impairment. To date, different procedures aim at restoring this patency and include skin grafts and local flaps. Unfortunately, skin grafts are associated with a high contracture rate. Local flaps are associated with donor site morbidity. We present a case of an 85-year-old man who underwent auricular ablation due to squamous cell carcinoma which included the external auditory canal. Sparing the tragal and lobular areas within the surgical margins using frozen section-controlled margins, we were able to reconstruct the canal wall. The tragal lobular wrap flap provides a valuable and consistent long-lasting method for auricular canal reconstruction and postauricular amputation wound coverage.