OP4: Posterior Auricular Perichondrial Cutaneous Graft for Stable Reconstruction of Nasal Defects: Long-Term Outcomes

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INTRODUCTION: The posterior auricular perichondrial cutaneous graft (PCCG) was described in 2005 by Kalbermatten et al. as a functional, stable and aesthetic reconstructive option in case of cartilage or fibrofatty tissue defects of the nasal tip or ala. The composite graft is harvested using a posterior auricular donor site which is closed with a postauricular transposition flap, thus avoiding resection from the anterior conchal bowl. The present study aims at reporting long-term outcomes of the procedure. MATERIALS AND METHODS: We conducted a retrospective review of all patients undergoing nasal tip reconstruction with PCCG between 2005 and 2020. Graft survival, donor-site morbidity, nostril stability, reoperation rate and aesthetic outcomes were assessed at long follow-up. RESULTS: We identified 13 patients undergoing PCCG nasal reconstruction to cover defects presenting an average size of 2 cm2 on the ala and 2.5 cm2 on the tip after basal cell carcinoma resection. Twelve patients showed primary complete healing, while reoperation was required in one case due to partial necrosis of the graft. At a mean follow-up of 14.5 months, nostril stability and symmetry were achieved in all patients, while all donor sites healed uneventfully. Aesthetic outcomes were judged as satisfactory by both patients and surgeons. Oncological control was ensured by this reconstruction, allowing detection of relapse in three cases. CONCLUSION: This follow-up study confirmed the findings initially presented with a shorter 6months follow-up. The PCCG demonstrated to be a reliable and effective reconstructive option, able to restore function and aesthetic with minimal morbidity rate. Notably, the procedure allows optimal oncological control.