Reconstruction of full-thickness ear defects using conchal cartilage and pedicled temporoparietal fascia

Abstract

We describe method for reconstructing full-thickness ear defects using conchal cartilage graft covered by a pedicled temporoparietal fascial flap with a full-thickness skin graft. We treated eight partial, full-thickness defects of the ear in eight patients, two males and six females. The patients' ages ranged from 10 to 68 years. In five patients, the ear defects were caused by malignant tumor resection (three) and trauma (two). In the remaining three patients, the defect was created after correction of congenital ear deformity (constricted ear). In all cases, the defect included the helical rim and involved the upper third of the ear. The defect size to be reconstructed ranged from 10×14 mm to 16×20 mm. The ipsilateral conchal cartilage could be harvested without any problems in all cases. Grafted skin was obtained from the lower lateral abdomen. In all cases, the blood supply to the fascial flap was good, and the grafted skin took completely. The post-operative course was uneventful in all donor sites for cartilage, temporoparietal fascia, and full-thickness skin. Post-operative shrinkage was not significant and the reconstructed ear was close to the expected contour and size. In all cases, the defects were reconstructed almost completely satisfactorily in terms of contour of the helical rim and support. Although the color match of the grafted skin was not ideal, all patients were satisfied with the results. No donor deformity of the conchal cartilage was found in any case, and the donor scar of the temporoparietal fascia was hidden by the hair. We conclude that the use of conchal cartilage graft and temporoparietal fascial flap with full-thickness skin graft is useful in one-stage reconstruction of medium-sized full-thickness defects of the ear.