The Chondrocutaneous Helical Rim Advancement Flap of Antia and Buch

Abstract

The cutaneous surgeon commonly encounters defects of the helix, as 2-4% of all skin cancers occur at this site. We report our experience with 47 patients using the chondrocutaneous helical rim advancement flap of Antia and Buch. Incisions are made from the defect inferiorly into the lobule and, when necessary, superiorly along the helical sulcus into the helical crus. The postauricular skin is extensively undermined to allow maximal movement of the resulting broadbased, well-vascularized flap(s). We experienced very favorable results using this technique with our patients. No necrosis due to ischemia occurred in any of our cases. Hematomas formed postoperatively in two patients, but healing proceeded uneventfully after removal of coagulated blood. This technique is an excellent method of repairing many defects of the helical rim. Its advantages include technical simplicity, little risk of tip necrosis, patient convenience, and superior cosmesis.