Tubed flap interpolation in reconstruction of helical and ear lobe defects.

Abstract

A useful reconstructive tool, as a delayed method, for marginal defects of the ear of more than 2.5 cm wide with no deficit of the cartilaginous frame and low scapha involvement, consists of tubed flaps raised from neighboring areas. The patients treated with this technique sustained a dog bite in three cases, a human bite in one case, a motorcycle accident in one case, and finally, a burn trauma in two cases. Three different cases of acquired marginal defects, namely ascending superior helix, descending helix, and cauda elicis with lobule involvement, are shown. In the helix reconstruction, the tube width has not to be more than 15 mm, and the tube length has to be 1 cm longer than the defect. There was no conditioning of the flaps. No pedicle bridge was interposed along the major tube. The interval between two divisions was on average approximately 5 weeks. Seven patients were treated with this technique: In all cases, we had no infections or skin necrosis. To avoid a shrinkage of the tube, a correct ratio between flap dimensions and helical defect has to be estimated. Although it is considered an old technique and it is a multistage reconstructive sequence, this procedure could be the first preference in cases of marginal defects more than 2.5 cm wide. This is because it restores naturally the anatomy of the helix.