Conchal Flap Research Articles

Upper and middle third auricular reconstruction with a peninsular conchal flap

Background: Traumatic or iatrogenic full thickness auricular defects can be reconstructed in many ways. The defects exceeding 2 cm require challenging reconstruction techniques. The reconstruction options for those should include an- terior and posterior skin envelope repair with cartilaginous content. Providing color and texture match, while maintaining anatomic landmarks, should be considered. The outcomes of patients in which we used a peninsular conchal axial pattern flap (PCF) to reconstruct the composite defects of the auricle were outlined in this case series. Materials and Methods: Five patients with different etiologies were evaluated and operated with PCF between March 2012 and January 2015. The ages of the patients ranged from 21 to 91 years with a median age of 80. The mean follow-up period was 16.8 months. In PCF, the conchal subpart of the auricle was elevated as an axial pattern composite flap relied on the anastomotic connections between the superficial temporal artery and the posterior auricular artery. Donor sites were left to secondary healing. The statistical assessment was carried out with the Mann-Whitney U test. Results: The median age of the patients was 80 (21-91) years. The median percentage of flap survival was 100,00. The median operation duration was 92,00 minutes. Donor site epithelialization was 21 and 20 days in the first two patients, with a median of 20,5 days. In the latter three patients, a silver-containing dressing material was used prophylactically to suppress contamination by skin bacteria, which led to a decrease of the length of healing time to a median of 11,00 days, with a range of 3,00. Conclusion: PCF offers a one-stage procedure and can be used in the reconstruction of defects of the auricle exceeding 2 cm. The use of axial pattern peninsular conchal flap is recommended to all of our colleagues.

Repair of nasal septal perforation using middle turbinate flap (monopedicled superiory based bone included conchal flap): a new unilateral middle turbinate mucosal flap technique.

The purpose of this study is to present a new approach for treatment of nasal septal perforation using middle turbinate flap. A consecutive study with follow-up of 31 patients with nasal septal perforation treated using middle turbinate flap. All patients underwent an endoscopic repair of nasal septal perforation using middle turbinate flap. All patients were followed for 18-24 months. Complete closure of the perforation was achieved in 29 of the 31 patients. Complete failure of the repair was observed in two patients. All patients showed nasal crusting in varying degrees for a period of 2-4 weeks. None of the patients showed nasal obstruction or atrophic rhinitis symptoms (stuffy nose, purulent postnasal drip, nasal crusting, epistaxis and anosmia) in postoperative follow-up. This technique provides a new method with many advantages compared to other techniques for closure of septal perforations. IV.

A New Skin Flap Method for Total Auricular Reconstruction: Extended Scalp Skin Flap in Continuity With Postauricular Skin Flap and Isolated Conchal Flap

A sufficient skin envelope of good quality as well as definite auricular framework is a prerequisite for a successful auricular reconstruction. Various surgical techniques, such as recruitment of mastoid skin, skin graft, tissue expansion, and so on, have been used to get the necessary skin for covering of the auricular framework. However, debates about the drawbacks of these techniques have continued. In this article, I report on a new skin flap method for total auricular reconstruction, which is an extended scalp skin flap in continuity with postauricular skin flap and isolated conchal flap. Between January 2009 and March 2010, a total of 20 patients underwent an auricular reconstruction using a Medpor framework (Porex Surgical, Inc, Newnan, GA) and the new skin flap method. Follow-up time range was 4 to 17 months. The reconstructed ear showed no definite true hair growth except for some fine hair, which can be ignored. More favorable results such as a good color matched skin, well-formed ear convolution, no other donor site scars can now be achieved using this new method.

A long term follow up of conchal flap meatoplasty in chronic otitis externa

A long term follow up of conchal flap meatoplasty in chronic otitis externa

A long term follow up of conchal flap meatoplasty in chronic otitis externa

A long-standing diffuse chronic otitis externa can lead to itching. Resultant scratching may then lead to irreversible skin changes with canal stenosis by scar tissue. The poor ventilation and increased humidity gives rise to bacterial and fungal growths leading to breakdown of the skin defences and worsening itching. This vicious itching-scratch cycle or downward spiral often fails to respond to medical treatment. For these cases a simple conchal flap meatoplasty may improve ventilation of the external auditory canal and may lead to a self cleaning ear. We reviewed 84 patients who had undergone conchal flap meatoplasty in Calderdale and Huddersfield NHS Trust Hospitals from April 1993 to June 2002. A long-term follow up of conchal flap meatoplasty in chronic otitis externa showed no records of complications or further otitis in 93.2 per cent of cases. Thus surgical intervention plays an important role in the treatment of otitis externa not responding to treatment.

Conchal flap meatoplasty.

A meatoplasty technique is described which has proved successful in the treatment of chronic otitis externa. The procedure opens the superficial meatus by eliminating the sharp rim at the junction of the conchal bowl and the posterior canal wall cartilage; thinning the skin and increasing the circumference of the external auditory orifice.

Management of the External Auditory Canal in Skull Base Surgery

Transtemporal approaches to the skull base are being used with increasing frequency. When the external auditory canal is transected in the course of these operations, the risk of cerebrospinal fluid fistula is created. When hearing is to be sacrificed, we use a modification of the technique developed by Rambo for closure of the external auditory canal. This technique permits a cosmetically acceptable reliable watertight closure. When hearing is to be salvaged, we use a "conchal flap technique," which prevents circumferential scarring and stenosis and permits a watertight suture closure.

The conchal flap: an adjunct in otoplasty.

When the protruding ear is caused in whole or in part by an enlarged or abnormally angulated concha, the conchal set-back is a recognized technique in corrective surgery. The authors describe a modification of this procedure in which a posterior flap of cartilage, based laterally adjacent to the antihelix, is elevated and sutured to the mastoid process. The maneuver serves to bring the concha closer to the scalp and thus reduces the protrusion. The residual deformity in the conchal bowl, resulting from the development of this cartilage flap, is negligible. The authors stress the need for correct analysis of the original deformity and usually employ this maneuver in conjunction with a suture technique for creating or accentuating a poorly defined antihelix.