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An Alternative Posterosuperior Auricular Fascia Flap for Ear Elevation During Microtia Reconstruction

  • Original Article
  • Face and Neck Surgery
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Advances in staged total auricular reconstruction have resulted in improved anterior auricular appearance; however, satisfactory postreconstruction esthetics of the retroauricular fold remain challenging. The postauricular appearance of the reconstructed ear depends largely upon optimizing the covering material. When used as the covering soft tissue for ear elevation, a flap containing primarily the upper portion of the retroauricular fascia has potential advantages over the conventional book cover-type retroauricular fascia flap.

Methods

We developed a geometrically designed, posterosuperior auricular fascia flap to replace the conventional retroauricular fascia flap for ear elevation. During the second-stage operation, the posterosuperior auricular fascia flap is rotated downward and turned over to wrap around the inner strut and entire posterior auricular surface.

Results

Compared to the conventional book cover-type retroauricular fascia flap, the novel posterosuperior auricular fascia flap was easier to harvest and the operative time significantly decreased (110.3 vs. 121.5 min, p < 0.01). The modified flap produced a thin and natural contour of the postauricular surface, as well as reduced the incidence of postauricular hypertrophic scarring (from 24.7 to 13.2%, p = 0.03) and partial skin graft necrosis (from 43.4 to 31.2%, p = 0.01).

Conclusion

The geometrically designed posterosuperior auricular fascia flap improves ear elevation. Compared to the conventional book cover-type retroauricular fascia flap, this covering tissue is easier to perform so the surgical time is decreased. It was highly vascularized, well defined, thinner, and yields reliable results. Thus, favorable postauricular surface results can be achieved during auricular reconstruction by using the modified fascia flap.

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Acknowledgements

None of the authors has a financial interest to declare in relation to the content of this article.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai JiaoTong University School of Medicine, No. 639, Zhi Zao Ju Rd., Shanghai, 200011, China

    Yiyuan Li, Ruhong Zhang, Qun Zhang, Zhicheng Xu, Feng Xu & Datao Li

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  1. Yiyuan Li
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  2. Ruhong Zhang
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  3. Qun Zhang
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  4. Zhicheng Xu
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  5. Feng Xu
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  6. Datao Li
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Correspondence to Ruhong Zhang.

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Li, Y., Zhang, R., Zhang, Q. et al. An Alternative Posterosuperior Auricular Fascia Flap for Ear Elevation During Microtia Reconstruction. Aesth Plast Surg 41, 47–55 (2017). https://doi.org/10.1007/s00266-016-0743-5

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  • DOI: https://doi.org/10.1007/s00266-016-0743-5

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