New Posterior Auricular Perichondrial Cutaneous Graft for Stable Reconstruction of Nasal Defects

Abstract

The perichondrial cutaneous graft (PCCG), a reliable composite graft that provides stability, is routinely harvested from the anterior conchal bowl. This established PCCG was simplified by using the less conspicuous posterior auricular donor site, which can be closed without the need of cartilage resection for reconstruction with a postauricular interpolated skin island. Patients with basal cell carcinoma of the nose underwent reconstruction of the nose with a PCCG if parts of the tip cartilage or the fibrofatty tissue were resected. The defect surface area was assessed with a template. Follow-up evaluation included assessment of graft survival, donor-site morbidity, nostril stability, and aesthetic outcome. Of the 14 patients included in the study, whose average defect sizes were 2 cm² (ala) and 2.5 cm² (tip), 79% showed primary complete healing. Nostril stability was symmetrical 6 months postoperatively, and no contractions or depressed contour had occurred. In one case, a hyperpigmented area resulted in a slightly imperfect color match. All the donor sites healed without deformity or destabilization of the ear. With the use of this new posterior auricular donor site for graft harvest, functional, stable, and aesthetic reconstruction of the nose can be achieved. The graft- and donor-site morbidity rates are very low, and the results are fully satisfying.