Reconstruction of a Superior Helical Rim Defect, Transposition Flap

Abstract

Skin cancer is common on the superior portion of the helical rim. Loss of the superior helical rim results in a flattening and shortening of the helix. If the defect is shallow and only involves the helical crus, volume can be restored with transposition flap from either the preauricular or postauricular skin. In many cases of basal cell carcinoma, the cartilage is unaffected or only partially removed. This will allow the flap to recreate the vertical height of the auricle, without cartilage grafting. However, if a large segment is removed or if a cartilage graft is required, a larger two-stage flap procedure would be indicated instead.