Youn Seungki, Kim Youn Hwan, Kim Jeong Tae, Ng Siew-Weng
Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, South Korea.
J Craniofac Surg. 2011 Mar;22(2):635-7. doi: 10.1097/SCS.0b013e318208545e.
The retroauricular flap has many applications, providing coverage for various portions of the face as a pedicled flap or a free flap. The retroauricular skin, having similar attributes to the facial skin, is an ideal donor site for facial reconstruction. Also, the donor site can be primarily closed without morbidity, which is also an advantage. In this article, a large helical defect resulting from a traumatic amputation was reconstructed using the contralateral conchal cartilage graft and a retroauricular perforator-based island flap. Using the "perforator pedicled propeller flap" concept, no meticulous dissection around the perforator was done, and the flap was elevated only until sufficient rotation arc was achieved. There was some degree of venous congestion on the flap for 3 days postoperatively, but the flap survived completely. By using the conchal cartilage from the contralateral side, the final contour of the ear was maintained aesthetically. The flap had some bulkiness on the posterior side of the auricle where it was transposed, but it was inconspicuous on frontal or lateral view because the conchoscaphal angle had not changed. The patient was satisfied with the aesthetic results. The retroauricular flap is useful for resurfacing any portion of the ear, and by using the propeller flap method, significant reduction in operative time can be achieved without compromising the final results.
耳后皮瓣有多种应用，可作为带蒂皮瓣或游离皮瓣为面部的不同部位提供覆盖。耳后皮肤与面部皮肤具有相似的特性，是面部重建的理想供区。此外，供区可直接缝合而不产生并发症，这也是一个优点。在本文中，使用对侧耳甲软骨移植和基于耳后穿支的岛状皮瓣修复了因创伤性截肢导致的大面积耳轮缺损。采用“穿支蒂螺旋桨皮瓣”概念，未对穿支周围进行精细解剖，仅将皮瓣掀起至获得足够的旋转弧度。术后3天皮瓣出现一定程度的静脉淤血，但皮瓣完全存活。通过使用对侧耳甲软骨，从美学角度维持了耳部的最终外形。皮瓣在转移至耳郭后侧处略显臃肿，但从正面或侧面观并不明显，因为耳甲颅角未改变。患者对美学效果满意。耳后皮瓣可用于覆盖耳部的任何部位，采用螺旋桨皮瓣法可显著缩短手术时间且不影响最终效果。
