Auricular reconstruction

1. EAR
RECONSTRUCTION
Dr. Moeez Fatima
R1 Plastic Surgery

7. PARTIAL ACQUIRED DEFECTS

8. 1) Good surgical solution.
2) The more superior the defect, the more choices there are for
reconstruction.
3) Reconstruction of the lobule is the most difficult & important.
4) Options: Closed by soft tissue alone.
Cartilage (Conchal, rib)
5) Small Defects.
6) Rules of Firmin.

9. STRUCTURAL SUPPORT
• Contralateral conchal graft.
• Ipsilateral conchal graft.
• Composite flap

10. Contralateral conchal graft.

11. Ipsilateral conchal graft

12. Composite flap

13. Composite flap

14. Specific Regional Defects

15. External Auditory Canal

16. HELICAL RIM DEFECTS

22. Upper-third auricular defects
• Minor Losses: Helical advancement.
• Intermediate Losses: Banner flap, as described by Crikelair
(anterosuperiorly in the auriculocephalic sulcus)
• Major losses: A contralateral conchal cartilage graft, as classically
described by Adams. A chondrocutaneous composite flap.

23. Middle-third auricular defects

24. Adjacent skin flap

25. Converse’s tunnel procedure

29. Lower-third auricular defects

30. Pardue’s ingenious adjacent flap

31. Benign Tumors of the auricle
• Sebaceous cysts.
• Actinic keratosis.
• Granuloma pyogenicum.
• Beryllium granuloma.
• verruca contagiosa.
• verruca senilis
• cylindroma,
• Nevus
• Papilloma
• Lipoma
• Lymphangioma
• Leiomyoma
• chondroma

32. Malignant tumors
• BCC
• SCC
• MM

33. Microtia

34. MICROTIA
• History.
• Incidence: 1/6000 births.
• Genetics:
• Asian ethnicity
• Twice as common among males as females.
• Twice as common on the right side compared with the left.
• Bilateral microtia occurs somewhere between 10% and 20% of
patients with microtia

35. Microtia in Hemifacial Microsomia

36. Classification
• Lobule type.
• Small concha type.
• Concha (with or without acoustic meatus)
• Anotia
• Atypical Microtia.

37. Surgical Reconstruction
1. Autogenous reconstruction.
2. Composite autogenous/alloplastic reconstruction using an
alloplastic ear framework.
3. Prosthetic reconstruction.

38. Autogenous Reconstruction.
• Brent technique
• Nagata technique