Auricular Reconstruction Techniques for Skin Carcinomas
Summary
Auricular reconstruction after excision of skin carcinomas presents unique challenges owing to the ear’s intricate three-dimensional form, limited local tissue availability and need to preserve cartilage support and vascular supply. Small defects may be managed by primary closure or second-intention healing when margins permit. Split-thickness and full-thickness skin grafts offer straightforward coverage of superficial defects but can compromise contour and pigmentation. Local flap techniques—including pre-auricular translocation flaps, post-auricular subcutaneous pedicle island flaps and the revolving door flap—exploit adjacent skin to restore form while maintaining reliable blood supply. Larger or composite defects often require cartilage reconstruction using autologous costal grafts or alloplastic frameworks, sometimes combined with regional flaps such as the temporoparietal fascia flap. Microvascular free-tissue transfer has a role in extensive resections, providing both bulk and pliability, but demands meticulous surgical expertise. Tissue expansion may precede reconstruction to optimise soft-tissue match in selected cases. Across all approaches, the balance between oncological safety, aesthetic outcome and preservation of auricular function guides technique selection. Advances in three-dimensional imaging and custom-made implants continue to refine personalised reconstruction pathways, with increasing emphasis on long-term patient-reported outcomes.
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Auricular Reconstruction Techniques for Skin Carcinomas publication trend
The graph below shows the total number of articles in auricular reconstruction techniques for skin carcinomas across all publications each year (not limited to Nature Index journals).
Technical terms
Auricular concha: The bowl-shaped central part of the external ear leading to the ear canal.
Revolving door flap: A local flap utilising periauricular skin on a central pedicle rotated into a conchal defect.
Subcutaneous pedicle island flap: A skin island with preserved subcutaneous blood supply tunneled from the post-auricular area.
Pre-auricular translocation flap: A flap raised from in front of the ear passed through the intertragic notch to cover a defect.
Split-thickness skin graft (STSG): A graft comprising epidermis and part of the dermis harvested for defect coverage.
Full-thickness skin graft (FTSG): A graft including the epidermis and entire dermis for more durable and pigmented repair.
References
- Reconstructive Procedures of the Auricular Concha after Cutaneous Oncologic Surgery: A Systematic Review. Journal of Clinical Medicine (2023).
- Reconstruction of auricular conchal defects with local flaps. Medicine (2016).
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