Superior temporo-auricular perforator flap for reconstruction of extensive conchal defects

Anterior auricular concha reconstruction has always been a challenge for the plastic surgeon. The goal of optimal reconstruction is to achieve a natural aesthetic outcome taking care to avoid meatal stenosis and distortion. We present a new technique for reconstruction of large anterior conchal defects with meatal involvement using a perforator flap harvested from the superior auricular region. All patients undergoing post-oncological reconstruction with superior temporo-auricular perforator flap were retrospectively analysed. A handheld Doppler evaluation was performed prior to surgery. Follow-up at 1, 3, 6 and 12 months was carried out. Nine patients were evaluated. No partial or total vascular complications were observed. No relapse of the tumour and meatal stenosis developed. Eight patients were very satisfied with the aesthetic outcome. Only one patient was not completely satisfied due to the presence of hair at the level of reconstructed site. The superior temporo-auricular flap is a good alternative to flaps harvested from the retro-auricular region and should be considered as a primary choice for reconstruction of extensive defects of the conchal and external meatus area.