EDUCATIONAL OBJECTIVE: At the conclusion of this presentation, the participants should be able to understand the technique and its potential complications.

OBJECTIVE: To review a series of auricular reconstruction cases in which the helical advancement flap was utilized.

DESIGN: Case series.

SETTING: University medical center and private practice.

PATIENTS: 78 consecutive patients with auricular defects, resulting from oncologic resection, in whom reconstruction with a helical advancement flap was suitable.

INTERVENTION: Helical advancement flap by a single surgeon (W.H.L.).

MAIN OUTCOME MEASURE: Viability of the flap and presence or absence of surgical complications.

RESULTS: There were no complete flap failures. Partial necrosis of the distal end of the flap was observed in 2 smokers (2.6%). One patient required revision of the flap (1.3%). Hematoma occurred in 4 patients (5.1%), with 3 cases requiring a return to the operating room for control of bleeding. Infection developed in two patients (2.6%). Hypertrophic scarring was noted in 5 patients (6.4%), which responded to limited steroid injections. Contour deformities, including collapse or flattening of the helical rim, was not observed.

CONCLUSION: The helical advancement flap is a reliable tool in the reconstructive armamentarium of the facial plastic surgeon.