ABSTRACT

Purpose: The retroauricular flap has many advantages for facial reconstruction and is being performed by many surgeons. However, it is difficult for the retroauricular flap to perform reconstruction of the upper region of the auricle and its surroundings, because of the rotation arc and length of pedicle. We successfully reconstructed the upper region of the auricle and its surroundings with retroauricular flap by using the superior auricular artery as the pedicle. The purpose of this study is to present an anatomic study about the superior auricular artery and its clinical application.

Methods: We investigated the relationship between the superior auricular artery and its surrounding structures through anatomic studies with 7 fresh cadavers and then applied the findings clinically. From February to December 2008, we performed 7 cases with the superior auricular artery island flap to reconstruct the defects as a result of a skin cancer. Sizes of the defects varied form 0.8 • 0.8 cm to 3.5 • 3.0 cm.

Results: We found that the superior auricular artery is a reliable pedicle for the retroauricular flap, based on anatomical studies. All wounds of the patients were successfully closed. The flap donor site was primary closed except one patient with a large defect. The aesthetic outcomes of the donor and recipient sites were satisfied.

Conclusions: The superior auricular artery island flap has several advantages. Therefore, we suggest that the superior auricular artery island flap is a treatment of choice for reconstructing soft tissue defect at the upper region of the auricle and its surrounding area.

Table I.

Patient	Age/Sex	Etiology	Location	Defect Size (cm)	Donor site Closure Method	Complications / Secondary Procedure
1	80/F	SCC	Preauricule, Rt.	1.5•2.0	Primary closure	None
2	84/F	SCC	Helix, Lt.	0.8•0.8	Primary closure	None
3	51/F	BCC	Scapha fossa, Rt.	1.5•1.2	Primary closure	None
4	52/F	EOSC	Preauricle, Rt.	2.5•2.0	Primary closure	None
5	44/F	BCC	Preauricle, Rt.	3.0•3.5	Skin graft	Partial flap necrosis / None
6	68/M	BCC	Temple, Lt.	2.0•2.0	Primary closure	None
7	74/F	SCC	Temple, Lt.	2.3•2.5	Primary closure	None

SCC, squamous cell carcinoma; BCC, basal cell carcinoma; EOSC, extraocular sebaceous carcinoma.

Fig. 1.

Fig. 2.

Fig. 3.

Fig. 4.

Fig. 5.