Postauricular revolving door island flap: surgical option to concha squamous cell carcinoma

The postauricular revolving door island flap is one versatile option that may be used to reconstruct the auricular concha of the ear after remove a squamous cell carcinoma. The technique has been described as an immediate one-stage elegant reconstructive procedure for closure of anterior auricular defects, simple and safe to perform with early excellent cosmetic results. A 71-year-old female Portuguese patient with Squamous Cell Carcinoma in left auricular concha and the external auditory canal is reported. Cutaneous squamous cell carcinoma is the second most common cancer of the skin in the United States. In the ear, this type of cancer because of its location is high risk and has a high possibility of metastasis. The tumor was completely excised including the cartilage. The surgical defect was reconstructed with Postauricular Revolving Door Island Flap based on the post auricular vessels. A full thickness design is made considering the defect, the flap is maintained to a subcutaneous central pedicle and is passed through the anterior window to resurface the anterior ear. This case demonstrates the use of the postauricular (revolving door) island pedicle flap for cover large anterior ear defects with loss of cartilaginous support and illustrates how the flap improve ear contour after resection successfully.

Circular local skin flap: a new approach to areola reconstruction

PURPOSE: Despite the numerous surgical options available today for nipple-areola reconstruction, the results are often unsatisfactory. The present study proposes a simple and efficient method for areola reconstruction that uses a circular local skin flap. METHODS: We prospectively followed five patients that underwent areola reconstruction using a circular local skin flap. A circle, approximately 5 cm in diameter, was marked on the desired area for the new areola. A thin centripetal undermining of 1.5-2 cm was performed, which created a flap with a central pedicle of approximately 1-2 cm. After hemostasis, the thin flap was fixed in its former position with continuous sutures. RESULTS:The mean procedure time was 20 minutes (± 9). The postoperative results were classified as satisfactory by four of the five patients at six months postoperative. Due to superficial undermining, the resulting scar resembled the appearance of the transition from the mammary skin to the areola. Dermopigmentation was only required in one areola. No complications such as dehiscence, necrosis, hematoma, or infection occurred. CONCLUSION: This technique achieved satisfactory results with low morbidity and few complications, and is thus a potentially promising resource for areola reconstruction.