A Novel Technique for Reconstruction of a Congenitally Absent Earlobe

Objective: Congenital anomalies of the external ear may present a reconstructive challenge, particularly when normal chondrocutaneous components of the auricle fail to develop. Our goal was to develop a novel technique for lobule reconstruction of a congenitally absent earlobe with photographic documentation of the technique. Methods: Informed consent for perioperative photography and publication of case details was obtained. A postauricular, turnover flap with ipsilateral conchal cartilage grafting was performed to reconstruct the lobule, and a superiorly based, postauricular, rotation advancement flap was used to close the donor site defect. Results: Perioperative photographs are included demonstrating technique and cosmetic results. Conclusions: Malformations rarely involve the lobule or lower third of the ear primarily. Literature regarding lobule reconstruction for congenital malformations is scarce. We present a novel technique for lobule reconstruction of a congenitally absent earlobe performed in a single stage that avoids a visible neck scar and allows for simultaneous conchal cartilage harvest. The technique demonstrated satisfactory cosmesis regarding contour and overall appearance and these results remained stable at 1-year follow up.

The Value of Titanium Mesh in Cranio-Maxillofacial Reconstructive Surgery

Cranio-maxillofacial defects are often challenging to reconstruct due to the difficulty of selecting the most appropriate material for the individual case while ensuring good outcomes with minimal complications. The chemical properties of titanium regarding biocompatibility coupled with the physical properties of the mesh design, make titanium mesh an optimal material that is increasingly used in reconstructive surgery. We present our experience regarding the use of titanium mesh for the reconstruction of 14 cranio-maxillofacial bone defects of various etiologies, including 8 defects following oncologic resection, 4 posttraumatic sequelae defects, one osteofascial flap donor site defect and one defect following treatment for osteomyelitis. The advantages and disadvantages of this reconstructive method are discussed.

Plantar Flap for Foot Reconstruction

The medial plantar flap is an axial pattern flap from the non–weight-bearing area of the sole of the foot between the heel and the metatarsal heads. The flap can be raised as a pedicle or a free flap, based on either the medial or lateral plantar arteries, or both. Sensory function is provided by branches of the medial plantar nerve. The donor site defect in the foot has caused no difficulty except for occasional marginal hyperkeratosis.