Superior Auricular Artery Fascial Flap for Second Stage Microtia Reconstruction

Abstract

INTRODUCTION: The prevalence of microtia is high among the population, and 2-stage costochondral reconstruction using the Nagata technique is widely accepted. The second stage includes elevation of the previously carved framework to create the postauricular sulcus. Many techniques were described. The use of mastoid retroauricular fascia based on the superior auricular artery, not used previously up to our knowledge for microtia second stage frame elevation. AIM OF THE STUDY: Using the mastoid fascia based on the superior auricular artery for the second stage of microtia elevation, evaluating the viability of the flaps and long-term results of the reconstructed ear and postauricular sulcus. PATIENTS AND METHODS: Twenty patients underwent first-stage microtia reconstruction with costochondral cartilage graft, prepared for second-stage frame elevation, using the fascial flap from the mastoid area based on the superior auricular artery as a pedicle for the superiorly based fascial flap. RESULTS: The retroauricular and mastoid fascial flap based on the superior auricular artery was a good option, with uneventful results regarding flap viability and very minimal donor site morbidity; the artery is present in the majority of cases (90%). CONCLUSION: Superior auricular artery-based postauricular fascia flap covered with skin graft is a reliable option for the second stage microtia reconstruction with fine aesthetic outcomes, less donor site morbidity, and keeps the temporoparietal fascia (TPF) intact as a backup plan. LEVEL OF EVIDENCE: Level II-therapeutic study.