Reconstruction of extensive defects involving the entire upper third of the auricle: A case report

The auricle represents a complex anatomical region. Over the years, various techniques have been proposed for the reconstruction of different anatomical regions of the auricle. Defects in the upper third of the ear less than 3 cm wide can be reconstructed with superior and inferior pedicle flaps harvested from the postauricular region. In our Plastic Surgery department we have treated a patient with a 3.5 cm wide squamous cell carcinoma involving all the upper third of the pinna excluding helix. The patient had many comorbidities and asked for a safe reconstruction with low risk of local complications and the possibility to use glasses. For this reason we excluded the option of a superior de-epithelized pedicled post auricular flap that has got a high risk of venous congestion for defects more than 3 cm wide and performed a wide post auricular island flap with subcutaneous pedicle. At the seven-day follow-up, there was an absence of signs of venous congestion. At the six months follow-up, the patient reported satisfaction with the result and had no issues wearing glasses. Post auricular island flap with subcutaneous pedicle can be considered as an alternative in case of auricle upper third defects more than 3 cm wide.