Reconstruction of Defects in the Concha and Antihelix Following Oncologic Resection Using a Revolving Door Flap

Reconstruction of conchal and antihelical defects following oncologic resection is challenging due to the complex three-dimensional anatomy and limited local tissue.We report a case of recurrent basal cell carcinoma involving the cavum concha and antihelix in a 75-year-old man.Following complete excision with Mohs micrographic surgery, a significant full-thickness defect was created.A postauricular island flap (revolving door flap) based on the posterior auricular artery was elevated and transposed anteriorly through a cartilaginous window.Unlike skin grafts, this flap provided sufficient soft tissue volume to compensate for the lost cartilage, restoring the natural auricular contour and preventing depression deformity.The postoperative course was uneventful with no flap necrosis.At 1-year follow-up, the patient demonstrated excellent aesthetic outcomes with preserved external auditory canal patency and no tumor recurrence.The revolving door flap is a reliable option for reconstructing complex auricular defects, offering superior vascularity and structural stability.