Single-Stage Transposition Flap Reconstructions of Surgical Defects of the Concha Cavum, Incisura, Antitragus, Antihelix, and Lobule.

Abstract

Background: Single-stage flap reconstruction of surgical defects of the anterior mid and lower ear can prove challenging due to a relative paucity of local and adjacent tissues. While staged flap options for such defects are well described, similar single-stage options are lacking.

Objective: The authors describe surgical techniques for the design and execution of single-stage local flaps to repair soft tissue defects on the concha cavum, incisura, antitragus, antihelix, and lobule after skin cancer extirpation.

Materials and methods: A retrospective review was conducted on single-stage transposition flaps used to repair soft tissue defects of the lower half of the anterior auricle following Mohs surgery. This study included cases performed by two surgeons (D.K. and S.K.) at a single institution from 2018 to 2024.

Results: Twenty-four cases utilizing single-stage transposition flaps for reconstruction of the mid to lower anterior auricular surface were performed. Intraoperative steps, modifications, and postoperative outcomes are discussed. No major complications were observed.

Conclusion: Single-stage transposition flaps are useful options for repairing defects of the mid to lower anterior ear, which are not amenable to primary closure, second intent healing, grafting, or in patients who are not candidates for multistage repairs. This technique offers reliable cosmetic outcomes without flap necrosis or other complications.