Indications for and Limitations of Reconstruction of Auricular Defects with the “Mid-moon Flap” and Evaluation of Outcome by the Aesthetic Numeric Analogue Score

Abstract

Summary: A variety of skin grafting techniques and local flaps have been described for medium-sized auricular defect reconstruction. Despite this, the reconstruction of a medium-sized auricular defect starting from the opposite surface is not yet reported in the literature. In the present article, the authors describe a novel surgical approach, the “mid-moon flap” technique, used for 87 patients in that kind of reconstruction. Eighty-seven patients presenting tumors located on the pinnal surface were enrolled in this study. The patient distribution included 68 men and 19 women, aged from 52 to 94 years, with a median age of 77.4 years. For all the patients, a customized cutaneous flap, named the mid-moon flap, was performed for auricular defect reconstruction. Histopathology reports confirmed the diagnosis of malignant tumors, with complete excision of the lesions in all cases. Follow-ups ranged from 6 to 36 months, with a mean of 18 months. There were no recurrences of the malignancy during the study, and the aesthetic outcome was globally considered good. The authors reported that the mid-moon flap technique is most appropriate for medium-sized auricular defects for two principal reasons: it covers the recipient area very well and, at the same time, leaves almost imperceptible relics on the donor area without causing any morphofunctional alteration of the ear.