Review of helical rim reconstruction techniques
Abstract Introduction and objective: In this article we review the results of the reconstruction of the helical rim defects after the removal of the skin cancer. We Analyze the different methods of reconstruction and treatment modalities. Method: Narrative review in PubMed databases and search strategy: (((((((helical rim) OR helix)) AND defects) AND reconstruction) AND skin cancer. 46 articles were obtained in English or Spanish from which were selected 19 for the qualitative study. Results: More than half were reconstructed by simple single?step techniques; others required several reconstruction times. Discussion: There are several methods of surgical repair of helical rim defects. Small defects can usually be closed primarily with various wedge resections. For medium-sized defects, chondrocutaneous advancement flaps. Large defects typically need bipediculated tubing flaps or a temporoparietal fascial flap with skin and cartilage grafts. Conclusions: This mini review summarizes various reconstruction options for defects involving helical rim defects, facilitating rapid decision for surgeons according to the nature of the defect.
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Bochnia F. Staged retroauricular flap for helical reconstruction after Mohs micrographic surgery. An Bras Dermatol. 2016;91:S144-7. https://doi.org/10.1590/abd1806-4841.20164733. PMid:28300924 PMCid:PMC5325023
Brodland DG. Auricular reconstruction. Dermatol Clin. 2005;23(1):23-41. https://doi.org/10.1016/j.det.2004.08.008. PMid:15620617
Butler C. Single- stage reconstruction of middle and lower third helical rim defects using chondrocutaneous helical rim and lobular advantacement flaps and scaphal reduction cartilage graft. Ann plast surg. 2007;122:463-7. https://doi.org/10.1097/PRS.0b013e31817d6098. PMid:18626362
Chung S, Feintisch A, Lee E. Helical Rim Reconstruction: Antia-Buch Flap. Eplasty. 2015;15: ic55.
Crisan D, Schneider A, Kastler S, Scharffetter M, Veit J. Surgical management of skin cancer and trauma involving the middle third of the auricle.JDDG. 2017;16:694-701. https://doi.org/10.1111/ddg.13544_g. https://doi.org/10.1111/ddg.13544. PMid:29873914
Elsahy NI. Acquired ear defects. Clin Plast Surg. 2002;29(2):175-86. https://doi.org/10.1016/S0094-1298(01)00002-5
Fangman W, Stoer C. Reconstruction of a helical rim defect. Dermatol surg. 2010;36: 245-9. https://doi.org/10.1111/j.1524-4725.2009.01399.x. PMid:20002639
García B, Sempau L, Rodríguez M. Escisión en cuña del pabellón auricular: cómo evitar una escotadura en el borde del hélix. Actas Dermosifiliorg. 2009;100:817-32. https://doi.org/10.1016/S0001-7310(09)72563-3
Graybill T, Richardson T. Repair of large helical rim defect. Dermatol Surg. 2001;27(6):601-3. https://doi.org/10.1046/j.1524-4725.2001.01019.x. https://doi.org/10.1097/00042728-200106000-00020. PMid:11442603
Hafner J,Mohrle M, Loeser CR. Retroauricular pedicled flap for reconstruction of large helix and antihelix defects. J Dtsch Dermatol Ges. 2016;147:753-5. https://doi.org/10.1111/ddg.13073_g. https://doi.org/10.1111/ddg.13073. PMid:27373263
Imahiyerobo J, Carucci J. Repair of a defect of the helical rim. Dermatol Surg. 2009;35(3):509-12. https://doi.org/10.1111/j.1524-4725.2009.01071.x. PMid:19243400
Krunic A, Weitzul S, Taylor S. Chondrocutaneous advancement flap for reconstruction of helical rim defects in dermatologic surgery. Australian Journal of dermatology. 2006;47:296-9. https://doi.org/10.1111/j.1440-0960.2006.00299.x. PMid:17034477
Levin B, Adams L, Becker G. Healing by secondary intention of auricular defects after Mohs surgery. Arch Otolaryngol Head Neck Surg.1996;122(1):59-69. https://doi.org/10.1001/archotol.1996.01890130051008. PMid:8554748
Low DW. Modified chondrocutaneous advancement flap: a technique for the ear reconstruction. Plat Reconstr Surg. 1998;102:174-7. https://doi.org/10.1097/00006534-199807000-00028
Morán K, Cabrera A, Cardona M, Medina A, Alcalá D, Torres S, et al. Te?cnicas de reconstruccio?n ba?sicas del pabello?n auricular por padecimiento dermatooncolo?gico. Dermatol Rev Mex.2015;59:310-6.
Olshinka A, Dean A. Repair helical rim cutaneous defect. Dermatol surg. 2017;43:134-7. https://doi.org/10.1097/DSS.0000000000000691. PMid:27153038
Randonich M, Zaher M, Bisaccia E, Scarborough D. Dermatol surg. 2002;28:62-5. https://doi.org/10.1046/j.1524-4725.2002.01051.x. PMid:11991274
Valesky E, Kaufmann R, Meissner M. Chondrocutaneous hélix rim advancement flap: two classical and two new modifications for very large defects of the ear. J Eur Acad Dermatol Venereol. 2015;29(11):2248-51. https://doi.org/10.1111/jdv.12778. PMid:25338650
Zilinsky I, Erdmann D, Weissman O, Hammer N, Sora M, Schneck T, et al. Reevaluation of the arterial blood supply of the auricule. J. Anat. 2017;230:315-24. https://doi.org/10.1111/joa.12550. PMid:27726131 PMCid:PMC5244454
Brodland DG. Auricular reconstruction. Dermatol Clin. 2005;23(1):23-41. https://doi.org/10.1016/j.det.2004.08.008. PMid:15620617
Butler C. Single- stage reconstruction of middle and lower third helical rim defects using chondrocutaneous helical rim and lobular advantacement flaps and scaphal reduction cartilage graft. Ann plast surg. 2007;122:463-7. https://doi.org/10.1097/PRS.0b013e31817d6098. PMid:18626362
Chung S, Feintisch A, Lee E. Helical Rim Reconstruction: Antia-Buch Flap. Eplasty. 2015;15: ic55.
Crisan D, Schneider A, Kastler S, Scharffetter M, Veit J. Surgical management of skin cancer and trauma involving the middle third of the auricle.JDDG. 2017;16:694-701. https://doi.org/10.1111/ddg.13544_g. https://doi.org/10.1111/ddg.13544. PMid:29873914
Elsahy NI. Acquired ear defects. Clin Plast Surg. 2002;29(2):175-86. https://doi.org/10.1016/S0094-1298(01)00002-5
Fangman W, Stoer C. Reconstruction of a helical rim defect. Dermatol surg. 2010;36: 245-9. https://doi.org/10.1111/j.1524-4725.2009.01399.x. PMid:20002639
García B, Sempau L, Rodríguez M. Escisión en cuña del pabellón auricular: cómo evitar una escotadura en el borde del hélix. Actas Dermosifiliorg. 2009;100:817-32. https://doi.org/10.1016/S0001-7310(09)72563-3
Graybill T, Richardson T. Repair of large helical rim defect. Dermatol Surg. 2001;27(6):601-3. https://doi.org/10.1046/j.1524-4725.2001.01019.x. https://doi.org/10.1097/00042728-200106000-00020. PMid:11442603
Hafner J,Mohrle M, Loeser CR. Retroauricular pedicled flap for reconstruction of large helix and antihelix defects. J Dtsch Dermatol Ges. 2016;147:753-5. https://doi.org/10.1111/ddg.13073_g. https://doi.org/10.1111/ddg.13073. PMid:27373263
Imahiyerobo J, Carucci J. Repair of a defect of the helical rim. Dermatol Surg. 2009;35(3):509-12. https://doi.org/10.1111/j.1524-4725.2009.01071.x. PMid:19243400
Krunic A, Weitzul S, Taylor S. Chondrocutaneous advancement flap for reconstruction of helical rim defects in dermatologic surgery. Australian Journal of dermatology. 2006;47:296-9. https://doi.org/10.1111/j.1440-0960.2006.00299.x. PMid:17034477
Levin B, Adams L, Becker G. Healing by secondary intention of auricular defects after Mohs surgery. Arch Otolaryngol Head Neck Surg.1996;122(1):59-69. https://doi.org/10.1001/archotol.1996.01890130051008. PMid:8554748
Low DW. Modified chondrocutaneous advancement flap: a technique for the ear reconstruction. Plat Reconstr Surg. 1998;102:174-7. https://doi.org/10.1097/00006534-199807000-00028
Morán K, Cabrera A, Cardona M, Medina A, Alcalá D, Torres S, et al. Te?cnicas de reconstruccio?n ba?sicas del pabello?n auricular por padecimiento dermatooncolo?gico. Dermatol Rev Mex.2015;59:310-6.
Olshinka A, Dean A. Repair helical rim cutaneous defect. Dermatol surg. 2017;43:134-7. https://doi.org/10.1097/DSS.0000000000000691. PMid:27153038
Randonich M, Zaher M, Bisaccia E, Scarborough D. Dermatol surg. 2002;28:62-5. https://doi.org/10.1046/j.1524-4725.2002.01051.x. PMid:11991274
Valesky E, Kaufmann R, Meissner M. Chondrocutaneous hélix rim advancement flap: two classical and two new modifications for very large defects of the ear. J Eur Acad Dermatol Venereol. 2015;29(11):2248-51. https://doi.org/10.1111/jdv.12778. PMid:25338650
Zilinsky I, Erdmann D, Weissman O, Hammer N, Sora M, Schneck T, et al. Reevaluation of the arterial blood supply of the auricule. J. Anat. 2017;230:315-24. https://doi.org/10.1111/joa.12550. PMid:27726131 PMCid:PMC5244454
Salom-Coveñas, C., Haro-García, M., & Porras-Alonso, E. (2019). Review of helical rim reconstruction techniques. Revista ORL, 10(4), 263–268. https://doi.org/10.14201/orl.20675
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