The management of auricular defect using retroauricular flap


  • Ratna Rayeni Natasha Roosseno Department of Plastic Surgery, Mangusada Hospital, Badung, Bali, Indonesia
  • Primawati . Department of Plastic Surgery, Mangusada Hospital, Badung, Bali, Indonesia



Auricular reconstruction, Ear amputation, Ear defect, Ear reconstruction, Retroauricular flap


Management of auricular defect is still a challenge for reconstructive plastic surgeons. The complexity of anatomy and shape will make the reconstruction complicated. It is also inevitable that choosing the right donor to close the defect that resembles the original contour is one of the success indicators of any ear reconstruction. There are wide selections of techniques for the management of auricular defect. Retroauricular flap is one of the best choices in auricular reconstruction due to its vascular richness, low of failure rate, similarity of tissue contour and the ease of closing the donor-site defect primarily. This article reported three cases of auricular defect with various causes: crushed injury, human bite, and tumor excision. Two stages of surgeries were performed on all three patients. After sufficient debridement, the ear defect is planted beneath retroauriculomastoid dermis. The second stage, three weeks from the first surgery, the donor flap is separated from it host. One week follow up after the second stage surgery, all of the post-operative wounds showed no signs of infection, minimal scar formation and has satisfied aesthetic outcomes. The retroauricular flap has the advantages of simple dissection, low failure rate and has a good shape, texture, color for a very good aesthetic results. This flap may be considered as a good solution in the management of auricular defect and a flap bank for ear reconstruction.

Author Biography

Primawati ., Department of Plastic Surgery, Mangusada Hospital, Badung, Bali, Indonesia

Department of Plastic Surgery, Mangusada Hospital, Badung, Bali


Chung JEREW, Chussi DC, Van Heerbeek N. External auditory canal stenosis after traumatic auricular amputation. J Craniofac Surg. 2018;28(1):e87-e88.

Menon A, Alagesan G. Traumatic partial avulsion of pinna reconstruction with Limberg flap. WJPS. 2018;7(2):231-234.

Zhang YZ, Li YL, Yang C, Fang S, Fan H, Xing X. Reconstruction of the postauricular defects using retroauricular artery perforator-based island flaps: Anatomical study and clinical report. Medicine. 2016 Sep;95(37):1-5.

Lavasani L, Leventhal D, Constantinides M, Krein H. Management of acute soft tissue injury to the auricle. Facial Plastic Surg. 2010;26(6):445-50.

Mevio E, Facca L, Mullace M, Sbrocca M, Gorini E, Artesi L, et al. Osseointegrated implants in patients with auricular defects: a case series study. Acta Otorhinolaryngol Italica. 2015 Jun;35(3):186-90.

Mevio E, Facca L, Schettini S, Mullace M. Bone-anchored titanium implants in patients with auricular defects: three years and 27 patients’ experience. Int J Otolaryngol. 2016;2016.7.

Ciorba A, Martini A. Tissue engineering and cartilage regeneration for auricular reconstruction. Int J Pediatr Otorhinolaryngol. 2006;70:1507-15.

Pickrell BB, Hughes CD, Maricevich RS. Partial ear defects. Seminars Plastic Surg. 2017;31(3):134-140.

Ebrahimi A, Kazemi A, Rasouli HR, Kazemi M, Motamedi MHK. Reconstructive surgery of auricular defects: an overview. Trauma Mon. 2015;20(4):e28202.

Da Silva JC, Filho WG, Araujo BGDO. Ear reconstruction after traumatic injuries. Rev Bras Cir Plast. 2011;26(3):428-432.

Brent B. The acquired auricular deformity. A systematic approach to its analysis and reconstruction. Plast Reconstr Surg. 1977;59(4):475-85.

American College of Surgeons. ATLS: Advanced Trauma Life Support for Doctors: student course manual. 10th ed. Chicago: American College of Surgeons; 2018: 2-59.

Rhee P, Nunley MK, Demetriades D, Velmahos G, Doucet JJ. Tetanus and trauma: a review and recommendations. Journal of Trauma and Acute Care Surgery. 2005 May 1;58(5):1082-8.

Centers for Disease Control and Prevention. Tetanus. [CDC Web site]. Available at: Accessed 23 January 2020.

Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ, et al. Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clini Infect Dis. 2005 Nov 15;41(10):1373-406.

Siegert R, Magritz R. Reconstruction of the auricle. GMS current topics in otorhinolaryngology, head and neck surgery. 2007;6:1-11.

Forte AJV, Alonso N, Freitas RS, Narayan D, Persing J. Ear trauma: treatment and reconstruction. A comprehensive approach. Rev Bras Cir Craniomaxilofac. 2009;12(2):64-73.

Gupta P, Gupta NK, Agarwal MP, Gupta A, Jain A. Post Auricular Flaps in Helical Rim Defect. People. 2016 Jan;9(1):40.

Schonauer F, Vuppalapati G, Marlino S, Santorelli A, Canta L, Molea G. Versatility of the posterior auricular flap in partial ear reconstruction. Plastic Reconstruct Surg. 2010 Oct 1;126(4):1213-21.

Kim P, Lee KS. Retroauricular cutaneous advancement flap. Austr Family Physic. 2012 Aug;41(8):601-2.

Cerci FB. Staged retroauricular flap for helical reconstruction after Mohs micrographic surgery. An Brasileir Dermatol. 2016 Oct;91(5):144-7.




How to Cite

Roosseno, R. R. N., & ., P. (2020). The management of auricular defect using retroauricular flap. International Journal of Research in Medical Sciences, 8(5), 1912–1917.



Case Reports