Reconstruction of the ear after skin and cartilage loss

Small defects (less than 1.5 cm) of the helix or antihelix of the middle third of the ear can be converted to a wedge-shaped excision and primary repair performed. In some cases, small Burrow's triangles on either side of the wedge must be exised from the scapha or antihelix to allow for closure without distortion or cupping [53]. In addition, the resection may go across the conchal rim and include the bowl to allow for rotation without deformity (Fig. 1) [17]. The advantages of wedge resection are it is a one-stage operation; it is simple, easy, and fast; and there is minimal resultant sear. Disadvantages include that: It can be applied only for small defects of the helical rim and neighboring structures. It should be located in the superior or posterior third to avoid deformity of the ear. If the defect is larger or located near the anterior helix, wedge resection cannot be used without severe deformity of the ear. It results in shortening of the ear. Repair may result in a constricted helical contour unless additional tissue is excised, that further decreases the size of the ear.