Disruption in the helical rim can result from trauma or oncological resections.
1Almost half of ear tumours involve the helical rim.
- Mahajan A.L.
Helix reconstruction with wedge resection in the right place.
J Plast Reconstr Aesthet Surg. 2009; 62: 125-127
2Numerous techniques have been described in the past to reconstruct defects arising in this area.
- Freedlander E.
- Chung F.F.
Squamous cell carcinoma of the pinna.
Br J Plast Surg. Apr 1983; 36: 171-175
Wedge-shaped full thickness excision is considered a simple, easy and effective method of reconstruction in some cases.
3This is commonly used in small defects (<1.5 cm) of the helix and antihelix.
- Lykoudis E.G.
- Seretis K.
- Demiri E.
Auricular wedge excision revisited: technical refinements to avoid postoperative ear deformities.
Plast Reconstr Surg. 2013; 131: 853e-854ehttps://doi.org/10.1097/PRS.0b013e318287a10a
4We describe a simple, quick and neat technique to perform auricular wedge excision. We used this technique in 42 skin lesions located at the helical rim.
- Armin B.B.
- Ruder R.O.
- Azizadeh B.
Partial auricular reconstruction.
Semin Plast Surg. 2011; 25: 249-256https://doi.org/10.1055/s-0031-1288916
The lesion is marked with the appropriate margins under loupe magnification. The superior and inferior margins are extended medially until they meet on both the anterior and posterior aspects of the ear. This forms an isosceles triangle with its base at the helical rim (Figure 1a and b).
We use a number 11 blade to penetrate and cut along the markings from anterior to posterior and medial to lateral through all layers (Figure 2a).
At the wedge tip a 2–3 mm circle of cartilage without skin is excised to prevent dog-ear formation. This is essential when the wedge tip is greater than 30° (Figure 3a). Wedge edges are approximated in layers using absorbable sutures (Figure 3b).
The use of number 11 blade instead of the 15 blade, more commonly used in plastic surgery procedures, added more simplicity and accuracy to the excision margins. The combination of the penetrating and cutting action of the 11 blade has improved the quality of the cut margins. In addition, the advantage of the simultaneous anterior to posterior symmetrical resection is reflected in the neat cut edges and aided closure (Figure 2b). This prevents under or overcutting the posterior wall layers as may happen whilst using the 15 blade.
The use of the 11 blade in our experience had made auricular wedge resection quick and easy. It also produced a reliable aesthetic outcome even in the hand of less experienced surgeons (Figure 3b).
Conflict of interest
- Helix reconstruction with wedge resection in the right place.J Plast Reconstr Aesthet Surg. 2009; 62: 125-127
- Squamous cell carcinoma of the pinna.Br J Plast Surg. Apr 1983; 36: 171-175
- Auricular wedge excision revisited: technical refinements to avoid postoperative ear deformities.Plast Reconstr Surg. 2013; 131: 853e-854ehttps://doi.org/10.1097/PRS.0b013e318287a10a
- Partial auricular reconstruction.Semin Plast Surg. 2011; 25: 249-256https://doi.org/10.1055/s-0031-1288916
Published online: March 12, 2016
Accepted: February 4, 2016
Received: January 27, 2016
© 2016 The Authors. Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.
User licenseCreative Commons Attribution – NonCommercial – NoDerivs (CC BY-NC-ND 4.0) |
How you can reuse
Elsevier's open access license policy
Creative Commons Attribution – NonCommercial – NoDerivs (CC BY-NC-ND 4.0)
For non-commercial purposes:
- Read, print & download
- Redistribute or republish the final article
- Text & data mine
- Translate the article (private use only, not for distribution)
- Reuse portions or extracts from the article in other works
- Sell or re-use for commercial purposes
- Distribute translations or adaptations of the article
Elsevier's open access license policy