The postauricular page flap

Jürg Hafner

The helical rim of the auricule is one of the most common sites of skin cancer to occur. Smaller excisional defects can be closed directly, and larger defects by a helical rim advancement flap, with a variety of modifications.

When a helical rim advancement flap is used to close a larger defect, the auricule becomes considerably smaller in size. Besides the esthetic concern, conchal bowl- or behind-the-auricule- hearing devices may not fit anymore, and acoustics may be impaired if the size of the auricule decreases by more than a third.

The postauricular page flap (retroauricular pedicle flap) is an interpolated staged procedure, using the postauricular scalp to form a bridge onto the missing section of the helicle rim. After 3-4 weeks the transposed flap tip is autonomized so that the pedicle can be dissected, to be wrapped around and shape a neo-helix. This simple and elegant procedure leaves the auricule size and anatomy virtually unchanged.