Tragal flap helps in reconstruction of the external auditory canal, Finds study

The study is published in the American Journal of Otolaryngology.

Primary malignancies arising in the external auditory canal (EAC) are rare and usually are treated surgically. Therefore, Ariana L. Shaari and colleagues from the Thyroid, Head, and Neck Cancer (THANC) Foundation, New York, USA carried out the present study with the aim to review techniques to reconstruct the EAC following ablative surgery, and introduce a rarely utilized tragal skin flap which has particular advantages for reconstruction of limited anterior EAC defects.

The ideal flap technique includes creating the base of the tragal flap to fit into the tragus is anchored to the deep tissues in front of the tragus with two sutures of 5-0 polypropylene. The rest of the skin is closed in two layers and the tragal flap is inset without tension.

The terms "tragal flap", "external auditory canal", "preauricular tragal flap", "reconstructive techniques" were searched and the authors derived that one description of a tragal flap to reconstruct the EAC following resection of a malignancy was found.

We add an additional case of a preauricular tragal flap to reconstruct the anterior EAC following resection of a recurrent basal cell carcinoma located in the EAC that led to a circumferential defect, explains Shaari.

Therefore, the authors concluded that "there are several surgical techniques that can be utilized to reconstruct the EAC. We describe a novel tragal flap used to reconstruct the anterior EAC following resection of a recurrent tumor."

The authors further inferred that the Tragal flap provided well-vascularized skin for re-lining the anterior half of EAC. Tragal flap allowed for excellent aesthetic and auditory outcomes and tha the Tragal flap prevented EAC stenosis post operatively.