Our experience and modification of the Antia-Buch flap for pinna reconstruction

Abstract

Objective: The Antia-Buch flap technique is used for the reconstruction of pinna helical defects. We present our modification of this flap to reconstruct large defects (greater than 20 mm) with good outcomes.

Methods: A retrospective review was conducted on all modified Antia-Buch flaps performed in a single unit from January 2011 to April 2019. All adult patients (greater than 16 years of age) who underwent this method of reconstruction after surgical excision of a pinna lesion were included. Measurements of the excision specimens from the final histological reports were used to determine the defect size. The helical lengths of the defect were used for analysis. Medical records were reviewed to identify postoperative complications from the reconstruction.

Results: A total of 103 patients underwent the modified Antia-Buch flap reconstruction. All cases were performed by a single surgeon (senior author SA). Patients were 51-96 years of age (mean 76 years, SD±8.6), including 92 males and 11 females. The helical length of defects closed was between 12 and 42 mm (mean 26.7 mm, SD±6.46), and defect widths were 6-37 mm (average 14.5 mm, SD±5.28). There were 5 complications in our series (4.8% complication rate), with a revision rate of 2.9% (n = 3).

Conclusions: Our case series is the largest in the literature. Our modification demonstrates that large pinna defects can be reliably repaired with modification of the Antia-Buch flap that gives patients the option of a single-stage reconstruction without added morbidity and a good cosmetic outcomes.

Keywords: Flap physiology; Otoplasty; Skin neoplasms; Wound healing.