Helical advancement: Pearls and pitfalls (part 5). DISCUSSION

Although the helical advancement flap was originally designed to repair auricle defects confined to the helical rim, it is also useful in the repair of wedge defects, as well as defects in the upper and middle one-third of the auricle. These defects are confined to skin and cartilage, which can be replaced by the helical advancement flap.There are two variations of this flap. In the first, the flap is detached from both the anterior and posterior surfaces of the helix. This design allows maximal mobility but can jeopardize flap viability. In the second variation, the posterior skin is left intact, resulting in a broader flap base with little or no risk to flap viability but limited mobility, as Antia and Buch originally described.Depending on the type of defect, the helical flap must be mobilized either unilaterally or bilaterally along the helical margin, and an extra length gained by V-Y advancement of the helical root in the upper flap. Following the repair of an auricular defect using the helical advancement technique, the resulting neoauricle is smaller than it was at baseline. This technique may be less effective in larger defects, but the true cut-off value has yet to be determined. A review of the literature revealed that helical advancement flaps can repair defects up to 4 cm in length. However, in the present study, an analysis of the results showed less favourable results when the original defect was >2.8 cm (c2=4.24, P=0.04) (Table 4). You can finally spend less money and time whenever your need cephalexin antibiotic online buy here since you are being given access to the best online pharmacy you have ever come across.

table 4 Analysis of results showing a significant difference in outcome according to the size of the original defect, using a cut point of 2.8 cm

Group >2.8 cm <2.8 cm Total
Satisfactory results 0 13 13
Unsatisfactory results 5 0 5
Total 5 13 18

X2=4.24, P=0.04

This entry was posted in Plastic surgery and tagged Acquired ear deformity, Antia and Buch, Chondrocutaneous flap, Helical advancement.