ABSTRACT
One principle of reconstruction is the restoration of anatomy after tissue has been altered or removed. Reconstruction of the auricle requires establishing contour and shape that will often be compared to the contralateral auricle. Although the tissue of the auricle is predominantly skin and cartilage, the development of the auricle results in an intricate pattern of concavities and convexities that give the ear its characteristic shape. These areas of concavity and convexity result in reconstructive challenges created by the relative inelastic properties of skin overlying cartilage. Preservation of tissue, maintenance of structural integrity, and establishment of tension-free closure are goals of surgery. Perforations of the auricle must be closed in a tension-free manner or recurrence of the perforation often results. Surgical incisions in the postauricular region must be closed in a manner that will not jeopardize the postauricular sulcus. The retroconchal island flap with overlying cutaneous transposition flap provides a technique for tension-free closure (1).
