RESUMEN
Auricle reconstruction is a challenging problem in plastic surgery due to the ear's prominent location, complex anatomy, and limited local tissue availability. The Dieffenbach flap, a folded postauricular flap, offers a viable flap for reconstruction of larger ear defects. Although the technique has been well defined in previous literature, there are few studies evaluating its outcomes and complications. The authors conducted a retrospective review of patients who underwent auricle reconstruction with the Dieffenbach flap by a single surgeon between 2016 and 2022. Data collection included demographics, medical history, cancer type, defect characteristics, postoperative care, outcomes, and complications. Univariable analyses using the Fischer exact test assessed the association between risk factors (smoking, anticoagulation use, and age) and complication rates, with P ≤ 0.05 considered statistically significant. A total of 40 patients were included in this study, with a mean age of 67.6 and a male prevalence of 77.5%. The mean defect size was 6.5 cm2, with most defects located on the superior helix. The most common complication was postoperative cellulitis (3 patients, 7.5%), followed by contour abnormality that required revision surgery (2 patients, 5.0%). History of smoking had a statistically significant association with complications (P = 0.013). Use of anticoagulants, or older age (defined as >70 years), had no significant association with complication risk. The Dieffenbach flap remains a reliable method for reconstruction of various auricle defects. It is low maintenance, well tolerated by patients, and involves minimal donor site morbidity without the need for cartilage.
RESUMEN
The Dieffenbach flap is often used for post-Mohs reconstruction of auricle defects, effectively restoring the auricle rim. However, its impact on auricle projection and length after division and inset is not well-documented. This study evaluates auricle projection and length following defect repair with the Dieffenbach flap, comparing results to the nonoperative ear. We conducted a retrospective review of patients who underwent a Dieffenbach flap repair surgery at a single institution from 2016 to 2023. Auricle projection and length of the reconstructed ear were measured within the first month following division and inset of the flap and compared with the contralateral ear. A subset of patients had additional measurements > 1 month following division and inset, and these measurements were compared with the contralateral ear. Our study included 23 patients with an average age 67.4 years and 78.3% male. Within 1 month following division and inset, the Dieffenbach flap resulted in a significant decrease in auricle projection (16.5 vs. 18.6 mm, p < 0.05) and length (67.0 vs. 69.7 mm, p < 0.05) compared with the contralateral ear. Subsequent follow-up showed no significant differences in projection (18.5 vs. 18.5 mm, p = 0.98) or length (68.0 vs. 68.7 mm, p = 0.54). Following division and inset of the Dieffenbach flap, auricle projection and length experience initial reduction but subsequently self-correct to match the contralateral ear.