Posterior auricular artery fasciocutaneous island flap: lateral temporal soft tissue reconstruction.

INTRODUCTION Reconstruction of the soft tissue surfaces of the ear and mastoid bowl can be challenging. From simple canal wall down mastoidectomies to more extensive reconstructions after ablative surgery and radiotherapy, the reconstruction options are limited. Several variations of posterior auricular artery based flaps, such as the “Singapore swing” and the “revolving door” are used for reconstruction of the auricle. The temporoparietal fascia flap is frequently used for temporal bone soft tissue coverage. The latter requires additional incisions that can lead to alopecia and increased operative times. For several years, we have used a pedicled posterior auricular artery fasciocutaneous (PAAF) island flap developed from the region of the postauricular incision to resurface the bone of the external auditory canal and mastoid bowl.