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At the Fifth International Symposium on Plastic and Reconstructive Surgery of the Head and Neck in Toronto, Canada, June 21, 1989, Hilko Weerda, MD, DMD, Lübeck, West Germany, presented his techniques for a number of auricular reconstructive problems. Weerda utilizes the Gersuny technique for correcting small defects of the pinna. This involves excision of a long narrow scaphal crescent in combination with removal of a wedge of the helix. The remaining superior chondrocutaneous segment is then slid down to reapproximate the remaining portion of the auricle. For larger full-thickness defects, Weerda uses a posteriorly based, bilobed, non-hair-bearing flap for skin coverage with rib cartilage for structural support.
Weerda's experience with traumatic avulsions of the auricle has shown that only small segments remain viable when replaced as a composite graft. He feels that there is often an inadequate base to nourish larger composite grafts. Therefore, for large avulsion injuries he prefers
BUCHWACH KA. Reproducing Near-Normal Pinna Anatomy. Arch Otolaryngol Head Neck Surg. 1989;115(12):1413. doi:10.1001/archotol.1989.01860360015001