The purpose of Levin and colleagues' investigation was to study those areas of the ear that should be repaired and those that can heal by secondary intention, as well as to study the best management of exposed cartilage.
The authors correctly conclude that the location of the wound is the most important factor in predicting the cosmetic result. I agree with their conclusion that helical rim defects often result in notching; therefore, I routinely reconstruct helical rim defects unless they are extremely superficial. 1 commonly use skin grafts if the base of the wound is adequate to support a graft, or alternatively use helical rim advancement flaps for small defects or a two-stage reconstruction with a cartilage graft and postauricular pedicle flap for very large defects that result in significant loss of cartilage. For wounds in combined locations, 1 routinely repair wounds of the scapha or helix and scapha. If allowed
Zitelli JA. Editorial Footnote. Arch Otolaryngol Head Neck Surg. 1996;122(1):67. doi:10.1001/archotol.1996.01890130059009
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