Microvascular Flaps From the Ear in Nasal Reconstruction: Aesthetic and Patient-reported Outcomes.

Background: This study evaluates the aesthetic results and patient-reported outcomes following the use of microvascular flaps from the ear in nasal reconstruction. Methods: A retrospective cohort study was conducted on patients who underwent nasal reconstruction with a microvascular ear flap between 2011 and 2021. Eleven plastic surgeons evaluated postoperative photographs using the validated observer-rated disfigurement scale and 5-point scales assessing the shape and color of the nose and donor ear appearance. Patient satisfaction with the reconstructed nose was assessed with the FACE-Q rhinoplasty module and satisfaction with the donor ear with 6-point scales. Results: Twenty-eight patients with microsurgical ear flaps were identified. One nasal subunit was reconstructed in 16 patients and the total nose in 3. Photographs were available for 25 patients. The shape and color of the reconstructed nose, and the shape of the ear, were assessed as good by the surgeons (median scores 2 IQR 2-3]; 2 [IQR 1-2], and 2 [IQR 1-3], respectively), whereas facial disfigurement was assessed as moderate (median score 3 [IQR 3-4]). Fifteen patients completed the questionnaire, reporting high levels of satisfaction with the appearance of the nose (median score 60; IQR 54-65) and nostrils (median score 64; IQR 42-81), and acceptable symmetry of the ears (median score 2; IQR 1-3). Conclusions: Microvascular flaps from the ear are a good alternative for complex nasal reconstruction, often yielding aesthetically favorable results.