# Auricular Composite Grafts Conforming to Nasal Cavity Anatomy Enable Functional and Aesthetic Reconstruction of Alar Full-Thickness Defects

## TL;DR

A single-stage surgical technique using ear tissue successfully reconstructed a complex nasal ala defect, achieving both function and aesthetics.

## Contribution

Demonstrates the novel use of auricular composite grafts for intranasal lining and structural support in alar reconstruction.

## Key findings

- The auricular composite graft provided complete survival and maintained natural intranasal contour.
- The technique achieved acceptable cosmetic results without the need for revision surgery.
- The auricular donor site healed without deformity, supporting the practicality of the method.

## Abstract

The nasal ala is an anatomically complex region composed of external skin, structural support, and internal lining, each of which must be reconstructed to achieve both functional and aesthetic outcomes. Conventional multilayered reconstructions often require technically demanding and staged procedures, imposing a considerable burden on both surgeon and patient. We report a male in his 60s with a sebaceous carcinoma of the right nasal ala. Following tumor excision with a 5-mm margin, a full-thickness alar defect was reconstructed in a single stage. An auricular composite graft, harvested in a shape conforming to the defect, was used to restore the mucosal lining and structural support, while a transposition nasolabial flap provided external cover. The graft survived completely and maintained a natural intranasal contour, and the external bulk gradually improved over time, resulting in an acceptable cosmetic outcome without the need for revision surgery. The auricular donor site healed uneventfully without deformity. Auricular composite grafts are traditionally used for reconstructing the alar rim or columella; however, to our knowledge, their application to the intranasal lining has not been reported. In this case, the graft provided both mucosal stability and structural support, demonstrating the morphological adaptability of auricular tissue. This technique allowed relatively simple and reliable single-stage reconstruction of a full-thickness alar defect. Auricular composite grafts tailored to the defect morphology may represent a practical and versatile option for intranasal lining and structural reconstruction in selected patients.