Revisiting Gavello's procedure for single-stage reconstruction of the earlobe: The vascular basis, technique and clinical uses

Abstract

Background Deformities or loss of the earlobe may be congenital, or acquired due to trauma, bites, burns or tumour excision. A variety of single-stage and two-stage procedures have been described for earlobe reconstruction, of which Gavello's procedure was one of the earliest. Objective To revisit Gavello's procedure with reference to the vascular supply of the flap, and discuss the relevance of the technique in current practice. Methods The authors discuss the vascular basis of Gavello's flap, and describe the clinical application of the single-stage Gavello's procedure in diverse clinical situations, including congenital absence of earlobe, post-burn earlobe deformity and traumatic amputation of the earlobe. Results Excellent cosmetic results have been achieved in all different clinical situations in the authors' experience, with preservation of earlobe shape and volume, good colour match and a well-concealed scar in the donor area. Discussion Gavello's procedure is a simple, one-stage procedure that relies entirely on local tissue for earlobe reconstruction; the flap has a predictable vascular supply, skin grafting is not required and the procedure can be used for large defects. An intact donor area over the postauricular mastoid region is a prerequisite. Conclusion The simple, century-old Gavello's procedure is still of great value for reconstruction of earlobe defects of diverse etiology.