Free Nasal Septal Cartilage Graft for Extensive Defects of the External Auditory Canal: A Case Report.

External canal reconstruction of extensive tissue defects, including auricle or ear canal defects, is challenging. We describe the case of a 28-year-old man who underwent staged skin and nasal septum cartilage grafting for ear canal reconstruction after resectioning a giant arteriovenous malformation of the auricle. We performed arteriovenous malformation resection and reconstruction of the significant tissue defect using an anterolateral femoral skin flap. Simultaneously, a Nelaton catheter stent was placed to temporarily form an external auditory canal. Subsequently, split-thickness skin grafting was performed. Following stent removal, severe external auditory canal stenosis developed. Nasal septum cartilage grafting was performed using a stent after dilating the ear canal. Two years after surgery, the ear canal was not stenotic without the stent. Staged treatment with skin and nasal septal cartilage grafting is a simple and practical option for treating patients with total ear defects for whom a skin flap cannot be used.