We read with interest the article "The trap door flap: A reliable, reproducible method of anterior pinna reconstruction", by Mcinerney et al., who reported their experience in reconstruction of ear defects with the trap door flap. We congratulate the authors for their excellent results and remarkable case series but we believe that the manuscript deserves some comments.The flap they describe -based on the posterior auricular artery- has been first introduced by Masson2 in 1972. The flap was revolutionary 40 years ago, when knowledge of the vascular anatomy of the ear was very basic and the introduction of a safe random flap made the difference in anterior ear defects reconstruction.Since then, several studies have described in detail the posterior auricular and superior auricular arteries that can be used to harvest safe axial flaps. These flaps, based on known pedicles, have a wide arc of rotation and can be used to reconstruct defects of any size in any area of the ear.Thus, the senior author's feeling that "the entire anterior surface of the pinna could be resurfaced, once the helix is intact", is not only a feeling but is an evidence well supported by anatomical and clinical studies published in several journals, including JPRAS.
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