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- ArticleWeerda H.Arch Otorhinolaryngol. 1978 Mar 03;220(1-2):133-9.We have shown some constructions of pedicled bi-lobed and tri-lobed flaps, "transposition-rotation flaps" and "double-rotation flaps". Using the big regional flaps in this matter we are able to close large defects primarily without the use of thin split grafts.