Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases^☆☆

Abstract

Background:

The ear is a region that has a high prevalence of cutaneous carcinomas and several guidelines indicate Mohs micrographic surgery as the first-choice treatment in such cases. Although the technique allows maximum preservation of healthy tissue, many auricular surgical wounds constitute a challenge due to the peculiar local anatomy, with evident curves and reliefs. Auricular reconstruction should prioritize function before aesthetics, but without leaving the latter aside, since postoperative distortions can have a significant psychological impact.

Objective:

To describe the authors’ experience in auricular reconstruction after Mohs surgery and to evaluate the most frequently used repair methods.

Methods:

Retrospective study of consecutive cases submitted to Mohs surgery and auricular reconstruction, over a period of 3 years.

Results:

One hundred and one cases were included and the most common repair method was primary closure (n = 35), followed by full-thickness skin graft (n = 30) and flaps (n = 24). In thirty cases, reconstruction methods were associated. Seven patients had complications (partial graft necrosis, postoperative bleeding or infection).

Study limitations:

Retrospective design and the absence of long-term follow-up of some cases.

Conclusions:

The dermatologic surgeon should be familiarized with different options for auricular reconstruction. Primary closure and skin grafts were the most frequently used repair methods.

KEYWORDS
Auricular pavilion; Ear neoplasms; Mohs surgery; Surgical flaps