A Retrospective Study on Single-Stage Reconstruction of the Ear following Skin Cancer Excision in Elderly Patients.

Alberto Bolletta,Mirco Pozzi,Emanuele Cigna,Michela Schettino,Luigi Losco

doi:10.3390/jcm11030838

Abstract

Ear reconstructive surgery aims to solve the deformities caused by cancer excision. Despite the numerous surgical procedures described, recreating the complex anatomy of the ear still represents a challenge, particularly for young surgeons. The purpose of this exploratory pilot study is to review our experience with single stage reconstruction of the partial defects of the auricle, and propose an algorithm based on defect size, location, and characteristics. We retrospectively reviewed patients who underwent ear reconstruction after cancer excision at our institution between February 2018 and November 2020. The data collected included patients’ demographics, defect characteristics, reconstructive technique used, complications, and outcomes. The patients were evaluated at a minimum follow-up time of 12 months. Forty-six patients were included in the study. The most common cause for ear reconstruction was basal cell carcinoma. The mean area of defect was 4.3 cm2 and the helix was the most frequent location of defect. Two patients experienced post-operative complications. At the one-year follow-up, difference in skin pigmentation was reported in 10 cases, a depressed contour of the ear was found in 4 cases, and moderate ear asymmetry was found in 11 cases. No patient needed a secondary procedure. In conclusion, the proposed reconstructive algorithm represents a reconstructive indication that is simple and characterized by low complication rates and good outcomes for both the patient and the surgeon.

Highlights

The reconstruction of the auricle represents a complex challenge for the plastic surgeon.The different etiologies, the wide range of reconstructive options available, and the patient’s expectations require a global evaluation of the appropriate surgical technique [1]
We reviewed our experience with single-stage reconstruction of the partial defects of the auricle after cancer excision
The most common cause for ear reconstruction was represented by basal cell carcinoma

Summary

Introduction

The different etiologies, the wide range of reconstructive options available, and the patient’s expectations require a global evaluation of the appropriate surgical technique [1]. The external ear is an important component of the face, as it guarantees balance between the various facial features and directs the sound waves into the acoustic meatus. It acts as a support base for glasses, earphones, and hearing aids. Ear reconstructive surgery aims to resolve the deformities generated by cancer excision, using various techniques capable of restoring the original shape of the auricle. Some of the surgical procedures described in literature require multiple stages, and this might be an issue for elderly patients [2,3]

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