Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases

Abstract

BackgroundThe 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. ObjectiveTo describe the authors’ experience in auricular reconstruction after Mohs surgery and to evaluate the most frequently used repair methods. MethodsRetrospective study of consecutive cases submitted to Mohs surgery and auricular reconstruction, over a period of 3 years. ResultsOne 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 limitationsRetrospective design and the absence of long-term follow-up of some cases. ConclusionsThe dermatologic surgeon should be familiarized with different options for auricular reconstruction. Primary closure and skin grafts were the most frequently used repair methods.