Melanoma of the ear: results of a cartilage-sparing approach to resection

Abstract

Melanoma of the ear is often treated by composite resection of the skin and cartilage and, occasionally, by total auriculectomy. This review analyzes the oncologic, functional, and esthetic results of cartilage-sparing wide local excision for melanoma of the ear. This retrospective study reviewed patients with ear melanoma treated between 1997 and 2002. All patients were treated with cartilage-sparing wide local excision, and ears were reconstructed with skin grafts and/or local flaps. The majority of patients were men (16/18 patients) who ranged in age from 42 to 82years. The most common sites of occurrence were the helical rim (7/18 patients) and the earlobe (6/18 patients). The average depth of invasion was 2.02mm (range 0.4-6.0mm). Sentinel lymph node biopsy was performed in 13 cases, of which only one was positive. The local control rate was 100%, overall survival was 72% (13/18 patients), and disease-specific survival was 89% (16/18 patients). Average follow-up was 30.5months (range 1-61). The rates for local control, overall survival, and disease-specific survival were excellent. These data indicate that for the majority of ear melanomas, cartilage-sparing wide local excision is an acceptable means of treatment.