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

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.

Reconstruction of partial auricular skin cancer defects: a review of current techniques

“…Of note, smokers and diabetic patients were not found to have higher rates of complications whilst those on immunosuppression suffered significantly higher rates of infection. Similarly, a retrospective review of 46 predominantly elderly patients undergoing single-stage reconstruction following skin cancer excision reported complications in two patients (4.3%), which consisted of infection and graft loss [62]. The most commonly performed procedures were the Antia-Buch flap followed by wedge excision, periauricular flaps and FTSG.…”

Single‐stage reconstruction of a large defect of the ear

“…This complex, multiple-stage reconstruction involves a high risk of necrosis, bleeding, and infection, especially in an elderly patient who is taking anticoagulants. 3 Here, we describe a single-stage reconstruction combining two local flaps to reconstruct a sturdy auricle: a revolving door flap (post-auricular island flap), [4][5][6] and a post-auricular and mastoid advancement flap. 7 Enoxaparin was suspended on the day of the surgery and for 48 h.…”

“…Several surgical procedures have been described to reconstruct auricular defects. [1][2][3] However, when operating on elderly patients, simple yet effective reconstructive procedures with low risk of complications must be prioritized. 3…”

“…[1][2][3] However, when operating on elderly patients, simple yet effective reconstructive procedures with low risk of complications must be prioritized. 3…”

Single-stage acellular dermal matrix reconstruction of defects in the nose and ears with exposed cartilage: a prospective case series

“…A local flap is the first choice for the treatment of auricular skin defects with exposed cartilage, such as the posterior auricular flap that is used for ear reconstruction [ 9 ]. Single-stage reconstruction of the ear after excision of tumors also shows good outcomes [ 16 ]. However, Asian are prone to contractures and scars after reconstructions with flaps [ 10 , 11 ].…”