Retrospective Analysis of Complication Rates Associated With Auricular Reconstruction After Skin Cancer Surgery

Abstract

Background There is limited data regarding postoperative complications after microtia surgery or tympanoplasty; however, complication rates after pinna reconstruction following tumor resection and comorbidities associated with suboptimal outcomes have not been investigated so far. Objective To examine the incidence of postoperative complications after auricular reconstruction surgery following tumor resection and determine the association between postoperative complications and defect size, patients’ comorbidities, and reconstruction type. Methods and Materials In a retrospective case series ( n = 146, January 2014 to October 2018), we examined the surgical outcome and amount of postoperative complications following auricular surgery as well as the association with different comorbidities. SPSS 16.0 was used for statistical analyses. Results The following early postoperative complications were identified: pain (29.5%), hematoma (4.1%), flap congestion (4.8%), infection (3.4%), and flap/graft necrosis (2.7%). Late complications including cartilage step-offs, helical rim sulcus alteration, granulomas, or ear deformities occurred only in 3.6% of subjects. Reconstructions of large defects (>1 cm2) were associated with a higher incidence of early postoperative complications compared to small defects (<1 cm2) ( P < .001). Neither the presence of smoking or diabetes nor immunosuppression was significantly linked to an increased incidence of early complications. Immunosuppression, however, was associated with a higher incidence of postoperative infection ( P < .001) Conclusion The incidence of early and late postoperative complications after skin tumor resection and external ear reconstruction is low. The occurrence of postoperative infection was not linked with smoking or the presence of diabetes, but strongly associated with a state of immunosuppression, which is why a perioperative antibiotic prophylaxis in immune-compromised patients may be considered.

Conditions Associated with Wound Healing Complications After Adjuvant Radiotherapy in Patients with Non-Melanoma Skin Cancer: A Retrospective Analysis

“…There was no statistically significant connection between the development of WHC and the size of the defect. Cri an ș et al found out that larger defects on the ears had more early complications like flap necrosis [4]. However, they differed between defect sizes smaller and larger than 1 cm2 which were smaller than the sizes of defects in the studied patients which ranged from 1 to 390 cm2 [4].…”

“…Cri an ș et al found out that larger defects on the ears had more early complications like flap necrosis [4]. However, they differed between defect sizes smaller and larger than 1 cm2 which were smaller than the sizes of defects in the studied patients which ranged from 1 to 390 cm2 [4]. Moreover, the association Cri an ș et al observed may not be generalizable to other surgical sites [4].…”

“…Rarely, WHCs occur after dermatosurgery [1][2][3][4][5][6][7]. In the University Hospital Carl Gustav Carus Dresden, Germany, approximately 3,000 patients are operated annually due to skin cancer.…”

“…Therefore, elaborate flap Patients with Non-Melanoma Skin Cancer: A Retrospective Analysis techniques or skin grafts are often used. After surgery, adjuvant radiotherapy may be necessary to reduce the risk of recurrence [8][9][10] Extensive defect closure and postoperative irradiation can influence wound healing [1][2][3][4][5][6][7] From January 1, 2016, to December 31, 2020, 75 patients underwent postoperative irradiation due to non-melanoma skin cancer (NMSC) in the University Hospital Carl Gustav Carus Dresden, Germany. The authors collected data from the patients to investigate the frequency of postoperative WHCs in the patient collective and to determine potential risk factors.…”

Sonography as a Prognostic Indicator of Breslow Depth: Primary Malignant Melanoma of the Auricular Helix

“…7 Areas of the head and neck that receive the most exposure to UVR are typically the ears, resulting in being an area of high risk for skin cancers, such as melanoma. 8 The normal anatomy of the auricle consists of a thin layer of skin over minimal subcutaneous tissue encasing the cartilage, excluding the lobule which comprises fatty tissue and skin. 8 In particular, the outermost portion of the auricle is the helix, consisting of a smooth rim, distinguishable from the antihelix crura, antihelix, antitragus, and the lobule (see Figure 6).…”