Skin Cancer on the Ear*

Patient

Age:: undisclosed
Gender:: Male
Ethnicity:: White
Height:: Over 6’ 0”
Weight:: 150 - 199 lbs
Gallery:: 61921

Procedure

Profile

**Dr. Thornwell H. Parker, III**

214-814-7965

Procedure Details

This 69 year old male has a squamous cell cancer on the rim of his ear. This is a very common location for skin cancer. He underwent Mohs surgery for removal followed by reconstruction using a type skin flap called an Antia-Buch flap. This is commonly used for holes confined to the rim of the ear because it easily fills small to medium sized defects and heals reliably. A larger defect can also be repaired with this technique but it can significantly reduce the size of that ear or distort the shape. For larger holes other options commonly used include skin grafting or a post-auricular flap. A post-auricular flap involves flipping skin up from behind the ear that lies between the hairline and the junction of the ear and head. In this case the Antia-Buch flap worked very well, as expected. This is a very typical result using this procedure. The patient was very happy but has unfortunately had to undergo other procedures for skin cancers on his nose, scalp and cheeks.

Typical "Helical Rim" Defect Before — Before

Typical "Helical Rim" Defect After Repair (7 weeks) — After Repair (7 weeks)

The outer rim of the ear is called the "helical rim." This cancer is on the mid-helical rim. The mid and upper helical rim are very common places for skin cancer, especially in men since they typically have shorter hair allowing more sun exposure. More

Antia-Buch Flap

Antia-Buch Flap Modified Antia-Buch Flap — Modified Antia-Buch Flap

This is a modification of a procedure called an Antia-Buch flap. This procedure releases the rim of the ear allowing it to be shifted up to fill in the hole. For larger holes the standard Antia-Buch flap releases the rim above the defect as well allowing the upper rim to slide down and the lower rim to slide up. More

Ear Skin Cancers need Mohs

Historically, ear skin cancers have had the highest rate of recurrence for skin cancers on the face. In the past the recurrence rates were 10-20% using traditional surgical excision. That's pretty high for skin cancer. Why?

We don't have all the answers, but here are a few of reasons that seem consistent:

1. Too conservative - traditional surgical excision may have been too conservative at times in order to avoid distorting the shape of the ear.

2. 3-D - the three-dimensional shape of the ear can make orientation in the laboratory difficult if residual cancer is discovered under the microscope.

3. More aggressive - ear skin cancer may grow in a more insidious way that other skin cancers on the face.

4. Prior treatment- multiple treatments with other therapies like cryotherapy or topical chemotherapy creams can sometimes leave skin cancer incompletely treated and more insidious.

For these reasons, Mohs surgery is typically recommended for skin cancer on the ear. For a primary skin cancer (primary = never treated before) the cure rates are in the upper 90 percentile. In addition to the highest cure rate, Mohs surgery allows for conservative layer by layer removal in order to maximize the functional and cosmetic results.

Location

Skin Cancer Consultants