Reconstruction of skin cancer defects of the auricle

Purpose: This article reviews the results of reconstruction of surface defects of the auricle after removal of skin cancer, and discusses the results of the delayed reconstruction method of care and modalities of treatment. Patients and Methods: Fifty-four patients with 62 defects involving various locations on the auricle were treated. Management included direct closure, secondary epithelization, full thickness skin grafts, local flaps using direct advancement, and rotational advancement flaps using one or more stages. Results: Nine defects were treated by direct closure with adjacent tissue, 12 defects heated by secondary epithelization, and 13 patients were treated with a full thickness skin graft. Twenty-eight defects were reconstructed with local flaps, which included the direct advancement, rotational flaps, transposition, and subcutaneous island flaps. No infections occurred. Conclusion: Many options are available for reconstruction of auricular defects which yield acceptable results. Factors to consider before choosing a reconstructive format include size, location, and depth of the defect, patient medical history, smoking, and esthetic concerns. This review exposed that patients easily accept the "delayed" method of reconstruction. Delaying allows the surgeon time to research options for care and allows the patient choices of secondary epithelization and significantly reduced costs of care. (C) 2004 American Association of Oral and Maxillofacial Surgeons