Plastic closure after excision of periauricular skin malignancies
18. April 2018 (online)
Basal cell- and Squamous cell carcinoma are the most common facial skin malignancies. The surgical excision is still the first line threapy. After histologic checked excision a plastic coverment is mostly needful, for example with shift or transposition flaps. Atypic surgical solutions could be necessary after pre-surgery or in case of relapse.
Case 1: This patient presented a large Basal cell carcinoma retroauricular on the right side. After twotime-resection the defect was closed with two shift flaps.
In progress the Basal cell carcinoma relapsed in the scare area. In course of excision resulted a defect of 1,8 × 2,5 cm. Because of the abnormal blood supply after reconstruction with transposition flaps we used a rotated flap from the cheek to close the defect.
Case 2: In this case we report from an expanded Squamous cell carcinoma of the lobule, which infiltrated the cavum conchae and the cheek. The external ear was amputated in part to completly remove the malignom. The defect was reconstructed with two rotated respectively shifted flaps.
Result: The presented cases show that shifted and rotated flaps are, instead of grafts, an approved option to close auricular skin defects. The outcome of blood supply was excellent.
Surgical ambitious flaps are contemplable to reconstruct large auricular defects. In case of complex preconditions, for example after pre-surgery, the procedure should be adapted. Photographic documentation and a sketch are always essential for good planning.