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Surgical management of auricular infantile hemangiomas
Opeyemi O Daramola1, Robert H Chun, Joseph E Kerschner
1Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, 53201, USA.
Insights
Surgical management of auricular infantile hemangiomas is effective for complicated cases and those unresponsive to medical treatment. Excision with Z-plasty reconstruction can limit deformities and prevent scarring.
Area of Science:
- Pediatric Surgery
- Dermatology
- Plastic Surgery
Background:
- Infantile hemangiomas are common benign vascular tumors in children.
- Auricular involvement can lead to significant cosmetic and functional issues.
- Surgical intervention is considered for specific cases of auricular infantile hemangiomas.
Purpose of the Study:
- To evaluate the surgical management outcomes of auricular infantile hemangiomas.
- To assess the effectiveness of reconstruction techniques in affected ears.
- To report experience from a dedicated vascular anomalies center.
Main Methods:
- Retrospective case series of ten patients.
- Patients had histopathologically confirmed auricular infantile hemangiomas.
- Surgical excision and reconstruction were analyzed.
Main Results:
- Indications for surgery included pain, bleeding, infection, and cosmetic deformity.
- Four patients had failed prior medical treatments.
- Nine patients underwent single-stage resection; two had otoplasty and two had Z-plasty reconstruction. No recurrences or complications were reported.
Conclusions:
- Surgical excision is effective for auricular infantile hemangiomas, especially in complicated or medically refractory cases.
- It prevents fibrofatty scarring and reduces cartilage deformities.
- Surgical excision with Z-plasty reconstruction is a viable option to minimize postoperative deformities.
Objective:
To report our experience with surgical management of auricular infantile hemangiomas and reconstruction of the affected ear.
Design:
Retrospective case series.
Setting:
Dedicated Birthmarks and Vascular Anomalies Center in a tertiary pediatric hospital.
Patients:
Ten patients with surgically treated, histopathologically confirmed auricular infantile hemangiomas.
Main Outcome Measures:
Outcomes of surgical management.
Results:
The case series included 5 male and 5 female patients (age range, 4 months to 4 years). Indications for surgery were pain, bleeding, infection, and cosmetic deformity. Four patients had failed prior medical treatment, including pulsed dye laser, topical corticosteroids, and intralesional corticosteroids. Nine patients underwent single-stage resection. Otoplasty reconstruction was performed in 2 patients with hemangioma-induced deformities, while primary Z-plasty closure was performed in 2 patients with extensive lesions. No recurrence or complication has been reported to date.
Conclusions:
Most infantile hemangiomas do not require treatment. Surgical excision of auricular infantile hemangiomas at any phase is effective in preventing fibrofatty scarring, reducing cartilage deformities, and treating complicated cases or patients who have failed medical management. Surgical excision with Z-plasty reconstruction is a viable option that should be considered to limit postoperative deformities.
