Ear Reconstruction after Mohs Cancer Excision: Lessons Learned from 327 Consecutive Cases

Area of Science:

• Plastic Surgery
• Otolaryngology
• Dermatologic Surgery

Background:

• Reconstructing the ear's complex structure for functional and aesthetic purposes is challenging.
• Objective data on reconstructing acquired ear defects is limited.
• This study addresses the need for analysis in a large clinical practice.

Purpose of the Study:

• To evaluate ear reconstructions performed over decades in a Mohs reconstruction practice.
• To identify lessons learned in treating complex acquired ear defects.
• To assess reconstructive modalities and complication rates.

Main Methods:

• Retrospective analysis of 327 patients undergoing ear reconstruction after Mohs surgery (2004-2018).
• Data collected included demographics, cancer type, defect characteristics, and reconstructive techniques.
• Complications and outcomes were analyzed.

Main Results:

• The superior helix and antihelix were the most common defect locations.
• Full-thickness skin grafts were used in 50% of cases; flaps in 33%.
• Complications occurred in 9% of patients, with no significant difference based on age.

Conclusions:

• Optimizing ear reconstruction requires consideration of preoperative variables.
• Ear reconstruction is a safe outpatient procedure, regardless of patient age.
• An algorithmic approach offers a safe and reproducible method for acquired ear defect reconstruction.