Spatial hearing after auricular resection for non-melanoma skin Cancer

To explore spatial hearing outcomes in patients undergoing auricular resection and reconstruction for non-melanoma skin cancer (NMSC) of the external ear.

Consecutive case series.

Twenty-three patients treated surgically for NMSC of the auricle between December 2023 and January 2026 were evaluated. Postoperative functional assessment included pure-tone audiometry (PTA) and the 12-item Speech, Spatial and Qualities of Hearing Scale (SSQ-12). Associations between spatial hearing performance and demographic, clinical, and surgical variables were analyzed using Spearman correlation and nonparametric group comparisons.

The mean age was 77.0 ± 9.2 years. Mean bilateral PTA was 40.2 ± 9.7 dB HL, consistent with mild-to-moderate hearing loss. The mean SSQ-12 total score was 3.9 ± 1.6, indicating mild-to-moderate self-reported spatial hearing difficulty. SSQ-12 total score demonstrated a strong correlation with PTA (ρ = -0.767, p < 0.001), whereas no significant association was observed with age, lesion size, or surgical duration. Comparison between patients undergoing reconstruction and those managed by primary/secondary intention revealed no significant difference in overall SSQ-12 scores.

In this exploratory series, spatial hearing outcomes following auricular resection for NMSC were primarily associated with baseline auditory thresholds rather than lesion size or reconstructive strategy. While restoration of auricular morphology did not significantly affect global spatial hearing scores, task-dependent differences in challenging listening environments suggest a potential functional role of restoring auricular contour. These preliminary findings highlight the need to integrate functional hearing considerations into auricular oncologic surgery and support further prospective studies incorporating objective localization measures.