Skin Cancer of the Ear: Mastoid Interpolation Flap Reconstruction Tips

Abstract

Skin cancers are very common on the ear, due to its unprotected position on the body during outdoor activity, and continuous exposure to the sun through the car window while driving. The incidence of squamous cell carcinomas on the ear appears to be higher than that of basal cell carcinomas – with reports suggesting squamous cell carcinomas being the most common (>50 %), followed by basal cell carcinomas (30–40 %), and less frequently, melanomas(<5 %) [1]. The ear has special considerations due to its lack of underlying subcutaneous tissue. This allows for the potential of early perichondrial involvement of cutaneous tumors. It is therefore important to always examine regional lymph nodes of the neck, especially in cases of squamous cell carcinoma and malignant melanoma. When it comes to skin cancers of the neck with perochondrial involvement, up to a third of patients may have lymphatic spread [2]. Of course the goal following oncological resection is to recreate the ear to match the other ear; however as both ears are rarely viewed simultaneously in any facial view and may be partially or completely covered by hair, the size, position, and orientation of the ear to the scalp and anterior face may be more important than a geometrically exact match of the other ear. The most important skin-cartilage components that are necessary to make a recognizable ear are the helix, tragus, antitragus, and concha [3].