Treatment of Post-Mohs Surgical Wounds of the Auricular Helix

Mohs micrographic surgery is the preferred method for treating certain types of skin cancer, including squamous cell carcinomas (SCCs) and basal cell carcinomas, as it preserves the greatest amount of healthy tissue while ensuring clear margins and can be performed as an outpatient procedure. Auricular post-Mohs surgical wounds can be challenging to address, however, due to the ear’s highly contoured nature. As noted by Bittner et al, function and aesthetic must both be considered in the healing process, not only for the potential impact on patient self-esteem, but also for individuals who require eyeglasses or hearing aids.¹

In a recent case series, 4 patients had Mohs micrographic surgery to remove nonmelanoma skin cancers located on the auricular helix. One patient, an 83-year-old man, had a keratoacanthoma-type SCC removed from his left posterior auricular helix. Following the Mohs procedure, he was left with a postsurgical defect that measured 6.0 cm x 4.5 cm after tumor-free margins were achieved. The patient declined the use of a large mastoid pedicle interpolation flap to treat the defect.

References

1. Bittner GC, Kubo EM, Fantini BC, Cerci FB. Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases. An Bras Dermatol. 2021;96(4):408-415. doi:10.1016/j.abd.2020.12.008