Abstract
Malignant tumors of the external ear are frequent. There is considerable discussion in the literature about the principles of surgical treatment. To find out whether ear preservation in these tumors is safe, a retrospective study was carried out in 77 consecutive patients with 91 tumors resected for suspicion of malignancy. In 70 patients the tumors were malignant. After three years, at review 62 of the 70 patients were alive, 59 (95.2%) were available for examination. Two of the 26 squamous cell carcinomas recurred, one of them in a patient with immunosuppression after kidney transplant. No metastatic disease was found. All ten patients with malignant melanoma — one of them with Breslow thickness >1.5 mm – were free of recurrence and metastasis after 49 months on average. One patient with Merkel cell carcinoma, however, died of metastatic disease to the neck, para-aortal and retroperitoneal lymph nodes. In conclusion, it is our experience that tumors of the external ear could be managed safely by conservative resection with intraoperative frozen section and meticulous long-term clinical follow-up. This allows for satisfactory preservation of the external ear.
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References
Afzelius LE, Gunnarsson M, Nordgren H (1980) Guidelines for prophylactic radical lymph node dissection in cases of carcinoma of the external ear. Head Neck Surg 2:361–365
Cocheril RC (1894) Essai sur la restauration du pavillon de l'oreille. MD thesis, L Danel, Lille
Converse JM (1977) Reconstructive plastic surgery, 2nd ed, vol 3. WB Saunders, Philadelphia, p 1718
Drepper H, Köhler CO, Bastian B, Breuninger H, Brocker EB, Göhl J et al. (1993) Benefit of elective lymph node dissection in subgroups of melanoma patients. Cancer 72:741–749
Hudson DA, Krige JEJ, Strover RM, King HS (1990) Malignant melanoma of the external ear. Br J Plast Surg 43:608–611
Leferink VJM, Nicolai JPA (1988) Malignant tumors of the external ear. Ann Plast Surg 21:550–554
7.Meland NB, Jackson IT (1986) Merkel cell tumor: diagnosis, prognosis and management. Plast Reconstr Surg 77:632–638
Pless J (1976) Carcinoma of the external ear. Scand J Plast Reconstr Surg 10:147–151
Ratner D, Nelson BR, Brown MD, Johnson TM (1993) Merkel cell carcinoma. J Am Acad Dermatol 29:143–156
Rogers GS (1991) Surgical management of stage I malignant melanoma. Dermatol Clin 4:649–655
Rowe DE, Carroll RJ, Day CL (1992) Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear and lip. J Am Acad Dermatol 26:976–990
Schauberger G, Keck G (1990) Beitrag zur Bestimmung der solaren UV Belastung der Haut: Eine epidemiologische Betrachtung zur Aetiologie des Basalioms. Aktuel Dermatol 16:298–302
Shack RB, Barton RM, DeLozier J, Rees RS, Lynch JB (1994) Is aggressive surgical management justified in the treatment of Merkel cell carcinoma? Plast Reconstr Surg 94:970–975
Shockley WW, Stucker FJ (1987) Squamous cell carcinoma of the external ear: A review of 75 cases. Otolaryngol Head Neck Surg 97:308–312
Sober AJ, Lew RA, Koh HK, Barnhill RL (1991) Epidemiology of cutaneous melanoma. Dermatol Clin 9:617–629
Thomas SS, Matthews RN (1994) Squamous cell carcinoma of the pinna: A 6-year study. Br J Plast Surg 47:81–85
Wanebo HJ, Cooper PH, Young DV, Harpole DH, Kaiser DL (1988) Prognostic factors in head and neck melanoma. Cancer 62:831–837
Zeitels J, LaRossa D, Hamilton R, Synnestvedt M, Schultz D (1988) A comparison of local recurrence and resection margins for stage I primary cutaneous malignant melanomas. Plast Reconstr Surg 81:688–693
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de Roche, R., Linden, M., Büchner, S.A. et al. Long-term experience with ear preservation in malignant tumors of the external ear. Eur J Plast Surg 19, 240–244 (1996). https://doi.org/10.1007/BF00171877
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DOI: https://doi.org/10.1007/BF00171877