Institute of Plastic Surgery, Padua University Hospital, 2 Giustiniani Street, 35128 Padua, Italy.
Eur Arch Otorhinolaryngol. 2012 Jun;269(6):1685-90. doi: 10.1007/s00405-011-1827-0. Epub 2011 Nov 12.
Adequate treatment of melanomas of the external ear offers unique surgical challenges because of the complex anatomical features of the auricle and the need for proper oncologic aggressiveness, as well as for valid aesthetic results. In this study, we evaluated nine different cases of melanoma of the auricle treated in our Institute between 1994 and 2008. Every enrolled patient underwent surgical excision, nonetheless reconstruction was performed with different surgical techniques. In accordance with histological reports, we could observe the absence of neoplastic cells in perichondral bone and in cartilagenous tissue, providing further assurance concerning the importance of preserving the outer ear in expectation of reconstruction. As a matter of fact, it has been proven that it is possible to reconstruct the auricle while guaranteeing oncologic safety in melanomas with a Breslow thickness >1 mm. Therefore, an excision preserving the cartilagenous tissue, thus allowing an efficient full-thickness cutaneous grafting may guarantee good functional and aesthetic results. In conclusion, the suggested therapeutic management may be considered in <1 mm melanomas without taking further unnecessary oncologic risks.
由于耳廓的复杂解剖结构以及适当的肿瘤侵袭性和有效的美学效果的需要，对外耳黑色素瘤的充分治疗提供了独特的手术挑战。在这项研究中，我们评估了 1994 年至 2008 年间在我们研究所治疗的 9 例不同的耳廓黑色素瘤病例。每个入组的患者均接受了手术切除，但采用不同的手术技术进行了重建。根据组织学报告，我们可以观察到软骨膜骨和软骨组织中没有肿瘤细胞，这进一步证明了保留外耳以期待重建的重要性。事实上，已经证明在 Breslow 厚度>1 毫米的黑色素瘤中，通过保留软骨组织的切除，同时保证肿瘤安全性，可以进行有效的全厚皮片移植来重建耳廓。因此，建议的治疗管理可以在外耳黑色素瘤厚度<1 毫米的情况下考虑，而不会带来不必要的肿瘤风险。
