Niparko J K, Swanson N A, Baker S R, Telian S A, Sullivan M J, Kemink J L
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor 48109-0312.
Laryngoscope. 1990 Oct;100(10 Pt 1):1047-51. doi: 10.1288/00005537-199010000-00004.
Three hundred ninety-seven patients with 407 cutaneous malignancies of the auricle, periauricular region, and cartilaginous external ear canal were reviewed. Tumors were most commonly located in the preauricular and postauricular regions, followed by the helix, concha, antihelix, and ear canal. All lesions were excised with Mohs microscopic control of margins. For lesions requiring lateral temporal bone resection, an adaptation of fresh-tissue microscopic control was used to analyze deep and anterior margins suspected of harboring residual tumor. Two-year minimum follow-up of 229 patients with periauricular and auricular tumors (N = 231 tumors) and 14 patients with cartilaginous ear canal tumors (N = 14 tumors) revealed recurrence rates of 6.9% and 14.3%, respectively. Recurrences were most common in cases of large tumors (greater than 2.5 cm), basal cell carcinomas with morphea elements, and multiply recurrent lesions. We conclude that Mohs surgery is comparatively effective, though not uniformly curative, and can be adapted to supplement excision of large tumors in these regions.
对397例患有耳廓、耳周区域和软骨性外耳道皮肤恶性肿瘤的407个肿瘤进行了回顾性研究。肿瘤最常见于耳前和耳后区域，其次是耳轮、耳甲、对耳轮和耳道。所有病变均在莫氏显微控制边缘下切除。对于需要进行颞骨外侧切除的病变，采用新鲜组织显微控制方法分析怀疑有残留肿瘤的深部和前缘。对229例耳周和耳廓肿瘤患者（共231个肿瘤）以及14例软骨性耳道肿瘤患者（共14个肿瘤）进行了至少两年的随访，结果显示复发率分别为6.9%和14.3%。复发在大肿瘤（大于2.5 cm）、具有硬斑病样成分的基底细胞癌以及多次复发的病变中最为常见。我们得出结论，莫氏手术相对有效，尽管并非总能治愈，并且可用于辅助切除这些区域的大肿瘤。
