Peters Mallory, Smith Joshua D, Kovatch Kevin J, McLean Scott, Durham Alison B, Basura Gregory
William Beaumont School of Medicine, Oakland University, Rochester, Michigan, USA.
Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan, USA.
OTO Open. 2020 Oct 19;4(4):2473974X20964735. doi: 10.1177/2473974X20964735. eCollection 2020 Oct-Dec.
To report a single institutional experience with the surgical management of cutaneous periauricular basal cell carcinoma.
Retrospective chart review.
Tertiary academic center.
Retrospective chart review of 71 patients diagnosed with periauricular basal cell carcinoma managed surgically from 2000 to 2016. Data were analyzed with descriptive statistics.
The median age at diagnosis was 73.0 years (interquartile range, 13.0). Of all lesions, 2.8% (n = 2) were preauricular, 80.3% (n = 57) auricular, and 16.9% (n=12) postauricular. Auricular subsites included conchal bowl (36.6%, n = 26), helix (21.1%, n = 15), antihelix (1.4%, n = 1), peritragus (5.6%, n = 4), triangular fossa (1.4%, n = 1), external auditory canal (2.8%, n = 2), and lobule skin (1.4%, n = 1). Surgical approach included wide local excision (80.3%, n = 57), partial auriculectomy (8.5%, n = 6), and total auriculectomy or other combinations of surgical methods (11.3%, n = 8). Due to aggressive pathology, 3 cases required concurrent parotidectomy, neck dissection, ear canal sleeve resection, or mastoidectomy. In sum, 52.1% (n = 37) of cases had clear margins on first pass in the operating room; 25.4% (n = 18) required further resection; and 12.7% (n = 9) demonstrated final positive/overturned margins read as negative from the frozen sections. Reconstruction included full-thickness (25.4%, n = 18) or superficial-thickness (29.6%, n = 21) skin grafts and local flap reconstruction (25.4%, n = 18), while 5.6% (n = 4) required combinations of free flap and/or other reconstruction techniques; 14.1% (n = 10) did not undergo formal reconstruction.
Periauricular basal cell carcinoma occurs in anatomically diverse locations in and around the ear, and multiple surgical methods are required for successful treatment.
报告单中心关于耳周皮肤基底细胞癌手术治疗的经验。
回顾性病历审查。
三级学术中心。
回顾性审查2000年至2016年期间71例经手术治疗的耳周基底细胞癌患者的病历。采用描述性统计方法分析数据。
诊断时的中位年龄为73.0岁（四分位间距为13.0）。在所有病变中，2.8%（n = 2）位于耳前，80.3%（n = 57）位于耳廓，16.9%（n = 12）位于耳后。耳廓亚部位包括耳甲腔（36.6%，n = 26）、耳轮（21.1%，n = 15）、对耳轮（1.4%，n = 1）、耳屏周围（5.6%，n = 4）、三角窝（1.4%，n = 1）、外耳道（2.8%，n = 2）和耳垂皮肤（1.4%，n = 1）。手术方式包括广泛局部切除（80.3%，n = 57）、部分耳廓切除术（8.5%，n = 6）以及全耳廓切除术或其他手术方法组合（11.3%，n = 8）。由于病理表现侵袭性强，3例患者需要同时进行腮腺切除术、颈部淋巴结清扫术、耳道袖状切除术或乳突切除术。总之，52.1%（n = 37）的病例在手术室首次切除时切缘清晰；25.4%（n = 18）需要进一步切除；12.7%（n = 9）的病例最终切缘阳性/冰冻切片阴性结果被推翻。重建方法包括全厚皮片移植（25.4%，n = 18）或薄厚皮片移植（29.6%，n = 21）以及局部皮瓣重建（25.4%，n = 18），而5.6%（n = 4）的病例需要游离皮瓣和/或其他重建技术联合使用；14.1%（n = 10）未进行正式重建。
耳周基底细胞癌发生于耳部及其周围解剖结构各异的部位，成功治疗需要多种手术方法。
