Mohs F E
Department of Surgery, University of Wisconsin Hospital and Clinics, Madison.
Arch Otolaryngol Head Neck Surg. 1988 Jun;114(6):625-31. doi: 10.1001/archotol.1988.01860180039026.
Auricular melanoma poses two primary problems: eradicating the primary neoplasm and managing potential satellites; both must be solved without spilling the highly transplantable cells. A secondary problem is the need to spare the cartilaginous framework that gives shape to the ear. With fixed-tissue micrographic surgery, all incisions are made through fixed (killed) tissue as successive layers of tissue are conservatively removed for microscopic scanning of their undersurfaces by the systematic use of frozen sections. Because no incisions are made through live tissue, no melanoma cells are spilled during the excision of the neoplasm and its "silent" outgrowths. Satellites too small to be seen are not moved or disturbed and can be removed as they appear. The reliability of the method is indicated by a five-year cure rate of 75% in a series of 17 patients.
根除原发性肿瘤并处理潜在的卫星灶；必须在不溢出高转移性细胞的情况下解决这两个问题。第二个问题是需要保留赋予耳朵形状的软骨框架。采用固定组织显微手术时，所有切口均通过固定（灭活）组织进行，随着组织的连续层被保守切除，通过系统使用冰冻切片对其底面进行显微扫描。由于未对活组织进行切口，在肿瘤及其“隐匿性”生长物切除过程中不会溢出黑色素瘤细胞。太小而看不见的卫星灶不会被移动或干扰，可待其出现时再切除。在一组17例患者中，该方法的五年治愈率为75%，表明了该方法的可靠性。
