Malignant Tumours of the External Ear

CH Karsli, OM Antonyshyn, CR Forrest, D Assaad, I Ackerman. Malignant tumours of the external ear. Can J Plast Surg 1994;1(4): 177-183. This study employs a retrospective chart review to describe the demographic features, clinical presentation and treatment of malignant tumours of the external ear. This series includes 129 tumours of the external ear in as many consecutive patients presenting to the Toronto Bayview Regional Cancer Centre between January 1986 and December 1991. Sixty-seven per cent of those tumours were basal cell carcinomas, 32% were squamous cell carcinomas, and a single case of Kaposi's sarcoma was encountered. The majority of patients was male and the mean age was 70.1 years. The helical rim was the most common site of involvement, followed by the postauricular, conchal and antihelical regions. Small tumours were located in the visually obvious areas of the ear, namely the helix and lobule, whereas larger tumours were found in the deeper central portions such as the concha and external auditory meatus. Twelve per cent of squamous cell carcinomas were metastatic at the time of treatment. Treatment methods included electrodesiccation and curettage, surgical excision with or without frozen sections, radiotherapy or combination therapy. Surgical excision, with frozen section control in carefully selected cases, remains the treatment of choice for the majority of external ear tumours. Various methods of reconstruction of the resulting defects are described.