Case 2: Wedge excision

Authors: Frederik Gulmark Hansen, med.stud. and Magnus Balslev Avnstorp, MD

Aggressive squamous cell carcinoma on the left antihelix.

Before and after

Step 1: Drawing

Drawing is made in a 6-7 mm margin

Step 2: Excision

Excision in 6-7 mm margin including chondral parts. A wedge excision was used, strecthing into the cavum concha.

Step 3: Undermining

Radical excision was verified by a pathologist. The skin was undermined and the upper and lower part of the ear was adapted using absorbable sutures (mattress suture).

Step 4: Closure

The skin was closed with nylon sutures

Step 5: Assessment of adaption

Perfect adaptation of the helical rim is important to close the posterior side on the ear and excise medially enough to avoid “a cup ear”

Step 6: Posterior view of adaption

Posterior view of the adaption

Step 8: Closure

After the removal of the tumor the left ear was a bit smaller compared to the right side, but remained its natural shape.

Step 9: Result

Posterior view of the final result

Step 10: Post operative photo

Micropore is applied to the cicatrice to avoid stretching