Basal cell carcinoma of the conchal bowl: Interdisciplinary approach to treatment

Objective: The auricle is the site of only 6% of cutaneous neoplasms, but r epresents an area of high risk for recurrence. The purpose of this work is to present a series of patients with basal cell carcinoma (BCC) of the conc hal bowl, and a review of the literature concerning the management of such patients, and to propose an algorithm for use in the treatment of such case s. Method: Nine patients with BCC of the conchal bowl were treated using an in terdisciplinary approach. Each patient was assessed by both otolaryngology and dermatology. Results: None of the patients was found to have clinical evidence of signif icant spread into the external auditory canal (EAC). All were treated with Mohs' micrographic surgery (MMS). In each case, otolaryngology was availabl e to perform en bloc resection of the temporal bone, should the tumour be f ound to extend significantly into the EAC such that it could no longer be a ccessed by MMS. None of the patients were found to have such extension. All cases were reconstructed using full-thickness skin grafts. All patients re main free of recurrence at an average follow-up of 12.2 months. Conclusion: Based on our experience and a review of the literature, we prop ose an algorithm for use in the management of BCCs of the conchal bowl. We suggest that an interdisciplinary approach that combines the efforts of oto laryngology and dermatology can provide optimal care by saving patients nee dless procedures and loss of cosmetically important tissue.