In this case we have a 77 year old lady with a basal cell carcinoma of her left ear. The lesion is excised and repaired using a wedge resection. The procedur.. Simple wedge resection is widely used for reconstruction of full-thickness helical rim defects smaller than 1.0 to 1.5 cm. 1 For reconstruction of defects up to 2.5 cm, crescentic or star excisions can be used. However, these techniques can frequently cause skin contraction and ear cupping Anesthesia with 1% lidocaine with epinephrine 1:100,000 and another sterile prep were performed. A wedge excision was completed by carrying down an excision through the full thickness of the ear and cartilage with an inward facing Burow's triangle If the specimen is a wedge resection, slice off the resection margins at the two ends of the specimen, then serially section the remainder of the specimen, roughly parallel to the end margins. If the specimen is a subtotal or total external ear, slice off the margin, then serially section the specimen perpendicular to the border of the helix Defects on most aspects of the helix can be repaired with a wedge excision (see the image below). The principle behind the wedge closure is the conversion of the defect into a full-thickness..
Wedge excision is considered an easy, effective, single-stage method of ear excision and reconstruction. 1 However, it is associated with certain deformities, such as webbing, butterfly deformity, and cupping of the ear. 2 Webbing is attributed to progressive cartilage separation at the suture line caused by its elastic memory 69110 Excision external ear; partial, simple repair 69140 Excision exostosis(es), external auditory canal 40510 Excision of lip; transverse wedge excision with primary closure 40520 Excision of lip; V-excision with primary direct linear closure 40525 Excision of lip; full thickness, reconstruction with local flap (e.g., Estlander or fan). The ear wedge is a useful repair option for excision of tumors on the helix or for a large Mohs defect, encompassing both anterior and posterior skin of the auricle with or without loss of cartilage. A large tumor on the helix is excised in a wedge shape, and the resultant edges are brought together
Skin cancer on the ear is not uncommon. Complete excision offered the best cure rate. Excision is quite easy as demonstrated It is not uncommon to be able to get the two edges of the auricular rim approximated, but the resulting ear will have a significantly different shape and height than the unaffected ear on the contralateral side (▶ Fig. 19.6 and ▶ Fig. 19.7). Fig. 19.6 Primary closure following wedge resection
Wedge excisions are used on the external ear and (lower) eyelid and have unusual properties. They are frequently submitted as orientated specimens. A wedge of the pinna will have skin on both sides and as such has no deep margin. Instead, the margins are the sides of the wedge and the point Wedge excision is a technique used to remove cancers from the edge of the lip, ear or eyelid. It involves a full thickness wedge of tissue being removed and repaired with sutures to restore a normal appearance Certain practices such as sleeping on the affected ear, extensive phone or cell phone usage, large ear pieces worn by telephone operators, and headphones have all been linked to cases of CNH. and some physicians advocate a partial excision procedure involving the cartilage rather than a wedge excision of the auricle The excision can be performed by cutting a triangle wedge from the ear, extending as necessary in to the anti helix. Attempt to allow at least 1mm of skin overhang beyond the cartilage on either side to allow approximation with skin eversion and complete cartilaginous coverage. For deep/extensive wounds, consider layered closure
Wedge excision per se is insufficient therapy and should only be MALIGNANT MELANOMA OF THE EXTERNAL EAR used as a diagnostic excisional biopsy. If a melanoma is confirmed, the definitive procedure should be a wide local excision encompassing margins of at least 10 mm. Lesser resection margins in the ear, in our series, inevitably led to either. . Helical rim advancements can result in anteversion of the ear and a smaller lobule. Mastoid interpolation flaps, which are also called retroauricular to auricular flaps, can be a.
LIP, EYELID OR EAR, FULL THICKNESS WEDGE EXCISION OF, with repair by direct sutures Multiple Operation Rule (Anaes.) Fee: $339.25 Benefit: 75% = $254.45 85% = $288.4 wedge excision to ear and lip. Squamous cell carcinoma to the ear and lip requiring wedge excision. Wedge excision is reserved for the eye-lids, lips and ears. The lip is very elastic, 1/3 of the lip can be wedged out without obvious deformity. The inside surface barely scars. Wedge excision to the ear can be tricky Karam F, Bauman T (1988) Carbon dioxide laser treatment for chondrodermatitis nodularis chronica helicis. Ear Nose Throat J; 67:757-763. Kitchens GG (1989) Auricular wedge resection and reconstruction. Ear Nose Throat J; 68:673-683. Lawrence CM (1991) The treatment of Chondrodermatitis nodularis with cartilage removal alone. Arch Dermatol; 127.