Auriculectomy

Auriculectomy is a surgical procedure that removes all or part of the external ear, or auricle. It can be performed as a partial (subtotal) auriculectomy, preserving some ear tissue, or as a total auriculectomy, removing the entire auricle. The operation is most commonly done for oncologic reasons, but may also be indicated for severe trauma, necrotizing infection, or other nonviable tissue affecting the auricle.

Indications include malignant tumors of the auricle or surrounding skin, most commonly basal cell carcinoma and squamous cell carcinoma, with other cancers such as melanoma being less frequent. Other indications are extensive traumatic loss or destruction of the ear, chronic or nonhealing skin conditions, and, in some cases, congenital deformities where removal aids reconstruction. The choice between subtotal and total resection depends on tumor extent, tissue viability, and cosmetic considerations.

Surgical technique generally involves general anesthesia. The surgeon excises the auricle or its affected portion with appropriate margins, shaping the defect for optimal healing and function. Soft-tissue coverage is achieved with local retroauricular or scalp skin flaps, regional flaps, or, in larger defects, free tissue transfer. For cosmetic restoration, an auricular prosthesis may be used and can be anchored with implants or adhesives when reconstruction is not feasible or desired.

Complications can include bleeding, infection, hematoma, wound dehiscence, flap or graft failure, and numbness of surrounding skin from nerve injury. There is a risk of cosmetic deformity and, in oncologic cases, the need for ongoing surveillance for recurrence. Outcomes depend on indication, achieved margins, and reconstructive options, with prosthetic rehabilitation offering a common route to facial symmetry.