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We describe a simple, quick and neat technique to perform auricular wedge excision. We used this technique in 42 skin lesions located at the helical rim.
The lesion is marked with the appropriate margins under loupe magnification. The superior and inferior margins are extended medially until they meet on both the anterior and posterior aspects of the ear. This forms an isosceles triangle with its base at the helical rim (Figure 1a and b).
Figure 1Nodular BCC to helical rim marked with appropriate margins: a. anterior aspect b. Posterior aspect.
At the wedge tip a 2–3 mm circle of cartilage without skin is excised to prevent dog-ear formation. This is essential when the wedge tip is greater than 30° (Figure 3a). Wedge edges are approximated in layers using absorbable sutures (Figure 3b).
Figure 3a. A 2–3 mm circle of cartilage without skin is excised from the wedge tip to prevent dog-ear formation b. Wedge edges are approximated in layers.
The use of number 11 blade instead of the 15 blade, more commonly used in plastic surgery procedures, added more simplicity and accuracy to the excision margins. The combination of the penetrating and cutting action of the 11 blade has improved the quality of the cut margins. In addition, the advantage of the simultaneous anterior to posterior symmetrical resection is reflected in the neat cut edges and aided closure (Figure 2b). This prevents under or overcutting the posterior wall layers as may happen whilst using the 15 blade.
The use of the 11 blade in our experience had made auricular wedge resection quick and easy. It also produced a reliable aesthetic outcome even in the hand of less experienced surgeons (Figure 3b).
Conflict of interest
None.
Funding
None.
References
Mahajan A.L.
Helix reconstruction with wedge resection in the right place.
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