What degree of deformity resulting from upper auricular wedge resection in elderly patients is acceptable?

Introduction: Auricular malignant tumors are common in elderly patients; therefore, there is a need to establish a simple reconstructive surgery. This study aimed to determine the extent to which surgical wedge resection can be used in elderly patients with auricular malignant tumors. Patients and Methods: Clinical photographs were taken of three elderly patients (case 1: age 75 years, defect 15 mm; case 2: age 93 years, defect 30 mm; case 3: age 88 years, defect 35 mm) who underwent wedge resection and simple suture for squamous cell carcinoma of the upper part of the ear and were evaluated by 28 plastic surgeons. The following evaluation items were rated on a 5-point scale: balance, length, width, standing and curvature of the auricular region. Results: In case 1 (15-mm defect), the 75th percentile of length, width, and erection was less than 1 point (within the acceptable range). However, overall balance and curvature were less than 2 points (within the acceptable range only for elderly patients). In cases 2 and 3 (defects: 30-35-mm), the 75th percentiles of overall balance, length, width, and erection were less than 2 points, while in case 3, the curvature exceeded 2 points. The average scores for each item in case 1 were generally less than 1 point, and the average scores for all items in cases 2 and 3 were less than 2 points. Discussion and Conclusion: This study suggests that only simple suturing is cosmetically acceptable for ear defects of approximately 30 mm in elderly patients, representing significantly reduced surgical invasiveness.