Abstract
Approximately 6% of all head and neck skin cancers arise from the external ear, of which squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are the most common. Acquired helical rim defects can be caused by injury or after excision of a tumor. Since many patients feel that the auricle has a functional and cosmetic importance, it is crucial to consider the esthetics. In cases where the defect exposes bare cartilage, second-intention healing is usually not achieved. Therefore, full-thickness skin grafts have been adopted, but the healing time is long and in many cases, mismatch of color between the grafted skin and the surrounding ear has been observed. Alternatively, reconstruction with flaps may provide optimal coverage. Among the many possible flap designs, the rhombic transposition flap has become widely utilized in dermatologic surgery, due to its simplicity and versatility. Herein, we report a case of SCC on the superior helical rim (of which the cartilage was spared) successfully managed with a rhombic transposition flap. The surgical procedure had been relatively simple and the resultant ear helix was free from deformity. In future, we recommend that defects of the ear helix, which have an intact cartilage, should be treated with a rhombic transposition flap to give a successful cosmetic and functional outcome.