Use of a special knife and blade for Mohs layers when tumor extends to the perichondrium of the ear

摘要

Excision of skin cancers on various locations on the ear is one of the most common challenges in Mohs surgery. The thinness of the auricular skin and the cartilaginous convolutions pose particular challenges. Ulcerated, aggressive, and neglected tumors often extend deep to involve the perichondrium. The Mohs surgeon then faces the challenge of obtaining a complete layer that achieves a tumor-free plane while preserving subjacent cartilage. Use of a 15 blade to dissect the perichondrium off of the cartilage or to excise an ultrathin layer of cartilage can be difficult. This report details a fairly simple method using the Goulian knife with a Week blade to obtain a layer during Mohs surgery when the prior stage reveals tumor histologically deep to perichondrium.