ABSTRACT
The external ear has obvious functional and cosmetic importance. Dermatologic surgeons frequently treat skin cancers and a variety of dermatologic diseases affecting this area. Proper selection of the method(s) of therapy depends upon many factors that include the following:
1. Anatomy of the region 2. Pathology type of the lesion to be treated 3. Skin type and degree of solar damage 4. Age and general health of the patient 5. Surgeon’s knowledge of various therapeutic
modalities
ANATOMY The auricle or pinna, formed by skin and cartilage, is dependent upon a complex cartilaginous framework for its contour and support. The auricle contains a number of prominences and depressions. The concha, anthelix and helix, and tragus and antitragus (Fig. 1) are important landmarks. The anterior one-third is attached to the skull and the posterior two-thirds to the scalp only. The skin is intimately attached over the surface of the cartilage except along the helix. The blood and nerve supply is abundant and complex (Fig. 2). The blood supply consists of the anterior auricular artery, a branch of superficial temporal artery supplying the lateral surface, and the posterior auricular artery supplying the medial surface and a small portion of the lateral surface. In addition, the occipital artery gives off a branch supplying the medial surface. The lymphatic drainage consists of superficial, deep cervical nodes and mastoid lymph nodes. The retroauricular area includes the mastoid process behind the ear. The medial area faces the retroauricular area, and the lateral surface is the external auricular surface.
