Local flaps

1. A case of Cutaneous
Horn of pinna
Dr Ajay Manickam MS DNB
Fellow Head & Neck Oncology

2. Pathophysiology

3. Case History
88 years old male gentleman
presented with ℅ swelling in the Rt
side pinna for the past 1 year.
℅ discharge from bottom of the
growth for the past 10 days

4. Case History
h/o surgery for thyroglossal cyst 15 years
back @Thanjavur medical college
No h/o bleeding
No h/o pain
No h/o hard of hearing
No h/o loss of weight / appetite
No h/o TB / any other chronic diseases
No h/o ear discharge
No h/o neck swelling

5. Clinical
Examination
ECOG 1
Proliferative growth seen over the RT
side pinna around 5 cm in length
width of around 2cm with base over
the conchae
Small warty growth seen around its
basal attachment

6. Clinical picture

7. Clinical
examination
Examination of RT side ear - WNL
Examination of nasal cavity - WNL
Examination of oral cavity. - WNL
Examination of neck - no palpable swelling
Video Otoscopy, Nasal endoscopy, Video
laryngoscopy - WNL

8. Differential
diagnosis
1. Cutaneous Horn
2. Verrucous Hyperplasia
3. Verrucous carcinoma
4. Invasive squamous cell carcinoma

9. Investigations
Routine workup for Pre anaesthesia
check up was done

10. Wide local excision of the
lesion + Split skin graft /
Local flap under GA
PLAN

12. The specimen after wide
excision with margins

15. Post op care
No antibiotics - clean wound
Mastoid dressing - removed after 24
hours
Pain killers
Discharged on day 10

16. Histopathology
reports
Squamous cell hyperplasia without
evidence of invasive cancer

17. Thank you
DR Bamini, DR Ponnarasi,
DR Thanu, DR Tharun, DR Tahera, DR Tamil,
DR Swathika, DR Surya