A Los Angeles-based music industry professional came to the SCARS Center desperate to preserve his ability to hear. He had been diagnosed with basal cell carcinoma in his ear canal three years earlier, but deferred treatment for professional reasons. Over time, his hearing began to diminish due to the cancerous mass obstructing his ear canal. Specialists at a leading academic institution scheduled surgery, but a week before his procedure they sat him down and informed him, “We will need to remove your ear drum.”
He was stunned. “It would have been career ending,” he affirmed. There had to be other options. Through a family friend, he learned about the SCARS Center and came to see Dr. Simon Madorsky, a Facial Plastic Surgeon.
Dr. Madorsky recommended Mohs surgery and a complex reconstruction. Mohs surgery of deeply invasive carcinomas can have limitations–Mohs is generally done with local anesthesia, limited equipment, and in a clinic setting. At SCARS Center, the patient was able to have his Mohs surgery done in an operating room. This extended the reach of standard Mohs surgery by providing general anesthesia, advanced surgical cautery, OR suction, advanced surgical instrumentation, and skilled surgical technologists.
A Mohs surgeon (Dr. Baron) excised the patient’s outer ear cancer under local anesthesia. As predicted, complete cancer clearance could not be accomplished, and the patient was moved into the operating room as planned. At that point, under general anesthesia, Dr. Madorsky removed additional deep ear canal skin and cartilage. Tissue were examined on-site in the SCARS Mohs laboratory. Several progressive excisions advanced towards the ear canal, each verified in the lab for cancer clearance. Finally, within 5 mm of the eardrum, Dr. Madorsky was able to achieve clear margins.
Reconstruction of the ear canal was performed at the same time with a tissue flap and a skin graft. The cancer was cleared, and the patient’s hearing was preserved.
“Clear margins. I thought I’d never hear that.”
The recording engineer is back in the rhythm of his profession, the cancer scare in his rear-view mirror.
“The level of professionalism and personalized service at SCARS [Center] can’t be beat. And the surgery center right here. For something that was going so wrong, coming here was a great turning point.”