16.  A patient has a 2-cm basal cell cancer of the concha.  What do you do?

Answer:
If after excision, the perichrondium is intact then you can skin graft the conchal defect. Several options are possible if the perichrondium is resected.  Dermal punches can be taken so that the opposite perichrondium is allowed to granulate into the wound and allow skin grafting. The cartilage can be resected completely to expose the opposite side's perichrondium to allow immediate reconstruction.  A full thickness defect can be reconstructed with a postauricular flap.  This can be based superiorly or inferiorly and can include only skin or postauricular muscle as well.

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