Surgical management of auricular infantile hemangiomas.

OBJECTIVE To report our experience with surgical management of auricular infantile hemangiomas and reconstruction of the affected ear. DESIGN Retrospective case series. SETTING Dedicated Birthmarks and Vascular Anomalies Center in a tertiary pediatric hospital. PATIENTS Ten patients with surgically treated, histopathologically confirmed auricular infantile hemangiomas. MAIN OUTCOME MEASURES Outcomes of surgical management. RESULTS The case series included 5 male and 5 female patients (age range, 4 months to 4 years). Indications for surgery were pain, bleeding, infection, and cosmetic deformity. Four patients had failed prior medical treatment, including pulsed dye laser, topical corticosteroids, and intralesional corticosteroids. Nine patients underwent single-stage resection. Otoplasty reconstruction was performed in 2 patients with hemangioma-induced deformities, while primary Z-plasty closure was performed in 2 patients with extensive lesions. No recurrence or complication has been reported to date. CONCLUSIONS Most infantile hemangiomas do not require treatment. Surgical excision of auricular infantile hemangiomas at any phase is effective in preventing fibrofatty scarring, reducing cartilage deformities, and treating complicated cases or patients who have failed medical management. Surgical excision with Z-plasty reconstruction is a viable option that should be considered to limit postoperative deformities.