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When Is Chemotherapy (Mohs' Technique) Necessary?

Robert M. Bumsted, MD; Roger I. Ceilley, MD; William R. Panje, MD; Roger L. Crumley, MD

Arch Otolaryngol. 1981;107(11):721-724.

Abstract
• A prospective study of 71 auricular malignant neoplasms was performed to identify lesions with a high risk of recurrence. Previously recommended margins for conventional surgical excision were marked. Then, all lesions were excised by the Mohs' technique. The Mohs' defect was compared with previously marked margins for conventional excision. Conventional excision would have been inadequate in 13% of primary and initially recurrent lesions smaller than 1 cm (clinical examination) and in 27% of primary lesions and 33% of recurrent lesions larger than 1 cm. All cases successfully excised by conventional excision would have resulted in a larger defect than the actual Mohs' defect. Morpheaform basal cell carcinoma was the most common lesion inadequately excised. Either cases of this histologic type or lesions larger than 1 cm or both require consideration for the use of the Mohs' technique.

(Arch Otolaryngol 1981;107:721-724)

Author Affiliations
From the Departments of Otolaryngology and Maxillofacial Surgery (Drs Bumsted and Panje) and Dermatology (Dr Ceilley), University of Iowa Hospitals and Clinics, Iowa City; and the Department of Otolaryngology, University of California, San Francisco (Dr Crumley).

Footnotes
Accepted for publication May 26, 1981.

Read before the combined meeting of the Society of Head and Neck Surgeons and the American Society for Head and Neck Surgery, Phoenix, Ariz, March 11, 1981.

Reprint requests to the Department of Otolaryngology and Maxillofacial Surgery, University of Iowa Hospital and Clinics, Iowa City, IA 52240 (Dr Bumsted).

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