No abstract available.
Carcinoma, Basal Cell* ; Mohs Surgery* ; Sutures*

The nasal ala is a challenging area for surgical reconstruction, with thick sebaceous skin, the lack of an ample tissue reservoir, and an adjacent free margin. Numerous flaps have been reported for the repair of alae defects. A 71-year-old woman with simultaneous basal cell carcinomas involving both nasal alae was treated by Mohs micrographic surgery. The surgical defects measured 1.5x1.5 cm on the center of the right nasal ala and 1.0x1.0 cm on the left nasal ala, including the alar crease and rim. The right nasal ala was used as a nasolabial transposition flap and the left nasal ala was reconstructed by an island pedicle flap. The final shape and texture were satisfactory. The flaps survived and nasal symmetry was preserved. Combined nasolabial transposition and island pedicle flaps thus offer a superior esthetic and functional result owing to minimized tension. This may be a valuable reconstructive option in the repair of bilateral nasal alae defects.
Aged ; Carcinoma, Basal Cell ; Female ; Humans ; Mohs Surgery ; Skin ; Succinates

In reconstructing skin defects on the periorbital area, functional maintenance, as well as cosmetic outcomes, should be seriously considered. The periorbital defects, after Mohs micrographic surgery, are not easily treated with simple closure or flaps, as the defects are relatively large, but the areas have low laxity and locate closely with cosmetically important components in the face. We experienced two patients of basal cell carcinoma (BCC) on the medial canthus, which were completely excised with Mohs micrographic surgery. The defects after Mohs surgery were reconstructed by combining the techniques of transposition flap, island pedicle flap, and skin graft. Two patients were very satisfactory with post-operative results in both functional and cosmetic aspects. To our experiences, the combination of flaps and graft can be a simple and a cosmetically excellent method in reconstructing the relatively large defects for BCC removal on the periorbital area.
Carcinoma, Basal Cell ; Cosmetics ; Humans ; Mohs Surgery ; Skin ; Transplants

BACKGROUND: The transposition flap is one of the most useful methods of facial reconstruction after Mohs micrographic surgery of the basal cell carcinoma, but occasionally some variations are needed. OBJECTIVE: We present our experience with several variations of the transposition flap to overcome the disadvantages of classic rhomboid flaps. METHODS: We performed the Webster 30-degree angle flap on the lower eyelid, the double 30-degree angle flap on the temple area and the nasolabial flap on the ala nasi. RESULTS: These variations of the transposition flap gave no complications such as ectropion, tissue distortion, protrusion, or trapdoor deformity. CONCLUSION: The variations of the transposition flap in our cases might be of help in selecting the ideal method in facial reconstruction.
Carcinoma, Basal Cell* ; Congenital Abnormalities ; Ectropion ; Eyelids ; Methods ; Mohs Surgery*

A technique for the chemical fixation of cutaneous tumors followed by serial excision using microscopic control has been developed since the mid 1930s. Mohs micrographic surgery is the most reliable and cost effective treatment modslity, offering maximal preservaticn of normal tissue and therefore the lowest functional and cosmetic morbidity in the cancer treatments. We report a case of basal cell carcinoma treated with Mohs micrographic surgery and reconstructed with nasalis myocutaneous sliding flap. The pstient was a 56-year-old woman, who had a been sized basal cell carcinoma on her nasal tip for the previous 3 years. The lesion was removed under complete microscopical control using fresh tissue technique. The defect healed with atrophic scar formation ore and half months later. To remove scar tissue and to gsin proper cosmetic results, reconstruction with nasalis myocutaneous sliding flap was performed successfully.
Carcinoma, Basal Cell* ; Cicatrix ; Female ; Humans ; Middle Aged ; Mohs Surgery

Nevus-like basal cell carcinoma syndrome (NBCCS) is a rare autosomal dominant disease characterized by the occurrence of multiple maxillofacial keratocysts, basal cell carcinoma, child medulloblastoma, and various skeletal and soft tissue dysplasia. In 2020, a patient with NBCCS dominated by facial basal cell carcinoma was admitted to Xiangya Hospital of Central South University. The patient was an elderly woman. Ten years ago, the systemic mass appeared, especially on the face, but it was not treated. Later, these masses gradually increased in volume and number, and showed invasive properties. The nasal mass was broken and suppurated, seriously affecting the patient's life quality. The patient came to the hospital to improve the symptoms. Staphylococcus aureus and Providencia rettgeri were cultured in the patient's nasal secretions. Nasal sinus enhanced MRI showed that the subcutaneous soft tissue of the right cheek and the anterolateral mucosa of the left nasal cavity were invaded, indicating multiple malignant skin lesions. After admission, local anesthesia was performed and some masses were removed. Pathological examination of the mass showed basal cell carcinoma. After general anesthesia, multiple masses were resected. The postoperative pathological examination showed that multiple basal cell carcinoma invaded the deep dermis near subcutaneous fat layer. Combined with the results of clinical and immunohistochemical examination, the patient was diagnosed as NBCCS. There were no clear tumor thrombus in the vessel and no nerve invasion. No recurrence or new tumor was found after 1 year follow-up. The incidence rate of NBCCS is low and clinical symptoms are different. The patient's life quality is poor and the patient needs long-term individualized treatment.
Aged ; Basal Cell Nevus Syndrome/surgery* ; Carcinoma, Basal Cell/surgery* ; Child ; Female ; Hamartoma Syndrome, Multiple ; Humans ; Magnetic Resonance Imaging

Objective: To explore the methods for the accurate resection of malignant tumors of the external nose, and the accurate evaluation and repair of tissue defects. Methods: We collected 48 cases with nasal malignant tumors treated in 980 Hospital, Joint Support Force of the People's Liberation Army from January 2010 to June 2020, including 28 males and 20 females, aged 36-86 years. The pathological types of tumors included basal cell carcinomas (n=29), squamous cell carcinomas (n=11), trichilemmal carcinomas(n=6), denoid cystic carcinoma (n=1) and non-Hodgkin lymphoma (n=1). Tumor resection was mainly based on the traditional extended resection determined by the safety margin, and Mohs surgery was used to minimize the scope of resection, for the margin that significantly affected the repairing results, such as the lesion adjacent to the nasal alar margin, nasal columella or deep easy-penetrating margin. All cases obtained tumor resection and primary/secondary defect reconstruction. Results: According to the pathological type and tumor size, the safe resection margin was mainly 4-10 mm, and Mohs surgery was used in 24 cases. Limited-size defects in 38 cases were repaired with double-leaf flaps, kite flaps, nasal dorsum brow flaps, nasolabial flaps or free tissues. Among 10 cases with compound defects, 8 cases were repaired with frontal flaps, including 4 cases with single frontal flaps, 2 cases with additional titanium mesh stent reconstruction and 2 cases with over and out frontal flaps. During follow-up of 1 to 10 years, all the flaps survived without flap necrosis, and the postoperative nasal contour and ventilation were satisfactory. One patient had tumor recurrence 18 months after operation, 2 patients died of cardiovascular and cerebrovascular diseases, and other patients survived without tumors. Conclusions: Mohs surgery can basically meet the requirements for precise resection of external nasal malignant tumors. Individualized application of adjacent tissue flaps and various frontal flaps is a reasonable choice to achieve the satisfactory outcome of external nasal repair and to take into account the complexity of operation.
Carcinoma, Basal Cell/surgery* ; Female ; Humans ; Male ; Nasal Septum ; Nose Neoplasms/surgery* ; Skin Neoplasms ; Surgical Flaps

OBJECTIVETo introduce the application of slender narrow pedicle flap in repairing facial tissue defects after skin carcinoma excision, and investigate its survival mechanism.

METHODSThe slender narrow pedicle iateral maxillocevical flap was designed with its pedicle including skin fascia or only the fascia located in front of auricle or behind of it, repaired 26 cases of facial defects, including 5 temporal skin basal cell carcinoma, 6 skin squamous cell carcinoma, and 1 facial skin malignant melanoma, 8 skin basal cell carcinoma, 5 skin squamous cell carcinoma, 1 skin mucinous carcinoma. In 26 cases, 24 cases their pedicles in front of the auricle, 2 cases behind of the auricle; 4 cases their pedicles only including fascia. The size of the flaps ranged from 3.0 cm x 2.5 cm to 10.0 cm x 8.0 cm. The width and length of the pedicle ranged 1.0-1.5 cm and 2-6 cm.

RESULTS26 cases of the slender narrow pedicle flaps all survived and the results were satisfactory except 5 cases of distal congestion, then gradual recovery.

CONCLUSIONSThis slender narrow flap don't include any major blood vessel, without dissecting the blood vessels in operating. Due to its slender pedicle, the whole flap looks like "pingpang bat", the flap rotation is easy and its coverage area is very large, without cat ears. The postoperative appearance (color, texture, cosmetic aspect) is satisfactory. This slender narrow flap is an extraordinary new flap design and is ideal for the repair of the facial tissue defect after skin carcinoma excision.

Carcinoma, Basal Cell ; surgery ; Carcinoma, Squamous Cell ; surgery ; Ear Auricle ; Ear, External ; Facial Neoplasms ; surgery ; Fascia ; transplantation ; Humans ; Melanoma ; surgery ; Skin Neoplasms ; surgery ; Surgical Flaps ; transplantation

Photodynamic therapy (PDT) is based on a photochemical reaction which is initiated by light activation of a photosensitizer. The photosensitizer accumulates more in tumor tissues than in normal tissues and is activated with specific wavelength of light, usually laser. The photochemical reaction produces highly reactive oxygen products causing cytotoxiciy and vascular shutdown to the tumor. The advantages of PDT are its relative selective tumor destruction and tissue healing by regeneration, which can maintain important structures with very good functional and esthetic results. Therefore, PDT is considered as an alternative modality for cancers of the head and neck. In this article, we will report three cases of photodynamic therapy for treatment of oral leukoplakia, squamous cell carcinoma, and basal cell carcinoma of head and neck. It was observed that premalignant and malignant lesions responded well to the photodynamic therapy with Aminolevulinic acid (ALA) and Foscan(R). Photodynamic therapy can be considered as a new treatment method for the premalignant and malignant tumors in Oral and Maxillofacial Surgery.
Aminolevulinic Acid ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Head ; Leukoplakia, Oral ; Neck ; Oxygen ; Photochemotherapy* ; Regeneration ; Surgery, Oral*

BACKGROUND: The O-Z flap is a kind of rotational flap that consists of a combination of two opposing rotation flaps. The double O-Z flap is a variant of the O-Z flap applied in multiple adjacent surgical defects that can simplify closure by combining closure into one technique. OBJECTIVE: To report our experience with the O-Z flap and double O-Z flap in the reconstruction of surgical defects of the face after Mohs' micrographic surgery (MMS), using postoperative clinical and cosmetic results. METHODS: Sixteen patients diagnosed with non-malignant melanoma skin cancer on the face were treated with MMS. The resultant surgical defects were reconstructed with an O-Z flap in 14 patients and with a double O-Z flap in 2 patients. Clinical outcomes were reviewed, and cosmetic results were scored as excellent, good, fair, poor, or very poor. RESULTS: In the 14 patients using O-Z flap, 6 cases were located on the temple, 4 on the forehead, 2 on the cheek, and 1 of each on the nose and philtrum. Of the two patients using double O-Z flap, one had two adjacent basal cell carcinomas on the cheek, and the other had two adjacent squamous cell carcinomas on the forehead. The size of the primary defects ranged from 1.1 to 2.5 cm in greatest diameter (mean, 1.93 cm). There were no significant local complications. There was no tumor recurrence, and 14 of 16 patients showed satisfactory aesthetic outcomes scored as excellent or good. CONCLUSION: O-Z flap reconstruction was effective for the closure of surgical defects with limited skin laxity in the face. The double O-Z flap is ideally suited to combine closure of adjacent surgical defects into one technique without exerting undue tension or distorting the surrounding structures. We found these flaps were simple to construct and provided aesthetically pleasing results. Therefore, they could be useful reconstructive options in facial skin defects after MMS.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheek ; Cosmetics ; Forehead ; Humans ; Lip ; Melanoma ; Mohs Surgery ; Nose ; Recurrence ; Skin ; Skin Neoplasms