Paramedian Forehead Flap in Large Nasal Skin Defects: Twenty-years' Experience.

Objective: Skin cancers occur most commonly in the head and neck region where the nose is the most commonly affected unit. The nose is the part of the face that is most exposed to trauma, sunlight, and other environmental factors. From the aesthetic and functional point of view, reconstruction of the defects occurring after skin cancer removal creates a great challenge for the surgeon.

[Reconstruction of facial skin defects by the V-Y subcutaneous pedicle flap].

To investigate the method and efficacy of reconstruction of facial skin defects after removing the lesions by applying the V-Y subcutaneous pedicle flap. A retrospective analysis was performed on 23 patients with facial reconstruction by using V-Y subcutaneous pedicle flap in the Otolaryngology Department of Guangdong Integrated Traditional Chinese and Western Medicine Hospital from March 2012 to April 2021. Patient ages ranged from 45 to 85 years old, with a mean age of 66.

Mohs Defect Repair with Dehydrated Human Amnion/Chorion Membrane.

Reconstructing cosmetically sensitive defects in an aging population undergoing multiple Mohs micrographic surgeries (MMS) may be addressed with alternatives to surgery. Patients undergoing MMS with defect reconstruction in visually prominent areas receiving placental allograft were compared with traditional autologous tissue-based procedures-flaps and full-thickness skin grafts (FTSG). This retrospective case-control study evaluated patients who underwent MMS for removal of a basal or squamous cell carcinoma with same-day repair.

Misinterpretation of head and neck masses can delay the correct diagnosis. A two-step demolitive-reconstruction surgery for saving patient's life.

Objective: To present a rare case of sebaceous cyst masking skin squamous carcinoma. The delayed diagnosis made necessary a two-step (demolition and reconstruction) surgery to save patient's life.

Material And Methods: A 77-year-old male, suffering from persistent right hemicrania and eye pain referred to different specialists, who misinterpreted his symptoms.

Surgically Treated Advanced Cutaneous Squamous Cell Carcinoma of the Head and Neck: Outcome Predictors and the Role of Adjuvant Radiation Therapy.

Objectives: Advanced cutaneous squamous cell carcinoma of the head and neck (CSCCHN) is associated with poor outcome despite multimodality therapy. Comprehensive risk stratification may pinpoint the most suitable adjuvant treatment. This study aimed to evaluate the outcomes of surgically treated locoregional CSCCHN and to identify prognostic indicators of treatment outcomes.

Patient, Defect, and Surgical Factors Influencing Use of Ancillary Procedures after Facial Mohs Repairs.

This article determines if patient, defect, and repair factors can be used to predict the use of additional treatments to achieve optimal aesthetic results after repair of facial Mohs defects. An electronic chart review of patients undergoing Mohs excision and reconstruction of facial neoplasms from November 2005 to April 2017 was performed, reviewing patient demographics and history, tumor size, defect size and location, method and service of reconstruction, time between resection and repair, complications, and subsequent treatments. A total of 1,500 cases with basal cell and squamous cell carcinoma were analyzed.

Composite submental flaps in facial reconstructive surgery involving the zygoma and orbit.

Background: The submental island flap (SIF) is a reliable option for reconstructing defects in the facial region and offers several advantages when compared to free-flap alternatives. While the reconstructive applications of the SIF have been demonstrated in the lower face, there are limited reports on its utility as a composite flap for reconstructing defects of the upper facial skeleton. To our knowledge, we report the first cases of composite (osteocutaneous) SIFs used for reconstruction of complex facial defects involving the zygoma and lateral orbit respectively.

33% hydrogen peroxide as a Neoadjuvant treatment in the surgical excision of non-melanoma skin cancers: a case series.

Background: Hydrogen peroxide (HO) is a product of respiration in mitochondria and an important oxidizing agent in biological systems. Previous investigations have shown the efficacy of HO in treating skin conditions such as seborrheic keratosis and actinic keratosis. In an area like the face, reconstruction of excision defects and ultimately aesthetic outcomes are of utmost importance.

Targeted Therapy and Traditional Chemotherapy in Melanoma and Cutaneous Squamous Cell Carcinoma.

Cutaneous squamous cell carcinoma (cSCC) and melanoma encompass the majority of all malignant skin cancers. There has been an increase in their incidence globally in recent decades. In cases of high-risk, unresectable, or metastatic disease; or when patient factors or preferences limit the availability of conventional surgery or radiotherapy; or a systemic therapy is often warranted.

Mohs Surgery versus Standard Local Excision for Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanoma Skin Cancer.

Basal cell carcinoma, squamous cell carcinoma, and melanoma represent the three most common skin cancers that occur on the face. The most common surgical treatments for facial skin cancers are Mohs' surgery and standard local excision. The effective utilization of either of these techniques is based on tumor and patient risk stratification incorporating known risk factors for occult invasion and local recurrence, combined with patient comorbidities, expectations, and desires.

Reconstruction of a subtotal septorhinectomy defect with a chimeric paramedian-pericranial forehead flap.

The nose is a complex structure important for aesthetic appearance, social interaction, and respiration. Full thickness nasal defects with resection of the septum pose a significant challenge to the reconstructive surgeon due to the lack of local tissues to replace the nasal lining and significant risk of nasal collapse owing to the paucity of rigid infrastructure. The purpose of this paper is to present a unique case of nasal reconstruction utilizing a bilaminar paramedian forehead flap (combined pericranial flap and forehead flap) with embedded cantilever rib graft in a patient who underwent resection for an intranasal malignancy involving the septum and soft tissue envelope.

Nonmelanoma Skin Cancer.

This article reviews the most common nonmelanoma skin cancers affecting the head and neck region. Although the most common of these malignancies rarely result in mortality, local morbidity caused by the tumors and their extirpation cannot be underestimated. Complete tumor extirpation with pathologically confirmed negative margins is the gold standard.

Reflections on Shared Decision Making.

Decisions about medical and surgical treatment can be complex-even for health care providers, who can struggle with which treatment option to offer their patients. In the current landscape of patient-centric value-based health care, the need for appropriate medical decision making to maximize treatment outcomes is evermore important. Shared decision making is a process in which clinicians and patients make decisions together using the best available evidence while accounting for the patients' values and beliefs.

Risk of Venous Thromboembolism in Patients With Keratinocyte Carcinoma.

Importance: Although malignancy is an established risk factor for venous thromboembolism (VTE), the risk of VTE specifically in patients with keratinocyte carcinoma (KC) has not been previously studied.

Objective: To determine the risk of VTE in patients with KC compared with patients not diagnosed with cancer and with patients diagnosed with common malignant neoplasms associated with VTE.

Design, Setting, And Participants: Population-based retrospective analysis of patient insurance claims made between January 1, 2007, and December 31, 2014, from the Truven MarketScan Commercial and Medicare Supplemental Databases.

Total lower lip and chin reconstruction with radial forearm free flap: A novel approach.

Background: The management of large chin and lower lip defects is challenging due to this facial subunit's tremendous functional and aesthetic importance. Specific methods for total lower lip and mentum reconstruction are not well chronicled. Aesthetic and functional goals of this reconstruction include restoration of oral competence by maintaining lower lip height, vermilion reestablishment, color-matched skin introduction to the chin, sensation restoration, and ideally restoration of dynamic activity to the lower lip.

Reconstruction of Cheek Defects Secondary to Mohs Microsurgery or Wide Local Excision.

Successful reconstruction of the cheek following excision for cutaneous malignancy requires careful consideration of defect location, size, and depth in relation to the anatomic properties of the affected cheek unit. Various reconstructive options are available to the surgeon, ranging from simple excisions to complex cervicofacial advancements to meet the needs for functional and aesthetically pleasing reconstructive outcomes. The surgeon must prevent distortion of mobile structures, such as the eyelid, nose, and lips; respect aesthetic subunits; and avoid blunting natural creases.

Skin and Composite Grafting Techniques in Facial Reconstruction for Skin Cancer.

Skin and composite grafting provide effective resurfacing and reconstruction for cutaneous defects after excision of the malignancy. The goal is to restore a natural appearance and function while preventing distortion of the eyelid, nose, or lips. With careful planning and attention to aesthetic subunits, the surgeon can camouflage incisions and avoid blunting aesthetically sensitive sulci.

Clinical perineural invasion of the trigeminal and facial nerves in cutaneous head and neck squamous cell carcinoma: Outcomes and prognostic implications of multimodality and salvage treatment.

Background: Clinical perineural invasion (PNI) of the trigeminal and facial nerves from cutaneous head and neck squamous cell carcinoma (cutaneous HNSCC) is a rare clinical entity that poses unique therapeutic challenges.

Methods: A retrospective chart review of a skull base oncology database was performed of patients with the diagnosis of clinical PNI from a cutaneous HNSCC. Patients who were previously untreated underwent multimodal treatment entailing surgical resection and postoperative radiotherapy (PORT) and patients who were previously treated with radiotherapy underwent salvage surgical resection between the years 2006 and 2012.

Orbitomaxillary Reconstruction Using a Combined Latissimus Dorsi Musculocutaneous and Scapular Angle Osseous Flap.

Immediate reconstruction of orbitomaxillary defects is challenging for head and neck reconstructive surgeons. The primary goals of orbitomaxillary reconstruction are to cover the skin and mucosal defects, fill the defect space, and reconstruct the natural facial contour. This report describes 2 patients who underwent extended orbitomaxillectomy and immediate reconstruction using a combined latissimus dorsi musculocutaneous and scapular angle osseous free flap (LD-SA flap).

Cutaneous squamous cell carcinoma of the scalp in the immunocompromised patient: review of 53 cases.

Objective: We analyzed outcomes from immunocompromised patients with scalp squamous cell carcinoma (SCC) treated with surgical excision with and without radiation in order to explore 3-year disease-free survival and overall survival.

Study Design: The study design was a retrospective chart review.

Setting: This study was conducted in a private practice setting.

The role of elective superficial parotidectomy in the treatment of temporal region squamous cell carcinoma.

Objective: In order to determine rates of metastasis and efficacy of elective superficial parotidectomy, we examine parotid specimens in patients with temporal region cutaneous squamous cell carcinoma treated with local excision and ipsilateral parotidectomy.

Study Design: This paper is a retrospective review.

Setting: This study was conducted at a private tertiary referral practice in Fort Worth, Texas, from 1998 to 2013.

An Inferiorly Based Rotation Flap for Defects Involving the Lower Eyelid and Medial Cheek.

We report a series of 20 patients who underwent inferiorly based rotation flaps for reconstruction of defects of the medial and infraorbital cheek and lower eyelid following Mohs micrographic surgery for nonmelanoma skin cancer. Defects ranged from 1.2 to 3.

Regional flaps in head and neck reconstruction: a reappraisal.

Purpose: Starting from our experience with 45 consecutive cases of regional pedicled flaps, we have underlined the effectiveness and reliability of a variety of flaps. The marketing laws as applied to surgical innovations are reviewed to help in the understanding of why regional flaps are regaining wide popularity in head and neck reconstruction.

Materials And Methods: From January 2009 to January 2014, 45 regional flaps were harvested at San Paolo Hospital to reconstruct head and neck defects.