Abstract
Basal cell carcinoma (BCC) occurs and recurs most commonly on the nose. The authors conducted a study to establish reliable guidelines for resecting BCC on the nose. During a 20-year period from 1981 to 2000, the authors experienced 88 cases of BCC, in 37 (42%) of which tumor cells were found histologically to invade muscle layers. The authors propose the following methods of adequate excision and reconstructions in different areas of the nose.
Part I: Nasal ala (7 aggressive, 5 non-aggressive) . Full-depth or submucosal excision and one-step reconstruction by free composite graft is recommended.
Part II: Nasal groove (24 aggressive, 3 non-aggressive) . A two-step procedure. The tumor, including part of the muscle, should be excised. After complete removal of the tumor has been confirmed histologically, the defect should be reconstructed by naso-labial flap.
Part III: Lateral side of nasal dorsum (3 aggressive, 20 non-aggressive) . The tumor may be excised in a one-step procedure. It is desirable to cover the defect by naso-labial flap.
Part IV: Nasal dorsum (3 aggressive, 18 non-aggressive) . The tumor may be excised below SMAS and the defect should be covered by axial frontonasal flap.
Part V: Nasal tip and Columella (5 non-aggressive) . This area should be considered as a dangerous zone. A two-step procedure is recommended. [Skin Cancer (Japan) 2003; 18: 278-289]
