A successful nose reconstruction is represented by a normal look and nasal breathing preservation. The choice of method is based on the site, size, depth of the defect, donor availability, and surgeon experience. There are multiple methods of restoring nasal cover, from primary repair to healing by secondary intention, from primary suture, skin graft to locoregional flaps, but all of them should be integrated into a personalized approach, keeping the nasal functions, a good aesthetic outcome and without any tumor infiltration. This paper consisting of a retrospective study of 9 patients diagnosticated with squamous cell carcinoma revealed the importance of skin properties and skin changes during aging. Despite all aesthetic principles, skin is the most important resource in facial reconstruction.
Due to its scarcity, the basosquamous carcinoma represents a challenging pathology both as a result of its aggressiveness and potential of relapse and metastases, and also due to unclear management guides. Encountered under the name of basal cell carcinoma or metatypical carcinoma, the pathophysiology of such tumors is still unclear and it is not known yet if it either derives from a basal cell carcinoma or it could be a variant of transition to a squamous cell carcinoma. Due to low incidence, unclear treatment protocols and not enough research regarding squamous component in the aggressivity of basosquamous carcinoma, the aim of this paper is to analyze histopathological features of 5 cases of basosquamous carcinoma from Plastic Surgery Department of Emergency University Hospital, Bucharest, and correlate them with current literature.
Skin cancer represents an important part of the reconstruction is the most frequently used procedure. The main objective of this paper is to report and evaluate our experience in the treatment of facial nonmelanoma skin cancer. Method. The study is based on 303 patients who were diagnosed with facial malignant tumors, between 2004 and 2015, in the Plastic and Reconstructive Surgery Clinic, Emergency University Hospital Bucharest Romania. We statistically analyzed the distribution by age, gender, facial location, the time from onset until the presentation, the type of tumor, the size of the tumor, the margin status, and the recurrence. Results were as follows: median age at 70 years, with an even gender distribution. The most affected areas were the cheek, followed by the nose, forehead, and eyelids. We calculated the dimensions of the tumors between 1.57 mm2 and 1,846 mm2, with a median value at 235 mm2, and a mean value at 421.23 mm2. Patients in whom safe margins were not obtained had a 4.15 times higher relapse rate versus the ones with safe margins at the first intervention, with a high statistical significance p=0.002 (15% recurrence rate if safe margins were not obtained, versus 4.1% if margins were safe). Conclusion. When discussing tumor excisions, one of the most controversial topics is that of safety edges. Currently, even if there are recommendations, a unified protocol is not formulated, which is why we found it useful to research this topic with extensive medical associations.
