[Surgical treatment of basal cell epitheliomas of the nose (author's transl)]

The surgical treatment of basal cell epitheliomas of the nose is based on wide excision and histological control with preferably an extemporaneous examination. The decision to operate should be made by a group consisting of the radiotherapist, the surgeon, and the dermatologist. Repair is usually carried out immediately, once it is certain that ablation is complete. There are no true contra-indications due to the age of the patient and treatment is less costly than irradiation. Surgery is essential for reconstruction of the nasal pyramid destroyed partially or completely by the tumor and consists of a reconstructive rhinoplasty using a frontal flap. Lesions that are of moderate dimensions but are too large to be treated by electrocoagulation, especially if they are close to the nasal orifices, are a good indication for surgery. A graft, especially a total skin graft taken from behind the ear or from the subclavicular region, is usually used. However, local flaps using the excess skin at the root of the nose (glabellar flap) or from the cheek (nasogenial flap) give excellent results. The authors describe the results obtained in a series of 93 patients in whom relapses were observed in only 7.6%. The only 3 cases in which the recurrence was not able to be treated, all three patients eventually dying, were cases in which the tumors had been operated upon for recurrences after radiotherapy.