Nonmelanoma skin cancer of the head and neck II: surgical treatment and reconstruction

Surgical treatment of non-melanoma skin cancers (NMSC) is most often straight forward and can be performed as an office-based procedure by non-surgically trained professionals. However, the cases that present to an Otolaryngology practice typically will involve difficult-to-treat lesions around the face and lesions that necessitate an in depth knowledge of how to balance the need for adequate surgical margins with the reconstructive contraints imposed by aesthetic subunits of the face. This article discusses modern concepts of surgical margins for NMSC, including the Moh's micrographic surgical technique, and then reviews the most common reconstructive strategies for difficult-to-treat areas on the face. The goal of this paper is to help the general Otolaryngollogists to understand the basic principles of surgical resection and reconstruction of NMSC lesions on the face.