Management of nasal cutaneous malignant neoplasms. An interdisciplinary approach.

Standard methods of managing large or recurrent cutaneous nasal malignant neoplasms are often inadequate, leaving extensions of the tumor that are clinically invisible. Conventional methods may also allow considerable amounts of normal tissue to be sacrificed in an attempt to ensure the removal of all carcinoma. Through partnership of the dermatologic surgeon and the reconstructive surgeon, a more effective method of curing and rehabilitating patients with nasal skin cancer can be achieved. The dermatologic Mohs' surgeon can perform microscopically controlled excision of malignant neoplasms, providing the highest cure rates obtained by any method. This method is particularly suited for basal cell carcinomas that are recurrent, larger than 1 cm in size, or are of the morpheaform histologic subtype. Total microscopic excision allows nasal reconstruction to proceed with the highest degree of confidence of tumor control. The location and extent of the malignancy dictate the surgical approach for nasal reconstruction.