ABSTRACT
Facial reconstruction is a challenging yet rewarding endeavor. The interpolated forehead and melolabial flaps are well-established methods for facial restoration, especially for the repair of nasal defects following excision of cutaneous malignancies. Repair of facial defects using interpolation flaps requires an appreciation of variations in skin thickness, facial contours, and functional concerns at the donor and recipient sites. A detailed review of flap design, modifications, and implementation is provided for the forehead and melolabial flaps.
Subject(s)
Facial Neoplasms/surgery , Nose Neoplasms/surgery , Plastic Surgery Procedures/methods , Skin Neoplasms/surgery , Surgical Flaps/blood supply , Esthetics , Facial Neoplasms/mortality , Facial Neoplasms/pathology , Female , Forehead/surgery , Graft Survival , Humans , Male , Nose Neoplasms/mortality , Nose Neoplasms/pathology , Rhinoplasty/methods , Risk Assessment , Skin Neoplasms/mortality , Skin Neoplasms/pathology , Survival Rate , Suture Techniques , Tissue Expansion , Treatment Outcome , Wound Healing/physiologyABSTRACT
Nasal reconstruction is a challenging yet rewarding endeavor. Repair of nasal defects requires an appreciation of variations in nasal skin thickness and the influence of these differences on potential reconstructive methods. Multiple factors help determine the optimal method of repair, including the size of the defect relative to the amount of remaining skin, the depth and location of the defect, and the strength of the underlying nasal framework. Maintaining symmetry, contour, and function is essential for a successful nasal reconstruction.
ABSTRACT
We report our histologic and immunohistochemical findings in a rare case of cutaneous carcinosarcoma involving the helix of the ear. The tumor exhibited cellular features of both basal cell and squamous cell carcinoma and a malignant mesenchymal component that was consistent with malignant fibrous histiocytoma. The epithelial component exhibited a positive immunohistochemical reaction to cytokeratin and a negative reaction to vimentin, whereas the mesenchymal component showed a positive immunohistochemical reaction to vimentin and a negative reaction to cytokeratin. To the best of our knowledge, this is only the third reported case of a carcinosarcoma of the ear and the second case in which it developed on the helix.
Subject(s)
Carcinosarcoma/diagnosis , Ear Neoplasms/diagnosis , Skin Neoplasms/diagnosis , Aged , Carcinosarcoma/pathology , Carcinosarcoma/surgery , Ear Neoplasms/pathology , Ear Neoplasms/surgery , Ear, External , Humans , Immunohistochemistry , Male , Skin Neoplasms/pathology , Skin Neoplasms/surgeryABSTRACT
OBJECTIVE: To obviate the difficulty of ruling out confounding variables (eg, age, individual variability) as the source of differences seen when comparing tumor tissue and control tissue from unrelated individuals, we examined the expression of matrix metalloproteinase (MMP)-1 (interstitial collagenase) and MMP-9 (92-kDa gelatinase B) in histologically normal skin immediately adjacent to basal cell carcinomas (peritumoral tissue) after Mohs micrographic surgery and postauricular skin from the same patients. DESIGN: Peritumoral and postauricular skin samples were obtained from 17 patients undergoing Mohs surgery. Expression of MMP-1 and MMP-9 was examined in these specimens using a combination of approaches including zymography, collagen-degradation assays, and immunohistology. RESULTS: The expression levels of MMP-1 and MMP-9 were consistently elevated in the peritumoral tissue compared with skin from the distal site. CONCLUSION: This finding indicates that even when potentially important variables such as age and individual variability are controlled for, tumor-specific effects on the expression of MMP-9 and MMP-1 remain.
Subject(s)
Carcinoma, Basal Cell/metabolism , Matrix Metalloproteinase 1/biosynthesis , Matrix Metalloproteinase 9/biosynthesis , Skin Neoplasms/metabolism , Skin/metabolism , Carcinoma, Basal Cell/surgery , Cells, Cultured , Fibroblasts , Humans , Keratinocytes , Mohs Surgery , Skin Neoplasms/surgeryABSTRACT
Nasal reconstruction is a challenging yet rewarding endeavor. Repair of nasal defects requires an appreciation of variations in nasal skin thickness and the influence of these differences on potential reconstructive methods. Multiple factors help determine the optimal method of repair, including the size of the defect relative to the amount of remaining skin, the depth and location of the defect, and the strength of the underlying nasal framework. Maintaining symmetry, contour, and function is essential for a successful nasal reconstruction.
