The nose and ears are common anatomical sites of invasive skin cancer in fair-skinned individuals living in environments with high levels of sun exposure. Invasive skin cancer of the nose was a frequent presentation in the author’s clinical practice, probably because he worked for a decade in New Zealand’s region with the highest ultraviolet light levels and daytime sunshine hours. The ears attached to the lateral side of the head are also a high-risk facial landmark. Both the human nose and ears have distinct morphological features, which when afflicted with skin cancer and subsequent surgical excision are at risk of rendering the patient with significant deformity. The principles of nose reconstruction define the history of plastic surgery since pre-biblical times in ancient India. Complete local excision with aesthetic reconstruction should be the goals of managing all skin cancers in these sites. The nose has a trilaminar structure of lining, support and cover, which must be respected in terms of the reconstructive plan and the nasal breathing functions. The ear is a unique human appendage, which guards the external auditory meatus and the inner auditory mechanism. This chapter considers common and not so common clinical presentations of challenging nose and ear malignancies. The focus is on high-risk skin cancers, which are most likely to recur if not adequately treated.
Keywords
- Complete and adequate wide local excision plus staging
- Forehead and nasolabial local flaps
- Periauricular loco-regional flaps