Cheek and perioral cancers are considered from the perspective of historical reconstructive principles and anatomical zones. The nose and lower eyelids, lips and the intraoral cavity are in proximity and may influence the challenges to form and function. The two sentinel goals are to guarantee wide local excision and to prevent the stigma of deformity with aesthetic reconstruction. Metastases to the parotid and neck regions need to be considered in the overall management plans. Whether the cheek defect in a patient is a result of trauma or cancer ablation, the principles of repair as defined by Sir Harold Gillies (1882–1960) are fundamental: lining with mucous membrane, structural stability with bone and cover with skin. A fourth dimension is the importance of normal function including facial expression, speech and swallowing. Reconstructive options include local flaps, regional flaps and free flaps with or without bone grafts. Mandibular and maxillary reconstruction may also be required which exposes the patient’s aerodigestive tract to risk, and therefore, tracheostomy and nutritional support should be considered in the mix.
Keywords
- Lateral cheek
- Medial cheek
- Lower eyelid cheek junction
- Upper and lower lips
- Malar and buccal regions
- Chin