[Treatment results after surgery for basal cell carcinomas of the head and neck region taking into consideration various reconstruction techniques].

BACKGROUND: Basal cell carcinomas are the most frequently occurring malignant tumors in the white population. They exhibit a multitude of histological/morphological forms.

PATIENTS AND METHOD: All cases of basal cell carcinoma treated at the department for oral and maxillofacial and regional plastic surgery of the HELIOS hospital in Erfurt between 1976 and 2003 were analyzed and partly reexamined in a retrospective study.

RESULTS: A total of 648 patients with 765 basal cell carcinomas were treated. Occurrences in females dominated those in males with a frequency distribution of 1.24:1. The average age was 70.6 years with a significantly larger number of female seniors above 60. In 64% of the cases the basal cell carcinomas were nodular, in 16% infiltrative. Other morphological/histological forms occurred with a frequency of <or=5%. The most frequent localizations were in of the regions of the highest sun exposure such as the nose, midface, and forehead.

DISCUSSION: If an infiltrative basal cell carcinoma is suspected or insufficient radical primary surgery is presumed, plastic reconstruction should be postponed until free margins can be confirmed histologically. The functional and aesthetic quality of reconstruction was better using pedicled flaps (90%) and primary closure (86%) than using free skin transplants (30-54%). Nevertheless, free skin flaps and epitheses were found to be well accepted by the reexamined patients.