Basal cell carcinoma of the head and neck: Surgical management and postoperative strategies – A researcher’s perspective

TL;DR

This paper reviews surgical and postoperative strategies for managing head and neck basal cell carcinoma, emphasizing tumor control, reconstruction, and long-term care.

Contribution

A structured narrative review combining literature and clinical experience to guide surgical and reconstructive management of head and neck BCC.

Findings

Surgical excision with risk-based margins is the standard curative treatment for BCC.

Mohs surgery offers better margin control in critical anatomical areas.

Reconstruction techniques vary based on defect size and patient factors.

Abstract

Introduction: Basal cell carcinoma (BCC) is one of the most common cutaneous malignancies and predominantly affects sun-exposed regions, particularly the head and neck. Although metastatic spread is rare, locally invasive growth may compromise functionally and aesthetically critical structures. Effective management therefore requires not only oncologic tumor control but also carefully planned reconstruction and long-term follow-up.

Materials and Methods: This study presents a structured narrative review of the literature combined with institutional clinical experience. Relevant publications on diagnosis, surgical management, reconstructive techniques, and postoperative strategies for head and neck BCC were identified through searches of PubMed, Embase, and the Cochrane Library. Clinical studies, systematic reviews, and guidelines published between 2000 and 2025 were analyzed and synthesized narratively due to heterogeneity in study designs and outcome measures.

Results: Surgical excision remains the cornerstone of curative treatment, with recommended margins depending on tumor risk stratification. Mohs micrographic surgery provides superior margin control in anatomically critical regions. Reconstruction must be individualized based on defect size, anatomical subunit involvement, and patient factors. Local flaps are commonly used for small- to medium-sized defects, whereas larger or deeply infiltrative tumors may require regional or free tissue transfer.

Discussion: Successful management of head and neck BCC requires interdisciplinary collaboration and individualized reconstructive planning. Advances in flap techniques, digital surgical planning, and systemic therapies have expanded treatment possibilities, enabling improved functional and aesthetic outcomes in complex cases.

Figures