Abstract / Summary
Abstract Background: Nasal basal cell carcinoma (BCC) may require surgical excision followed by reconstruction that preserves both oncological safety and the aesthetic and functional subunits of the nose. The glabellar flap is a useful single-stage option for selected defects of the upper nasal dorsum. Case presentation: A 70-year-old male farmer presented with a chronic, non-healing, pigmented ulcer over the nasal dorsum that had progressively enlarged over approximately 1 year. Examination revealed a 1.5–2 cm blackish, crusted, indurated ulcer with rolled edges. Punch biopsy confirmed BCC. Wide local excision was performed with a 5 mm clinical margin, followed by single-stage reconstruction of the dorsal nasal defect using a superiorly based glabellar V–Y advancement flap. Histopathological examination of the excision specimen confirmed BCC with negative margins. Management and outcome: The flap remained viable without necrosis, infection, or wound dehiscence. Sutures were removed on postoperative day 14. Follow-up at 2 weeks, 1 month, 3 months, and 6 months demonstrated satisfactory wound healing, acceptable nasal contour and scar maturation, and no clinical evidence of local recurrence.
Conclusion: For appropriately selected small-to-moderate upper dorsal nasal defects, a glabellar V–Y advancement flap can provide reliable single-stage coverage with good tissue match and satisfactory cosmetic and functional outcomes. Careful oncological excision and flap design are essential.