Excision of basal cell carcinoma at dorsum of nose and Nasasandhana i.e. repair with Zitellis Bilobed Flap method- A Case Study

Abstract

Sandhankarma as explained by Aacharya Sushruta is a very old scientific method of surgical repair which can be compared with the plastic surgery or reconstructive surgery in recent times. The advancement of plastic surgery is closely related and based on operative techniques used in ancient India. Aacharya Sushruta has explained Sandhankarma in Sutrasthana. Basal cell carcinoma is a type of skin cancer which is locally destructive and spreads to adjacent structures. It does not cause secondary lymphadenopathy. It is locally invasive, aggressive and destructive but slow growing, and no tendency to metastasize. It develops on skin area, which has been exposed to the ultraviolet rays of sun. It appears on nose as a thin yellow area, a reddish patch, a clear bump, or an open sore that will not heal. Surgery to remove tumour is a treatment of choice. 80% of all skin cancer in people is basal cell carcinoma. Types 1.Nodular 2. Sclerosing  3.Superficial spreading  4. Pigmented. It can be treated by surgical removal, radiation, immunotherapy, and cryotherapy. Present patient had complains of non-healing ulcer on nose since last one year. Ulcer was classical basal cell carcinoma clinically, ulcer of size 1×1cm, at supra-tip area of nose, raised/ everted edges with blackish brown discolouration. Granulation at floor of ulcer and firmly adherent to underlying tissue, no on touch bleeding, not with much inflammatory signs. No lymphadenopathy, no vascularization in surrounding area.