Skin Cancer Resection and Reconstruction

At Spokane ENT, we provide comprehensive evaluation and surgical treatment of skin cancer affecting the head and neck, including basal cell carcinoma, squamous cell carcinoma, and melanoma. Skin cancers on the face, scalp, ears, and neck require specialized expertise in both resection and reconstruction to achieve clear margins while preserving cosmesis and function. Our head and neck surgeons are experienced in Mohs defect repair, wide local excision, and when indicated, sentinel lymph node biopsy for melanoma staging. We work closely with dermatologists and Mohs surgeons when lesions have been previously biopsied or treated with Mohs micrographic surgery.

Our evaluation includes review of any prior biopsies, physical examination to assess the primary lesion and regional lymph nodes, and when appropriate, imaging to evaluate for nodal or distant disease. For melanoma, we discuss sentinel lymph node biopsy, which identifies the first lymph node(s) draining the tumor site. A negative sentinel node can avoid more extensive lymph node dissection while a positive result guides further treatment. We collaborate with nuclear medicine for lymphoscintigraphy and with pathologists for accurate staging.

Surgical resection aims to remove the cancer with adequate margins. Reconstruction is tailored to the defect size and location—options include primary closure, local advancement or rotation flaps, and for larger or complex defects, regional flaps or microvascular free tissue transfer. Our goal is to restore form and function while minimizing scarring. We coordinate with medical and radiation oncology when adjuvant therapy is indicated. Postoperative care includes wound management, surveillance, and sun protection counseling to reduce recurrence risk.