Name of the Procedure:

Destruction of Malignant Lesion on the Face, Ears, Eyelids, Nose, Lips, or Mucous Membrane (lesion diameter over 4.0 cm)

• Also known as laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement

Summary

This procedure involves the removal or destruction of cancerous skin lesions on delicate and cosmetically important areas such as the face, ears, eyelids, nose, lips, or mucous membranes. Techniques may include laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement, depending on the specific case.

Purpose

The purpose of this procedure is to treat and remove malignant lesions (cancerous growths) to prevent the spread of cancer and to ensure complete removal of the malignant tissue.

Indications

• Presence of malignant (cancerous) lesions on the face, ears, eyelids, nose, lips, or mucous membranes larger than 4.0 cm in diameter.
• Symptoms such as bleeding, pain, or ulceration in the affected area.
• Medical history of skin cancer or suspicion of malignancy based on biopsy results.

Preparation

• Follow any pre-procedure instructions provided by your healthcare provider, which may include fasting if specific anesthesia is used.
• Adjust or pause certain medications as advised.
• Complete any required diagnostic tests (e.g., biopsy, imaging studies) to confirm the diagnosis and plan the procedure.

Procedure Description

1. Local anesthesia is administered to numb the area.
2. The specific technique (laser, electrosurgery, cryosurgery, chemosurgery, or curettement) is employed to destroy the malignant lesion.
   • Laser Surgery: Uses focused light to vaporize the lesion.
   • Electrosurgery: Uses electric currents to cut tissue and control bleeding.
   • Cryosurgery: Involves freezing the lesion with liquid nitrogen.
   • Chemosurgery: Applies chemical agents to target and destroy cancer cells.
   • Surgical Curettement: Scrapes away the lesion with a curette, a surgical instrument.
3. The area is treated and monitored for complete removal of the malignant tissue.
4. Dressings may be applied to help healing.

Duration

Typically, the procedure can take between 30 minutes to 2 hours, depending on the complexity and size of the lesion.

Setting

This procedure is generally performed in an outpatient clinic, dermatological office, surgical center, or hospital.

Personnel

• Dermatologist or surgeon
• Nursing staff
• Anesthesiologist (if general anesthesia is needed)

Risks and Complications

• Common risks: bleeding, infection, scarring, pain at the procedure site.
• Rare risks: nerve damage, changes in skin sensation, incomplete removal requiring additional treatments, allergic reactions to anesthesia.

Benefits

• Effective removal of cancerous lesions.
• Prevention of cancer spread.
• Improved cosmetic and functional outcome in sensitive areas.
• Benefits are typically seen within a few weeks as the area heals.

Recovery

• Follow the post-procedure care instructions, which may include keeping the site clean, applying prescribed ointments, and avoiding strenuous activity.
• Attend follow-up appointments to monitor healing and ensure complete removal.
• Most patients can return to normal activities within a few days to a week, but complete healing can take several weeks.

Alternatives

• Surgical excision with margins.
• Mohs micrographic surgery.
• Radiation therapy.
• Topical chemotherapy or immunotherapy.
• Each alternative has its own pros and cons; for instance, surgical excision may ensure clearer margins but can be more invasive, while topical treatments may be less invasive but might not be suitable for larger lesions.

Patient Experience

• During the procedure: You may feel pressure or mild discomfort, but pain is usually well-managed with local anesthesia.
• After the procedure: Expect some redness, swelling, and discomfort at the site, which can be managed with prescribed pain relievers and appropriate wound care.
• Close follow-up is important to monitor healing and detect any recurrence of malignant lesions.