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Basal cell carcinoma is a common form of skin cancer whose global incidence is rising rapidly, with over 70 % of locations on the face. In contrast to their low mortality, their morbidity is high. Extensive basal cell carcinomas and infiltrative lesions are associated with a high recurrence rate, which can result a serious esthetic and functional damage. We report the case of a 65-year-old female patient, who consulted our ENT department for a large ulcerating lesion of the nasal pyramid. CT scan revealed a lesion of the nasal pyramid measuring 38 mm in long axis, which appeared to come into contact with the anterior part of the nasal septum. The pathological findings were consistent with an infiltrating basal cell carcinoma. The patient underwent surgical resection with reconstruction using a forehead flap. Following ANAES guidelines, when the diagnosis of a poor-prognosis BCC is uncertain, or when major reconstruction is required at the time of surgery, biopsy is strongly recommended to confirm the diagnosis. The evolution of BCCs is essentially local, and they rarely metastasize, with a maximum incidence rate of 0.55 %, of which around 85 % appears on the face. Thus, local extension of BCCs mainly involves adjacent tissues, including the perichondrium, in which case imaging is necessary to assess the extent of damage. The most common and effective treatment is surgical excision, with a margin of healthy tissue around the tumor. Because early diagnosis and carcinological excision are the keys to a good prognosis. We must insist on the role of primary and secondary prevention, and on the importance of early diagnosis. • The nasal pyramid is a highly affected area by basal cell carcinoma. • Infiltrating basal cell carcinomas have a greater sub-clinical extension than superficial and nodular forms. • Lesions of the nasal pyramid are complex to remove and in reconstruction, especially when the tumor is large. • Frontal flap is the most used flap. • We insist on the role of primary and secondary prevention, and the importance of early diagnosis at a stage when treatment is codified. [ABSTRACT FROM AUTHOR]

The pectoralis major flap is one of the leading regional pedicled flaps for reconstructive surgery of the head and neck, particularly in oncology after tumor resection. Despite the increasing use of free flaps, this type of flap is still highly recommended in defined indications. It is a highly reliable flap in terms of viability. We report the case of a man treated in our ENT department for a squamous cell carcinoma of the three laryngeal stages, anteriorly very extensive and requiring total laryngectomy extended to the skin and subcutaneous planes opposite, followed by reconstruction with a flap of the pectoralis major muscle. Post-surgical outcome was excellent. Aryan was the first person to describe the use of the pectoralis major muscle flap. Since then, several studies have demonstrated the great value of this flap in face and neck reconstruction, thanks to its wide indications and excellent viability rate. The pectoralis major muscle flap represents a valuable reconstructive option for substance loss in the cervicofacial region despite the great development of microsurgery and free flaps. • The axial vascularization makes the pectoralis major flap a highly reliable flap, with a viability rate of up to 98%. • This flap's volume is highly advantageous for reconstruction of the neck and lower third of the face after major tumor resection, especially for patients with cancer. • It is a flap with a simple surgical technique based on the preservation of the nourishing pedicle of the pectoralis major muscle. • The pectoralis major muscle flap is still recommended in numerous cases, despite the rise of microsurgery and free flaps. [ABSTRACT FROM AUTHOR]