Cancer of the perioral region.

The management of difficult perioral malignancies is often facilitated by an organized, multidisciplinary approach that utilizes the skills of a Mohs micrographic surgeon as well as a head and neck surgeon. This article summarizes such an approach with attention to anatomic considerations, tumor classification, prognosis, and a practical approach to such malignancies. Finally, an approach to reconstruction is presented that emphasizes the usefulness of a Karapandzic flap in large reconstructions of this region.