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Updated: Aug 18, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Defects of the nasal internal lining: etiology and repair
Kenneth C Fletcher1, David C Shonka, Mark A Russell
1Department of Otolaryngology--Head and Neck Surgery, University of Virginia Medical Center, Charlottesville, VA 22908, USA.
Objectives:
To analyze risk factors leading to full-thickness (FT) defects, to review methods of repair, and to present guidelines for management of aggressive basal cell carcinomas (BCCs) of the nose.
Design:
Retrospective medical chart review of patients who underwent nasal reconstruction by the Department of Otolaryngology-Head and Neck Surgery between 1996 and 2003.
Results:
Two hundred ten patients underwent nasal reconstruction; 183 had complete medical records and were included in this study. There were 53 patients with FT nasal defects, 38 (71.7%) of which were due to BCC. Among all patients presenting with an aggressive histologic subtype of BCC, 30.1% (22/73) developed FT defects. In contrast, 14.5% (16/100) with a nonaggressive subtype had FT involvement (P < .05).
Conclusions:
Internal lining defects are more likely to occur from aggressive histologic subtypes of BCC (infiltrative, morpheaform, and micronodular) than nonaggressive subtypes (P < .05). For BCCs 1 to 2 cm2 located on the nasal ala, histologic subtype is a significant risk factor for resulting in a FT defect, which should influence the method of excision (direct vs Mohs micrographic surgery) and the anticipated reconstruction. Large lesions (> 2 cm2) involving the ala have a high rate of internal lining involvement independent of pathologic subtype.
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