[Surgical management of nasal septum malignant tumor]

To summarize the surgical treatment strategy of nasal septum malignant tumor.

Between 1993 October and 2003 February, 16 patients with nasal septum malignant tumor were treated. In a retrospective review, the pathological character, the operation reports, and the follow up data were analyzed, particularly with respect to the surgical approaches.

Ten male, 37-79 years old, average 52.2 years old; 6 female, 18-71 years old, average 58 years old. The pathology of nasal septum malignant tumor in our department were: seven cases with squamous cell carcinoma in (5 cases were primary, 2 cases were secondary), 4 cases with adenoid cystic carcinoma (3 cases were primary, 1 case was secondary), 3 cases with malignant melanoma, 1 case with adenocarcinoma, 1 case with mucoepidermoid carcinoma. Duration range was from 1 month to 7 months. The strategy of operation was that 8 cases with lateral rhinotomy, 5 cases with endoscopy, 2 cases with midfacial degloving, 1 case via uvular pathway. All patients received postoperation radiation (30 Gy). After follow up for 1-10 years, 1 case was undetected, 2 cases were dead (1 case with malignant melanoma, 1 case with secondary squamous cell cancer), 3 cases survive with tumor (1 case with squamous cell cancer, 1 case with secondary adenoid cystic cancer, 1 case with malignant melanoma). Ten cases survive without tumor. The rate of death, survival with tumor and survival without tumor is 12.5%, 18.8%, 62.5%, respectively.

The prognosis of nasal septum malignant tumor is related to operation, radiation and pathological character. The surgical approach to nasal septum malignant tumor is related to the size of the tumor and the age of patient. It classifies the following indications: (1) Endoscopic approach in cases with tumor localized in nasal septum; (2) Lateral rhinotomy in cases with extensive tumor infiltration of the nasal septum, nasal turbinates, or even sinus; (3) Midfacial degloving or via uvular pathway in cases who are young persons.