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Nasal reconstruction after malignant tumor resection: an algorithm for treatment.
Sanne E Moolenburgh1, Linda McLennan, Peter C Levendag
1Rotterdam, The Netherlands; and Toronto, Ontario, Canada From the Departments of Plastic and Reconstructive Surgery, Dermatology, and Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center; Division of Plastic Surgery, University Health Network, University of Toronto; and Department of Radiation-Oncology, Daniel den Hoed Cancer Center.
This study presents a nasal reconstruction algorithm for various nasal defects, guiding treatment from simple skin loss to total reconstruction. The algorithm ensures optimal tumor control and aesthetic outcomes for nasal skin cancer patients.
Area of Science:
- Plastic Surgery
- Dermatology
- Oncology
Background:
- Nonmelanoma skin cancers frequently occur on the head and neck, with a significant proportion affecting the nose.
- Nasal defects pose a reconstructive challenge, necessitating effective treatment algorithms.
Purpose of the Study:
- To develop a structured algorithm for nasal reconstruction based on a large cohort.
- To guide the management of diverse nasal defects resulting from skin cancer and other pathologies.
Main Methods:
- Retrospective review of 788 nasal reconstructions performed between 2001 and 2008.
- Literature search using PubMed for nasal defect treatment and reconstruction outcomes.
Main Results:
- The algorithm categorizes defects into simple, small (skin), larger (skin/cartilage), or full thickness.
- Reconstruction strategies include primary closure, local flaps, paramedian forehead flaps, skin grafts, and free tissue transfer.
- Specific techniques are recommended for inner lining defects and total nasal reconstruction.
Conclusions:
- Nasal skin cancer is a growing concern requiring a structured, multidisciplinary approach.
- Effective nasal reconstruction is crucial for achieving excellent oncological, functional, and aesthetic results.