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Rhinectomy: timing and reconstruction.

J F Teichgraeber1, H Goepfert

  • 1Department of Plastic Surgery, University of Texas Medical School, Houston.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|April 1, 1990
PubMed
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Nasal skin cancer prognosis is usually excellent, but aggressive cases may need extensive rhinectomy. Tumor size and histology predict the need for extensive surgery and poorer outcomes, with recurrence often seen within two years.

Area of Science:

  • Oncology
  • Dermatology
  • Plastic Surgery

Background:

  • Nasal skin cancer typically presents with a good prognosis.
  • Aggressive or recurrent cases may necessitate partial or total rhinectomy.
  • Predictive factors for extensive nasal resection and prognosis require further elucidation.

Purpose of the Study:

  • To retrospectively analyze outcomes for patients undergoing nasal resections for cancer.
  • To identify predictors for extensive rhinectomy and poor prognosis in nasal skin cancer.
  • To inform reconstruction timing and management strategies for nasal cancer patients.

Main Methods:

  • Retrospective review of 147 patients with nasal cancer requiring full-thickness nasal resections.
  • Data collected from January 1, 1970, to December 31, 1980, at M.D. Anderson Cancer Center.

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  • Analysis of lesion characteristics, surgical extent, recurrence rates, and prognostic factors.

    • Main Results:

    • 46.3% of patients required hemi- or complete rhinectomy.
    • Extensive rhinectomy was associated with lesions involving the ala, recurrent multicentric squamous cell carcinomas >4 cm, and poorer prognoses.
    • Tumor size and histology predicted the need for extensive rhinectomy; primary site predicted recurrence.

    Conclusions:

    • Nasal skin cancer requiring extensive rhinectomy has a significantly poorer prognosis.
    • Tumor characteristics like size and histology are crucial in predicting surgical extent and outcomes.
    • Delayed reconstruction is recommended for high-risk patients, with a suggested 2-year waiting period post-surgery.