Skin cancer of the nose: options for reconstruction

The nose is the most common site of skin cancer on the human body. This review was compiled to enumerate the many reconstructive techniques which are available and to discuss the advantages and disadvantages of each technique. Five hundred twenty-one patients with nasal cancer were treated at Roswell Park Memorial Institute from 1964 to 1981. Four hundred five patients were treated by cryotherapy, electrocautery, chemosurgery, radiation therapy, or local excision with primary closure. Forty-six patients were treated with simple nasolabial flaps. The remaining 70 patients underwent more extensive resections and reconstructions. Their records were reviewed. At 5 years the local recurrence rate was 3% for basal cell carcinoma and 20% for squamous cell carcinoma. The multiple reconstructive techniques which were utilized in these patients are discussed. Skin-grafting procedures were used to manage 51% of the patients. Prostheses were used in 9%. Multiple different reconstructive flaps were used for the remaining 40% of the patients. The management of large nasal carcinomas must be individualized with therapeutic decisions being made by a practitioner who is familiar with the many reconstructive options. This will ensure the optimal functional and aesthetic result for each patient.