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Published on: June 20, 2018
Lateral rhinotomy approach for Mohs micrographic surgery of the anterior septum
I Zilinsky1, A Borenstein, H Tsur
1Mohs Micrographic Surgical Unit, Department of Plastic Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Background:
Neoplasms of the nasal septum and internal alar surface are very difficult to treat. This is because of the complicated surface, proximity to important anatomic structures, and technical difficulty--both to resection and follow up. Mohs micrographic surgery might be the ideal mode of treatment for such tumors; however, it is very difficult to accomplish through the nostril.
Objective:
To resect the tumor on the nasal septum and internal alar surface using Mohs micrographic surgery.
Methods:
Lateral rhinotomy was performed as a preparatory stage to Mohs micrographic surgery of the anterior septum and intranasal alar surface.
Results:
The ala nasi was detached from the cheek, thus exposing the anterior nasal cavity--enabling direct access to the neoplasms and allowing excellent visualization.
Conclusion:
Lateral rhinotomy, as described in this article, is a simple office procedure and in most cases heals with no visible scar.
Insights
Mohs micrographic surgery can effectively treat nasal tumors. A preparatory lateral rhinotomy provides excellent access and visualization for this challenging procedure, leading to successful tumor resection.
Area of Science:
- Dermatology
- Head and Neck Surgery
- Oncology
Background:
- Nasal septum and internal alar surface neoplasms present significant treatment challenges due to complex anatomy and proximity to vital structures.
- Traditional surgical resection and follow-up for these tumors are technically demanding.
- Mohs micrographic surgery is ideal but difficult to perform through the nostril.
Purpose of the Study:
- To achieve tumor resection on the nasal septum and internal alar surface using Mohs micrographic surgery.
- To evaluate the efficacy of a modified surgical approach for Mohs micrographic surgery in this anatomical region.
Main Methods:
- Mohs micrographic surgery was utilized for tumor removal.
- Lateral rhinotomy was performed as a preparatory step to facilitate access to the anterior septum and intranasal alar surface.
- Detachment of the ala nasi from the cheek exposed the nasal cavity for direct tumor access.
Main Results:
- The preparatory lateral rhinotomy allowed direct access to nasal neoplasms.
- Excellent visualization of the tumor site was achieved.
- The procedure enabled effective Mohs micrographic surgery for nasal tumors.
Conclusions:
- Lateral rhinotomy is a simple office procedure that facilitates Mohs micrographic surgery for nasal septum and alar surface tumors.
- This approach provides improved access and visualization, overcoming previous technical difficulties.
- The procedure typically heals with minimal to no visible scarring.
