Surgical Treatment with Locoregional Flap for the Nose.

Marco Marcasciano,Michele Maruccia,Paolo Fioramonti,Donato Casella,Lenia Sanchèz Wals,Giorgio La Viola,Sergio Ciaschi,Benedetta Fanelli,Mauro Tarallo

doi:10.1155/2017/9750135

Abstract

Nonmelanotic skin cancers (NMSCs) are the most frequent of all neoplasms and nasal pyramid represents the most common site for the presentation of such cutaneous malignancies, particularly in sun-exposed areas: ala, dorsum, and tip. Multiple options exist to restore functional and aesthetic integrity after skin loss for oncological reasons; nevertheless, the management of nasal defects can be often challenging and the best “reconstruction” is still to be found. In this study, we retrospectively reviewed a total of 310 patients who presented to our Department of Plastic and Reconstructive Surgery for postoncological nasal reconstruction between January 2011 and January 2016. Nasal region was classified into 3 groups according to the anatomical zones affected by the lesion: proximal, middle, and distal third. We included an additional fourth group for complex defects involving more than one subunit. Reconstruction with loco regional flaps was performed in all cases. Radical tumor control and a satisfactory aesthetic and functional result are the primary goals for the reconstructive surgeon. Despite tremendous technical enhancements in nasal reconstruction techniques, optimal results are usually obtained when “like is used to repair like.” Accurate evaluation of the patients clinical condition and local defect should be always considered in order to select the best surgical option.

Highlights

The nasal pyramid is the most common site for the presentation of head and neck cutaneous malignancies, in sun-exposed areas such as the ala, dorsum, and tip of the nose
Basal cell carcinoma (BCC) is considered the most frequent followed by squamous cell carcinomas (SCCs) [1]
A total of 310 patients (203 males and 107 females) with diagnosis of Nonmelanotic skin cancers (NMSCs) (115 SCCs and 195 BSCs) were enrolled in the study after treatment by conventional tumor excision followed by surgical reconstruction by locoregional flap

Summary

Introduction

The nasal pyramid is the most common site for the presentation of head and neck cutaneous malignancies, in sun-exposed areas such as the ala, dorsum, and tip of the nose. Nonmelanoma skin cancers (NMSCs) are mostly slow growing and unlikely to metastasize but represents the most common cancer in the world, with an incidence 18–20 times greater than that of malignant melanoma. Basal cell carcinoma (BCC) is considered the most frequent followed by squamous cell carcinomas (SCCs) [1]. With the increase in the incidence of these neoplasms, dermatologists and plastic surgeons are experiencing a sharp increase in the numbers of patients who need treatment because of the tremendous increase in the incidence of skin cancer [2]. A unique anatomy combined with the aesthetic and functional importance makes its reconstruction challenging [3]

Results

Discussion

Conclusion