Nasal reconstruction after skin cancer surgery; presentation of treatment
modalities for medically compromised patients.
Asterios Antoniou*, Alexandros Louizakis*, Dimitris Tatsis, Anestis Chrysostomidis, Athanassios Kyrgidis, Konstantinos Vahtsevanos
Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, General Hospital G. Papanikolaou, Thessaloniki, Greece (Director: Prof. K. Vahtsevanos)
DOI https://dx.doi.org/10.54936/haoms233185192
SUMMARY: Nasal reconstruction after surgical excision of non-melanoma skin cancer defects can be a challeng- ing condition for every head and neck surgeon. There are certain technical difficulties that may arise from the tissue deficit and the area that a locoregional flap could cover. What is more, patients with a compromised medical history cannot always receive surgical manage- ment under general anaesthesia, limiting even more the defect reconstruction options. The aim of the present study is to present two patients that were treated under local anaesthesia for advanced basal cell carcinomas of the nose, with modifications of paramedian and hemi- nasal flaps that provided excellent surgical and aesthetic outcomes, despite the limits of the surgical modality.
KEY WORDS: nasal reconstruction, basal cell carcinoma, compromised patients.
REFERENCES
Badash, I. et al. (2019) ‘Nonmelanoma Facial Skin Cancer: A Review of Diagnostic Strategies, Surgical Treatment, and Reconstructive Techniques’, Clinical Medicine Insights: Ear, Nose and Throat, 12, p. 117955061986527. doi: 10.1177/1179550619865278.
Bertozzi, N. et al. (2019) ‘Single center evidence for the treat- ment of basal cell carcinoma of the head and neck.’, Acta bio- medica: Atenei Parmensis, 90(1), pp. 77–82. doi: 10.23750/ abm.v90i1.6395.
Ciążyńska, M. et al. (2021) ‘The incidence and clinical analysis of non-melanoma skin cancer’, Scientific Reports, 11(1), pp. 1–10. doi: 10.1038/s41598-021-83502-8.
Derebaślnlloǧlu, H. and Özkaya, N. K. (2021) ‘Analysis of Basal Cell Carcinoma and Squamous Cell Carcinoma according to Nasal Subunit Location’, Facial Plastic Surgery, 37(3), pp. 407–410. doi: 10.1055/s-0041-1726024.
Dincă, D. et al. (2019) ‘Giant basal cell carcinoma of the nasal pyramid – Case report’, Romanian Journal of Morphology and Embryology, 60(1), pp. 255–259.
Eskiizmir, G., Baker, S. and Cingi, C. (2012) ‘Nonmelanoma Skin Cancer of the Head and Neck: Reconstruction’, Facial Plastic Surgery Clinics of North America, 20(4), pp. 493–513. doi: 10.1016/j.fsc.2012.08.003.
Helmy Ali, Y. et al. (2020) ‘Facial skin cancer reconstructive and cosmetic outcomes: Analysis with algorithm for its manage- ment’, Journal of Cosmetic Dermatology, 19(5), pp. 1182– 1190. doi: 10.1111/jocd.13121.
Janjua, O. S. and Qureshi, S. M. (2012) ‘Basal Cell Carcinoma of the Head and Neck Region: An Analysis of 171 Cases’, Journal of Skin Cancer, 2012, pp. 1–4. doi: 10.1155/2012/943472.
Losco, L. et al. (2020) ‘Reconstruction of the nose: Management of nasal cutaneous defects according to aesthetic subunit and defect size. A review’, Medicina (Lithuania), 56(12), pp. 1–15. doi: 10.3390/medicina56120639.
Neal, D. E. et al. (2020) ‘Local anesthesia is preferred for skin can- cer surgery - Results of a choice-based conjoint analysis exper- iment’, Dermatologic Surgery, pp. 1106–1108. doi: 10.1097/ DSS.0000000000001987.
Park, S. S. (2000) ‘Candidate’s thesis: Reconstruction of nasal de- fects larger than 1.5 centimeters in diameter’, Laryngoscope, 110(8), pp. 1241–1250. doi: 10.1097/00005537-200008000-
00001.
Peris, K. et al. (2019) ‘Diagnosis and treatment of basal cell carci- noma: European consensus–based interdisciplinary guidelines’, European Journal of Cancer, 118, pp. 10–34. doi: 10.1016/j. ejca.2019.06.003.
Rohrich, R. J. et al. (2004) ‘Nasal reconstruction - Beyond aesthetic subunits: A 15-year review of 1334 cases’, Plastic and Recon- structive Surgery, 114(6), pp. 1405–1416. doi: 10.1097/01. PRS.0000138596.57393.05.
Shokri, T. et al. (2019) ‘The paramedian forehead flap for na- sal reconstruction: From antiquity to present’, Journal of Craniofacial Surgery, 30(2), pp. 330–333. doi: 10.1097/ SCS.0000000000004976.
Uzun, H. et al. (2015) ‘Assessment of patients who underwent nasal reconstruction after non-melanoma skin cancer exci- sion’, Journal of Craniofacial Surgery, 26(4), pp. 1299–1303. doi: 10.1097/SCS.0000000000001563.
Vatamanesku, I. et al. (2019) ‘Basal cell carcinoma of the nasal pyra- mid excision margins: A retrospective study’, Romanian Jour- nal of Morphology and Embryology, 60(4), pp. 1261–1268.
Wiȩckiewicz, W. et al. (2013) ‘Interdisciplinary treatment of basal cell carcinoma located on the nose - Review of literature’, Advances in Clinical and Experimental Medicine, 22(2), pp. 289–293.
Wollina, U., Langner, D. and Bennewitz, A. (2014) ‘Basal cell carci- noma of the outer nose: Overview on surgical techniques and analysis of 312 patients’, Journal of Cutaneous and Aesthetic Surgery, 7(3), p. 143. doi: 10.4103/0974-2077.146660
Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, General Hospital G. Papanikolaou, Thessaloniki, Greece (Director: Prof. K. Vahtsevanos)
DOI https://dx.doi.org/10.54936/haoms233185192
SUMMARY: Nasal reconstruction after surgical excision of non-melanoma skin cancer defects can be a challeng- ing condition for every head and neck surgeon. There are certain technical difficulties that may arise from the tissue deficit and the area that a locoregional flap could cover. What is more, patients with a compromised medical history cannot always receive surgical manage- ment under general anaesthesia, limiting even more the defect reconstruction options. The aim of the present study is to present two patients that were treated under local anaesthesia for advanced basal cell carcinomas of the nose, with modifications of paramedian and hemi- nasal flaps that provided excellent surgical and aesthetic outcomes, despite the limits of the surgical modality.
KEY WORDS: nasal reconstruction, basal cell carcinoma, compromised patients.
REFERENCES
Badash, I. et al. (2019) ‘Nonmelanoma Facial Skin Cancer: A Review of Diagnostic Strategies, Surgical Treatment, and Reconstructive Techniques’, Clinical Medicine Insights: Ear, Nose and Throat, 12, p. 117955061986527. doi: 10.1177/1179550619865278.
Bertozzi, N. et al. (2019) ‘Single center evidence for the treat- ment of basal cell carcinoma of the head and neck.’, Acta bio- medica: Atenei Parmensis, 90(1), pp. 77–82. doi: 10.23750/ abm.v90i1.6395.
Ciążyńska, M. et al. (2021) ‘The incidence and clinical analysis of non-melanoma skin cancer’, Scientific Reports, 11(1), pp. 1–10. doi: 10.1038/s41598-021-83502-8.
Derebaślnlloǧlu, H. and Özkaya, N. K. (2021) ‘Analysis of Basal Cell Carcinoma and Squamous Cell Carcinoma according to Nasal Subunit Location’, Facial Plastic Surgery, 37(3), pp. 407–410. doi: 10.1055/s-0041-1726024.
Dincă, D. et al. (2019) ‘Giant basal cell carcinoma of the nasal pyramid – Case report’, Romanian Journal of Morphology and Embryology, 60(1), pp. 255–259.
Eskiizmir, G., Baker, S. and Cingi, C. (2012) ‘Nonmelanoma Skin Cancer of the Head and Neck: Reconstruction’, Facial Plastic Surgery Clinics of North America, 20(4), pp. 493–513. doi: 10.1016/j.fsc.2012.08.003.
Helmy Ali, Y. et al. (2020) ‘Facial skin cancer reconstructive and cosmetic outcomes: Analysis with algorithm for its manage- ment’, Journal of Cosmetic Dermatology, 19(5), pp. 1182– 1190. doi: 10.1111/jocd.13121.
Janjua, O. S. and Qureshi, S. M. (2012) ‘Basal Cell Carcinoma of the Head and Neck Region: An Analysis of 171 Cases’, Journal of Skin Cancer, 2012, pp. 1–4. doi: 10.1155/2012/943472.
Losco, L. et al. (2020) ‘Reconstruction of the nose: Management of nasal cutaneous defects according to aesthetic subunit and defect size. A review’, Medicina (Lithuania), 56(12), pp. 1–15. doi: 10.3390/medicina56120639.
Neal, D. E. et al. (2020) ‘Local anesthesia is preferred for skin can- cer surgery - Results of a choice-based conjoint analysis exper- iment’, Dermatologic Surgery, pp. 1106–1108. doi: 10.1097/ DSS.0000000000001987.
Park, S. S. (2000) ‘Candidate’s thesis: Reconstruction of nasal de- fects larger than 1.5 centimeters in diameter’, Laryngoscope, 110(8), pp. 1241–1250. doi: 10.1097/00005537-200008000-
00001.
Peris, K. et al. (2019) ‘Diagnosis and treatment of basal cell carci- noma: European consensus–based interdisciplinary guidelines’, European Journal of Cancer, 118, pp. 10–34. doi: 10.1016/j. ejca.2019.06.003.
Rohrich, R. J. et al. (2004) ‘Nasal reconstruction - Beyond aesthetic subunits: A 15-year review of 1334 cases’, Plastic and Recon- structive Surgery, 114(6), pp. 1405–1416. doi: 10.1097/01. PRS.0000138596.57393.05.
Shokri, T. et al. (2019) ‘The paramedian forehead flap for na- sal reconstruction: From antiquity to present’, Journal of Craniofacial Surgery, 30(2), pp. 330–333. doi: 10.1097/ SCS.0000000000004976.
Uzun, H. et al. (2015) ‘Assessment of patients who underwent nasal reconstruction after non-melanoma skin cancer exci- sion’, Journal of Craniofacial Surgery, 26(4), pp. 1299–1303. doi: 10.1097/SCS.0000000000001563.
Vatamanesku, I. et al. (2019) ‘Basal cell carcinoma of the nasal pyra- mid excision margins: A retrospective study’, Romanian Jour- nal of Morphology and Embryology, 60(4), pp. 1261–1268.
Wiȩckiewicz, W. et al. (2013) ‘Interdisciplinary treatment of basal cell carcinoma located on the nose - Review of literature’, Advances in Clinical and Experimental Medicine, 22(2), pp. 289–293.
Wollina, U., Langner, D. and Bennewitz, A. (2014) ‘Basal cell carci- noma of the outer nose: Overview on surgical techniques and analysis of 312 patients’, Journal of Cutaneous and Aesthetic Surgery, 7(3), p. 143. doi: 10.4103/0974-2077.146660
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