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Nasal reconstruction after malignant tumor resection: an algorithm for treatment.

Abstract：

BACKGROUND:Seventy-five percent of nonmelanoma skin cancers are located in the head and neck area, of which 30 percent occur on the nose (225,000 new cases per year). The aim of this study was to develop a nasal reconstruction algorithm for nasal defects, based on experience with 788 consecutive nasal reconstructions performed in a multidisciplinary university medical center setting over a period of 7 years. METHODS:Medical files of 788 consecutive patients who were operated on for various nasal pathologies between January of 2001 and December of 2008 were reviewed. In addition, a literature search on treatment of nasal defects and outcomes after nasal reconstruction was conducted using PubMed. RESULTS:The algorithm divides nasal defects into simple, small (skin only), larger (skin and cartilage), or full thickness. Small defects can be closed primarily or with various local flaps. For larger defects, the three-stage paramedian forehead flap is the flap of choice with or without the use of cartilage grafts. For small inner lining defects, full-thickness skin grafts or turn-down lining flaps with delayed primary cartilage grafts at the intermediate stage are currently the authors' preference. For medium to larger inner lining defects, the folded forehead flap with delayed primary cartilage grafts at the intermediate stage is the authors' preferred technique. For (sub)total nasal reconstructions with very large inner lining requirements, the authors would now consider free vascularized tissue transfer. CONCLUSIONS:Nasal skin cancer is an increasing problem. Proper treatment of nasal skin cancer, including nasal reconstruction, requires a structured multidisciplinary approach to achieve excellent tumor control and a satisfactory aesthetic and functional end result.

journal_name

Plast Reconstr Surg

journal_title

Plastic and reconstructive surgery

authors

Moolenburgh SE,McLennan L,Levendag PC,Munte K,Scholtemeijer M,Hofer SOP,Mureau MAM

doi

10.1097/PRS.0b013e3181da872e

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

97-105

issue

eissn

0032-1052

issn

1529-4242

pii

00006534-201007000-00012

journal_volume

126

pub_type

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Nasal reconstruction after malignant tumor resection: an algorithm for treatment.