[Reconstruction of nasal defect after tumor excision]

Abstract

Objective: To introduce the experience and comprehension to reconstruct nasal defect after tumor excision.

Methods: From April 1996 to April 2006, based on the aesthetic subunit principle and according to the size, shape, location of nasal defect and the conditions of surrounding skin, homologous local flap was selected to cover the nasal defect in 428 cases which nasal tumors were removed. Among 428 cases, there were 273 men and 155 women, with a median age of 52 years (12-78 years); including 146 cases of basal cell carcinoma, 83 cases of squamous cell carcinoma, 54 cases of epidermal cyst, and 145 cases of pigmented naevus. The clinical stage of malignant tumor was 0-I stage, the course of disease was 1 week to 3 months. The locations were nasal tip in 51 cases, nasal ala in 102 cases, dorsum of nose in 138 cases, and nasal side in 137 cases, across 2 nasal subunits in 83 cases. The area of the defect ranged between 0.6 cm x 0.6 cm and 3.0 cm x 4.0 cm. The origin of flaps was frontonasal flap in 58 cases, bilobed flap in 67 cases, reforming rhomboid flap in 152 cases, nasolabial flap in 118 cases, forehead falp in 33 cases. The secondary defect of donor site was directly sutured.

Results: Among 428 cases, 423 cases acquired complete recovery; 3 cases which had epiderm necrosis over the far end of the flap achieved healing by the first intention and 2 cases which had suffered low-grade infection of incision achieved healing by the second intention after regional change dressings. The nasal defect was successfully repaired in all patients, and the all flaps survived. A total of 385 patients were available for follow-up of 1 to 60 months, no tumor recurrence occurred, and the repaired tissue were good match with surrounding tissue, good nasal contour was obtained, the cosmetic results were satisfactory.

Conclusion: Based on the nasal aesthetic subunit principle, the local flap can reconstruct the nasal above medial defect, and a good color, contour and texture match with the surrounding skin can be obtained, the cosmetic results are satisfactory.