1. Outcome of Nasal Reconstruction Following Tumour Excision in 68 Patients
P. Surda, S. Hampal, H. Fowler, R. Goggins
ENT department, Warrington and Halton Hospitals NHS trust
Introduction
Nose is the most prominent feature, occupying the central aspect of the face and has a unique place in facial identity. Even minor lesions might have a great impact on a patient‘s self-esteem and persona. Cutaneous neoplasms of the nose are often more extensive than they appear to the naked eye. Reconstruction of medium and large sized defects of the nose poses a challenge to the reconstructive surgeon. A variety of techniques are available to the surgeon. Our aim was to ascertain patient satisfaction with reconstruction, local recurrence of tumour and complications arising from reconstruction.
Results BCC local recurrence was in 5 patients (8.8 %) and early complications were in 3 patients (4.4 %). Questionnaire revealed overall high patient satisfaction with outcome of the nasal reconstruction. The most commonly used techniques for each nasal subunit you can find in table below. 1. 2. 3. 1. 2. 3.
Paramedial forehead flap technique used for the tip of the nose lesion
Root
Dorsum
Lateral Side Wall
Tip
Columella
Ala Nasi n
Nasolabial Flap  8 21 29
Bilobed Flap  2 8 5 15
Rhombic Flap 2  5 9
Full Thickness Graft  3
Ellipse Advancement Flap 3 1 4
Paramedial Forehead Flap
Glabella Flap
Island Advancement Flap
Bilobed flap technique used for the tip of the nose lesion
Methods
68 patients were identified who underwent reconstruction of the nose following tumour excision between January 2010 to November patients were histologically confirmed to have basal cell carcinoma (BCC) , and remaining 5 with squamous cell carcinoma. A variety of reconstructive techniques were used including bilobed flap, rhombic flap, full thickness graft, nasolabial flap, glabella flap and paramedial forehead flap. We used the modified Rhinoplasty Evaluation Score Questionnaire to evaluate patient satisfaction. 1. 2. 3. 4.
Conclusion The audit showed that the most commonly used reconstruction techniques for each nasal subunit provide acceptable functional and cosmetic results. Our local recurrence rate is similar to recently published studies.
Nasolabial flap technique used for the left alar lesion