The management of nasal defects after non-melanoma skin cancer excision

Abstract

Background: The reconstruction of the nasal defects occurring after a tumor excision is rather difficult. The purpose of this study is to present our choices of reconstruction using flaps or grafts depending on the size, localization, and depth of the nasal defects occurring after a basal cell carcinoma and squamous cell carcinoma and to demonstrate our clinical approach and algorithm. Patients and methods: We retrospectively reviewed 224 patients who underwent nasal reconstruction after excision of nonmelanoma skin cancer between January 2010 and January 2015. Data collected included patients’ age and sex, anatomic location, tumor diagnosis, defect size, depth of the defects, reconstruction methods, recurrence, follow-up time, related to smoke and complications required. Results: A total of 224 patients were included in this study. Basal cell carcinoma was diagnosed 145 patients (64.7%), squamous cell carcinoma was diagnosed in 79 patients (35.3%). The most common location for nasal reconstruction was the nasal dorsum and sidewalls (56%). The nasolabial flaps were the most commonly used flap (n=49), followed by bilobed flap (n=34), forehead flap (n=32), V-Y rotation advancement flap (n=27), glabellar flap (n=26), skin graft (n=15), single or bilateral transposition flap (n=20), and other combined flaps (n=21). Conclusions: Obtaining tumor-free borders and satisfying aesthetic results are foremost aim in nasal reconstruction after nasal skin cancer excision. In this study, our clinical approach for nasal defects reconstruction is presented, which is based on frequently performed local flaps and skin grafting. © 2016, E-Century Publishing Corporation. All rights reserved.