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1.
J Craniofac Surg ; 32(8): e771-e773, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34727452

RESUMO

ABSTRACT: Esthesioneuroblastoma is a rare neoplasm originating from the olfactory neuroepithelium at the cribriform plate. The superior nasal cavity is primarily affected. Morbidity and mortality are related to locally destructive growth as well as metastatic potential. Orbital involvement is associated with decreased survival. The authors describe a case of advanced esthesioneuroblastoma with bilateral orbital involvement, presenting with a rare constellation of orbital hypertelorism and Foster-Kennedy Syndrome.


Assuntos
Estesioneuroblastoma Olfatório , Hipertelorismo , Neoplasias Nasais , Doenças do Nervo Óptico , Estesioneuroblastoma Olfatório/cirurgia , Humanos , Cavidade Nasal/diagnóstico por imagem , Neoplasias Nasais/complicações , Neoplasias Nasais/cirurgia
2.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 56(11): 1174-1178, 2021 Nov 07.
Artigo em Chinês | MEDLINE | ID: mdl-34749456

RESUMO

Objective: To evaluate the application of island flap and combined flap in one-stage reconstruction of nasal alae defects after external nasal tumor resection. Methods: Data of 11 patients with perforating or full-thickness defects of the alae after nasal tumor resection in XuanWu Hospital, Capital Medical University between June 2016 and February 2021 were analyzed retrospectively. There were 7 males and 4 females, and the ages ranged from 51 to 89 years. Island flap, island flap combined with nasolabial flap or V-Y advancement flap, and island flap combined with bilobed flap were applied according to the range of defects. Descriptive statistical method was applied to analyze the treatment effects. Results: All flaps of the 11 patients were successful survival and the incisions were primary healing. Being followed up for 5 to 59 months, the patients had satisfying appearance and ventilation function, and no tumor relapsed. Conclusion: For the patients with nasal alae defects after external nose tumor resection, selecting suitable island skin flap or combined skin flap can be used to reconstruct the ideal nasal appearance and function of the nose.


Assuntos
Neoplasias Nasais , Procedimentos Cirúrgicos Reconstrutivos , Rinoplastia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Estudos Retrospectivos , Transplante de Pele , Retalhos Cirúrgicos
3.
Curr Opin Otolaryngol Head Neck Surg ; 29(6): 487-491, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34710067

RESUMO

PURPOSE OF REVIEW: The aim of this study was to present the evaluation and current management of congenital paediatric nasal dermoid. RECENT FINDINGS: There has been a trend towards less invasive surgical excision techniques, including purely endoscopic excision, endoscopic-assisted approaches and midline excision with nasal bone osteotomies and bone flap. These approaches allow adequate access for both total resection and nasal contour and skull base reconstruction. Following resection, if nasal bone osteotomies are insufficient for restoring nasal appearance, free temporoparietal fascial graft and/or conchal cartilage can be considered. For nasal tip deformities, interdomal sutures and free fat grafting are a suitable option. SUMMARY: Complete surgical excision remains the treatment of choice for nasal dermoid lesions. The surgical approach taken and reconstruction depends on the type of lesion (cyst versus sinus or fistula), location (intranasal versus extranasal), whether or not there is intracranial extension, and experience of the surgical team.


Assuntos
Cisto Dermoide , Neoplasias Nasais , Criança , Cisto Dermoide/diagnóstico , Cisto Dermoide/cirurgia , Endoscopia , Humanos , Nariz , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/cirurgia , Base do Crânio
4.
Medicine (Baltimore) ; 100(35): e27136, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477164

RESUMO

RATIONALE: Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses is a rare but aggressive neoplasm with a poor prognosis and a strong propensity for regional recurrence and distant metastasis. Diagnosis is challenging and relies on immunohistochemical study. Treatment includes surgical resection, radiation therapy, chemotherapy, or a combination of these modalities. However, the optimal therapeutic strategy is still controversial. Due to its rarity, the complexity of the histological diagnosis, and the variety of the treatment regimens, we presented a case of primary small cell neuroendocrine carcinoma in the nasal cavity with description of the clinical manifestation, pathology features, and our treatment regimen. PATIENT CONCERNS: An 82-year-old female patient with hypertension presented with right epistaxis on and off with nasal obstruction for several days. DIAGNOSIS: An exophytic mass over the posterior end of the right inferior turbinate was found on nasopharyngoscope. Biopsy was done and the pathology confirmed small cell carcinoma, strongly positive for cytokeratin (AE1/AE3) and insulinoma-associated protein 1 (INSM-1), scatteredly positive for chromogranin A, synaptophysin and CD56. The final diagnosis was small cell neuroendocrine carcinoma of right nasal cavity, pT1N0M0, stage I. INTERVENTIONS: The patient underwent wide excision of right intra-nasal tumor and post-operative radiotherapy with a dose of 6600 cGy in 33 fractions. OUTCOMES: No local recurrence or distant metastasis was noted during the 12 months of follow-up. LESSONS: Multimodality treatment remains the most common therapeutic strategy, although no proven algorithm has been established due to the rarity of this disease. Further investigation is needed for providing evidence to standardize the treatment protocol.


Assuntos
Carcinoma Neuroendócrino/patologia , Cavidade Nasal/patologia , Neoplasias Nasais/patologia , Idoso de 80 Anos ou mais , Carcinoma Neuroendócrino/radioterapia , Carcinoma Neuroendócrino/cirurgia , Feminino , Humanos , Neoplasias Nasais/radioterapia , Neoplasias Nasais/cirurgia
5.
Hautarzt ; 72(10): 913-921, 2021 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-34529088

RESUMO

The nose has an important function in the esthetic perception of the face. The esthetic coverage of defects on the nose is therefore of particular importance; however, the position is exposed to sunlight and poses a particular risk for the development of non-melanoma skin cancer (NMSC) and melanomas. After tumor excision, the size of the defect is decisive for defect closure. In addition, multilayer defects in which the cartilage or mucous membranes must be reconstructed by plastic surgery, represent a particular challenge for the surgeon. There are various options for reconstruction depending on the extent of the defects on the nose. This article gives an overview of the paramedian forehead flap, the indications and implementation.


Assuntos
Neoplasias Nasais , Rinoplastia , Testa/cirurgia , Humanos , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Retalhos Cirúrgicos
6.
Ann Chir Plast Esthet ; 66(5): 395-405, 2021 Oct.
Artigo em Francês | MEDLINE | ID: mdl-34400003

RESUMO

Fortunately, traumatic total amputations of the nose are rare, especially in children. Their reconstructions generally require several operative steps, most often associating cartilaginous grafts (rib and/or concha), a free radial antebrachial flap for mucosal reconstruction and a frontal flap for the skin covering. These are therefore long and complex procedures requiring a trained surgical team and maximum patient adherence to their treatment plan. The clinical case described is that of an 11-year-old child presenting a sub-total amputation of the nose and having undergone reconstruction with skin expansion of the frontal flap due to a horizontal frontal scar of unknown origin and a particularly low hair implantation.


Assuntos
Amputação Traumática , Neoplasias Nasais , Rinoplastia , Amputação , Amputação Traumática/cirurgia , Criança , Testa/cirurgia , Humanos , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Retalhos Cirúrgicos
7.
J Surg Oncol ; 124(5): 731-739, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34236707

RESUMO

OBJECTIVES: Sinonasal and skull base tumors are rare, making it difficult to identify trends in surgical outcome. This study examines complications in a large cohort of patients undergoing surgery for sinonasal malignancy. METHODS: Following IRB approval, an institutional database was reviewed to identify patients who underwent surgery for sinonasal or skull base malignancies from 1973 to 2016 at our institution. Charlson comorbidity index score and Clavien-Dindo grade were calculated. The main study endpoint was subgroup analysis of Clavien-Dindo Grade 0, Grades 1-2, and Grades 3-5 complications. An ordinal logistic regression model was constructed to assess the association between comorbidities, demographics, tumor characteristics, and surgical complications. RESULTS: In total, 448 patients met inclusion criteria. Perioperative mortality rate at 30 days was 1.6% (n = 7). The rate of severe complications (Clavien-Dindo 3 or higher) was 13.6% (n = 61). Multivariate analysis using an ordinal logistic regression model showed no association between Charlson comorbidity index score and Clavien-Dindo grade of postoperative complication. Advanced T-stage was significantly associated with complications (p = 0.0014; odds ratio: 3.442 [95% confidence interval: 1.615, 7.338]). CONCLUSION: Surgery for sinonasal and skull base tumors is safe with a low mortality rate. Advanced T-stage is associated with postoperative complications. These findings have implications for preoperative risk stratification. Key Points Surgery for sinonasal malignancy is safe with a 30 mortality of 1.6% and rate of severe complications of 12.8%. There is no association between patient comorbidity and post operative complication. On multivariate analysis, only advanced T stage was associated with increased rate of surgical complication.


Assuntos
Neoplasias Nasais/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Complicações Pós-Operatórias/patologia , Neoplasias da Base do Crânio/cirurgia , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Nasais/patologia , Neoplasias dos Seios Paranasais/patologia , Complicações Pós-Operatórias/etiologia , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Neoplasias da Base do Crânio/patologia , Taxa de Sobrevida , Adulto Jovem
8.
Int J Pediatr Otorhinolaryngol ; 149: 110842, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34329830

RESUMO

OBJECTIVE: The study aimed to present the accuracy of radiological diagnostics in pediatric patients with nasal dermoids and to discuss the potential factors influencing the radiological pitfalls on imaging in these cases. MATERIAL AND METHODS: The patient's cohort included 25 surgically treated pediatric cases with nasal dermoid. The results of preoperative imaging studies were analyzed regarding intraoperative findings. A review of the literature concerning a series of cases with nasal dermoid was performed in order to evaluate the possible radiological pitfalls and the accuracy of radiological imaging. The following statistical parameters for the particular radiological tools was determined: sensitivity, specificity, predictive positive values and predictive negative values. RESULTS: Total number of 18 CT and 14 MRI were performed. 6 out of 32 radiological examinations occurred to be inconsistent with operative findings. Potential pitfalls were identified and discussed. All the patients with false radiological results were below the age of 5 and 83% were below the age of 3 y.o. The overall sensitivity (S), specificity (SP), predictive positive value (PPV) and predictive negative value (PNV) for CT vs. MRI were 68% vs. 79%, 90% vs. 95%, 65% vs. 86% and 90% vs. 92%, respectively. CONCLUSIONS: MRI technique characterizes with higher predictive values in terms of identifying intracranial extension of nasal dermoid on imaging. Further analysis of radiological methods' accuracy should be conducted based on the detailed data concerning age distribution. The combination of CT and MRI should become a gold standard in diagnostics of nasal dermoids in children under the age of 5.


Assuntos
Cisto Dermoide , Neoplasias Nasais , Criança , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/cirurgia , Humanos , Imageamento por Ressonância Magnética , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/cirurgia , Radiografia , Tomografia Computadorizada por Raios X
9.
Plast Reconstr Surg ; 148(1): 171-182, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34181615

RESUMO

BACKGROUND: Nasal defects following Mohs resection are a reconstructive challenge, demanding aesthetic and functional considerations. Many reconstructive modalities are available, each with varying utility and efficacy. The goal of this study was to provide an algorithmic approach to nasal reconstruction and illustrate lessons learned from decades of reconstructing Mohs defects. METHODS: A retrospective review was conducted of consecutive patients who underwent nasal reconstruction after Mohs excision from 2003 to 2019 performed by the senior author (J.F.T.). Data were collected and analyzed regarding patient and clinical demographics, defect characteristics, reconstructive modality used, revisions, and complications. RESULTS: A total of 2553 cases were identified, among which 1550 (1375 patients) were analyzed. Defects most commonly affected the nasal ala (48.1 percent); 74.8 percent were skin-only. Full-thickness skin-grafts were the most common reconstructive method (36.2 percent); 24.4 percent of patients underwent forehead flaps and 17.0 percent underwent nasolabial flaps. The overall complication rate was 11.6 percent (n = 181), with poor wound healing being most common. Age older than 75 years, defects larger than 2 cm2, and active smoking were associated with increased complication rates. CONCLUSIONS: Nasal reconstruction can be divided based on anatomical location, and an algorithmic approach facilitates excellent results. Although local flaps may be suitable for some patients, they are not always the most aesthetic option. The versatility and low risk-to-benefit profile of the forehead flap make it a suitable option for elderly patients. Although reconstruction is still safe to be performed without discontinuation of anticoagulation, older age, smoking, and large defect size are predictors of complications. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Assuntos
Cirurgia de Mohs/efeitos adversos , Neoplasias Nasais/cirurgia , Complicações Pós-Operatórias/epidemiologia , Rinoplastia/efeitos adversos , Neoplasias Cutâneas/cirurgia , Fatores Etários , Idoso , Estética , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/patologia , Nariz/cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Rinoplastia/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Fumar/epidemiologia , Retalhos Cirúrgicos/transplante , Resultado do Tratamento
11.
J Craniofac Surg ; 32(8): e719-e724, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33935147

RESUMO

OBJECTIVE: The reconstruction of nasal alar defects after resection of a melanocytic nevus becomes one of the most challenging procedures for surgeons. Choosing the most appropriate technique is still difficult sometimes. The authors reviewed our cases and published experience on choosing optimal surgical methods to repair different types of nasal alar defect following melanocytic nevus resection. METHODS: A total of 152 patients who were treated between 2016 and 2019 in Shanghai Ninth People's Hospital were evaluated. The surgical methods included primary closure, full-thickness skin graft, composite auricular graft, interpolated melolabial flap, paramedian forehead flap including hair-bearing paramedian forehead flap. RESULTS: Among the 152 patients with a melanocytic nevus, 49 underwent primary closure, 38 were treated with a full-thickness skin graft, 16 composite auricular graft, 28 were treated with interpolated melolabial flap, and 21were treated with paramedian forehead flap including 14 with hair-bearing paramedian forehead flap. Most skin graft, composite auricular graft, and flaps were survived. Patients who completed follow-up were satisfied with the contour of the nasal ala. CONCLUSIONS: After resection of the melanocytic nevus, the surgeon should choose the most appropriate surgical method for alar reconstruction according to the characteristics of the defect and personal desire of patient or the guardian.


Assuntos
Nevo Pigmentado , Neoplasias Nasais , Rinoplastia , Neoplasias Cutâneas , China , Testa/cirurgia , Humanos , Nevo Pigmentado/cirurgia , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Neoplasias Cutâneas/cirurgia
12.
Am J Otolaryngol ; 42(4): 103061, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34020819

RESUMO

BACKGROUND: The aim of this study was to describe the potential advantages of the 3D endoscope-assisted craniectomy for tumor of the nasal cavity. METHODS: A 77-year-old man with a 6 month history of persistent progressive right nasal obstruction and iposmia is reported. Physical examination, including nasal endoscopy, revealed a large mass within the right nasal cavity. He had no associated symptoms such as visual complaints, paresthesia, and facial pain. He worked as a carpenter. Further imaging by CT and MRI revealed a large, expansive nasal-ethmoid lesion that almost completely occupies the right nasal cavity with partial extension posterior to the choana, extensive erosion of the ethmoid. Medially marks the nasal septum with deviation to the left. Laterally it marks the medial wall of the maxillary sinus and at the top it is in contact with the cribriform plate which seems to be interrupted in the right parasagittal seat at the 3rd anterior of the olfactory cleft. Histopathological analysis of the specimen was consistent with sinonasal adenocarcinoma, intestinal type (ITAC) cT4aN0 ([1]). RESULTS: Patient was taken up for surgery by transnasal 3D endoscopic approach for excision of tumor with repair of the skull base defect, using Karl Storz IMAGE1 S D3-Link™ and 4-mm TIPCAM®. The mass could be dissected free of the dura and the entire specimen was removed completely and sent for histopthological examination. We followed our 8 main surgical steps: 1) Tumor disassembling; 2) Nasal septum removal; 3) Centripetal bilateral ethmoidectomy and sphenoidotomy; 4) Draf III frontal sinusotomy 5) Anterior and posterior ethmoidal artery closure 6) Skull base removal; 7) Intracranial work; 8) Reconstruction time. A 4 × 2.3 cm skull base defect was repaired using triple layer of fascia lata (Intracranial intradural, intracranial extradural and extracranial) and was sealed using tissue glue (TisselR). Post-operative recovery was uneventful, pack were removed on 3rd postoperative day and patient was discharged on the 7th post-operative day. After 2 years of follow up, the patient is free of disease. CONCLUSION: We describe 3D endoscopic transnasal craniectomy for Intestinal Type Adeno-Carcinoma (ITAC) of the nasal cavity as a feasible technique for the surgical management of sino-nasal tumors ([2].) Our experience with this approach has been outstanding. We firmly believe that in the first three steps of the procedure the 3D endoscope is not necessary because it extends the surgical time and induce eyestrain of the main surgeon. Nevertheless, 3D endoscope gives the major advantage during the skull base removal and the intracranial work. It offers an optimal vision and better perception of depth with safe manipulation of the instruments avoiding injuries to healthy tissue ([3]). Furthermore, 3D images offer better understanding of the relationship between anatomical landmarks, helping the didactic learning curve of our residents.


Assuntos
Adenocarcinoma/cirurgia , Craniotomia/métodos , Endoscopia/métodos , Imageamento Tridimensional/métodos , Cavidade Nasal/cirurgia , Neoplasias Nasais/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Cirurgia Assistida por Computador/métodos , Idoso , Seguimentos , Humanos , Masculino , Septo Nasal/cirurgia , Base do Crânio/cirurgia , Resultado do Tratamento
13.
Acta Chir Plast ; 63(1): 6-13, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34034490

RESUMO

Nasal basal cell carcinomas are the most common malignant tumors of the facial skin, which predilectively affect areas exposed to sunlight, including the nasal area. After their radical removal, there is a variable complex defect of the affected area (defect of all 3 layers of the nose) or even a composite defect (it also occupies the adjacent soft tissues around the nose), which are usually used to reconstruct this area. A 73-year-old female patient with recurrent infiltrative basal cell carcinoma of the left nasal ala underwent four re-excisions before histologically verified free margins without the presence of the tumor. The result was a composite defect that occupied the top of the dome of the right nostril, the entire left half of the soft nose, including the base of the wing, part of the upper lip, and a defect of the adjacent face area of 9 × 5cm. In the first phase, the left cheek and upper lip were reconstructed by advancement French plasty and coverage of the two residual skin defects with full-thickness skin graft. One month later, during the second phase of reconstruction, the flap was re-elevated, shifted and rotated, and a three-stage nasal reconstruction was started using a composite septal pivotal flap and left turbinate flap for inner lining reconstruction, and the nasal skeleton was reconstructed with a cartilaginous L-graft from the 6th rib, septal and conchal cartilages. The skin cover of the nose was reconstructed with the left paramedian forehead flap, which was thinned during the second stage with the simultaneous widening of the bottom of the left nostril by the transposition flap, during the third stage the flap pedicle was removed. In the reconstruction of a complex defect of the nose and its surroundings, it is first necessary to create a stable platform on which the reconstruction of the nose itself will be performed. To achieve an excellent functional and aesthetic result of nose reconstruction, it is appropriate to use a three-stage forehead flap. In this paper, we describe a unique method of nasal reconstruction - a combination of a septal pivotal flap with a turbinate flap to reconstruct the inner lining in conjunction with an L-graft to ensure a stable nasal skeleton and forehead flap to reconstruct the skin cover.


Assuntos
Neoplasias Nasais , Rinoplastia , Neoplasias Cutâneas , Idoso , Feminino , Testa/cirurgia , Humanos , Neoplasias Nasais/cirurgia , Neoplasias Cutâneas/cirurgia , Retalhos Cirúrgicos , Conchas Nasais
14.
J Craniofac Surg ; 32(7): 2292-2295, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33852521

RESUMO

ABSTRACT: Nasal reconstruction is one of the most challenging procedures in plastic surgery. To get optimal aesthetic and functional results, the surgeon should know all the options well. Forehead flap is the gold standard technique for closure of medium to large defects of the nose. Although it provides a very good color and texture match, it may become a difficult option in patients with poor condition. The aim of this study was to define a simpler technique for nasal reconstruction using combined local flaps.Twelve patients, operated using a dorsal nasal flap combined with a nasolabial perforator propeller flap, were presented in the study. Properties of the patients, defect size and locations, and complications were evaluated.The mean size of the reconstructed defects was 10.1 cm2. No flap loss was observed. Venous congestion was the most common complication and resolved spontaneously in all cases. Two cases had partial distal necrosis, which also healed spontaneously.Closure was achieved successfully in all cases with a medium to large nasal defect using a combined dorsal nasal flap and nasolabial perforator propeller flap. This method can be used as an alternative to forehead flap.


Assuntos
Neoplasias Nasais , Retalho Perfurante , Procedimentos Cirúrgicos Reconstrutivos , Estética Dentária , Humanos , Nariz/cirurgia , Neoplasias Nasais/cirurgia
16.
World Neurosurg ; 151: e58-e67, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33798777

RESUMO

OBJECTIVE: The endoscopic endonasal approach (EEA) has been applied in the treatment of olfactory neuroblastoma (ONB). However, there is a lack of research examining the impact of EEA on locally advanced ONB. This study assessed the outcomes of EEA in patients with locally advanced ONB and its impact on the quality of life (QOL). METHODS: We retrospectively reviewed patients with Kadish stage C ONB who underwent EEA between December 2004 and October 2019 and assessed demographic data, histopathologic grade, the extent of resection, postoperative complications, and outcomes. Preoperative and postoperative QOL was assessed using the Sino-Nasal Outcome Test. RESULTS: Twenty-six patients (18 men, 8 women; aged 26-79 years) were enrolled, with 12 cases of Hyams grade II and III and 1 case of grade I and IV each. In total, 25 patients received radiotherapy and 16 patients received chemotherapy, of whom 11 received preoperative neoadjuvant chemotherapy. Postoperative nasal bleeding was observed in 2 patients. The follow-up ranged from 8 to 124 months (median, 42.3 months). The 1-year and 5-year overall survival were 96.2% and 84.8%, respectively. The 1-year and 5-year disease-free survival were 76.9% each. The analysis of the postoperative Sino-Nasal Outcome Test scores showed significant improvement in certain psychological and sleep-associated domains, compared with the preoperative scores. CONCLUSIONS: Our results showed that pure EEA followed by radiotherapy offered excellent outcomes in the management of selected patients with locally advanced ONB. The postoperative QOL was significantly improved. More research is required on neoadjuvant chemotherapy to establish its role.


Assuntos
Endoscopia/métodos , Estesioneuroblastoma Olfatório/cirurgia , Cavidade Nasal , Procedimentos Neurocirúrgicos/métodos , Neoplasias Nasais/cirurgia , Qualidade de Vida , Adulto , Idoso , Quimiorradioterapia Adjuvante , Intervalo Livre de Doença , Endoscopia/psicologia , Estesioneuroblastoma Olfatório/diagnóstico por imagem , Estesioneuroblastoma Olfatório/psicologia , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/cirurgia , Procedimentos Neurocirúrgicos/psicologia , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/psicologia , Complicações Pós-Operatórias/epidemiologia , Hemorragia Pós-Operatória/epidemiologia , Estudos Retrospectivos , Análise de Sobrevida , Tomografia Computadorizada por Raios X , Resultado do Tratamento
17.
Artigo em Chinês | MEDLINE | ID: mdl-33832197

RESUMO

Objective: To evaluate the application of three-staged paramendian forehead flap technique in reconstruction of severe full-thickness nasal defect. Methods: Clinical data of 7 cases with nasal reconstruction by three-staged forehead flap technique in the First Affiliated Hospital of Xinjiang Medical University and HongKong University Shenzhen Hospital between June 2016 and October 2019 was retrospectively reviewed. All were males aged from 10 to 71 years. There were 4 cases of basal cell carcinoma of the external nose, 2 cases of traumatic nasal defects and 1 case of large rhinophyma. All the operations were performed with the paramedian forehead flap in three stages. In stage Ⅰ, full layered forehead flap was transposed to the nasal detect. Lining flaps were reconstructed with folded forehead skin (n=4), turn-over flap plus septal chondro mucosal pivotal flap (n=2), or bipedicled vestibular skin and nasal mucosa advancement flap (n=1). According to the reconstruction mode of the lining flaps, whether to implant cartilage to reconstruct the external nasal stent at stage Ⅰ was determined. At stage Ⅱ, the folded flaps were partly or completely separated from the covering flaps along the free edges of nasal alar. All the excess soft tissue including subcutaneous fat and frontalis muscle were excised, cartilage grafts were placed or sculpted to make an ideal nasal contour. The covering flaps were then returned on the recontoured, three-dimensional recipient bed. At stage Ⅲ, the pedicles were divided. Descriptive statistical method was used to analyze the data. Results: In all cases, restoration of the nasal contour was remarkably good, no flap necrosis occurred. All patients were followed up for 6 months to 2 years, and the appearance and function of the nose recovered well. All patients were satisfied with their final aesthetic results. Conclusions: Three-staged paramedian forehead flap technique ensures maximal blood supply for the lining flap and the inserted cartilage graft, and restores an ideal three-dimensional nasal contour for reconstruction of large full thickness nasal defects.


Assuntos
Neoplasias Nasais , Rinoplastia , Neoplasias Cutâneas , Idoso , Testa/cirurgia , Humanos , Masculino , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Estudos Retrospectivos , Neoplasias Cutâneas/cirurgia , Retalhos Cirúrgicos
18.
Facial Plast Surg ; 37(3): 407-410, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33853137

RESUMO

The nose is highly vulnerable to skin cancers due to the unavoidable sun exposure. The most common localization of skin cancers on the face is nose. Although the nose appears to be a single structure, it comprises many aesthetic units with different histological and anatomical properties. Our aim was to determine the relationship between the prevalence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), histologically and anatomically distinct nasal subunits. The study included patients who underwent excision and repair due to BCC or SCC of the nose. The lesions were classified according to their location in the following topographic subunits: tip, alar lobule, dorsum, sidewall, and medial canthal region. Patients were analyzed according to age, sex, topographic subunit, tumor type, and repair technique. There was no statistically significant difference in tumor location according to etiology (p > 0.05). The alar subunit was the most common location of BCC, while the dorsum was the most common location for SCC. There is no statistical relationship between the two most common skin cancers, BCC and SCC, and the aesthetic subunits of the nose. The only factor associated with the reconstruction method used was the subunit in which the tumor was located.


Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Neoplasias Nasais , Neoplasias Cutâneas , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/cirurgia , Estética Dentária , Humanos , Neoplasias Nasais/epidemiologia , Neoplasias Nasais/cirurgia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/cirurgia , Retalhos Cirúrgicos
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