Başaran Bora, Aslan Ismet, Tinaz Mehmet Emin, Başerer Nermin, Yazicioğlu Engin
Department of Otolaryngology, Istanbul Medicine Faculty of Istanbul University, Istanbul, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2007;17(3):133-7.
We evaluated functional results of surgical treatment for squamous cell carcinoma of the nasal vestibule.
A retrospective review of 2,763 patients treated for head and neck cancers between 1991 and 2000 revealed 10 cases of nasal vestibule tumors, with an incidence of 0.36%. All the patients were males with a mean age of 64.8 years (range 58 to 72 years). Based on the classification system of the AJCC 1992 for skin cancers, and the UICC classification for neck metastasis, three patients had T2, three patients had T3, and four patients had T4 tumors. Lymph node metastasis was present in three patients. Nine patients were treated with surgery as the primary treatment. One patient underwent surgical salvage following radiotherapy failure. The mean follow-up period was 3.65 years (range 6 months to 12 years).
Three patients with metastatic neck disease and four patients with advanced tumors underwent radical neck dissection and selective supraomohyoid neck dissection, respectively. Seven patients underwent reconstruction with paramedian forehead flap (n=3), nasolabial flap (n=2), aural composite graft, or split thickness flap. Including the one with radiotherapy failure, two patients died within the first postoperative year due to local and neck recurrences. Another patient died in the postoperative third year due to metastatic squamous cell carcinoma of the lung. No cosmetic or functional complaints were observed in patients with early stage lesions. Two patients with advanced tumors had nasal ventilation problems and a secondary revision procedure was required in one.
Surgery is a successful therapeutic modality for carcinoma of the nasal vestibule, especially when applied in conjunction with proper reconstruction techniques and, when necessary, neck dissection procedures.
我们评估了鼻前庭鳞状细胞癌手术治疗的功能结果。
回顾性分析1991年至2000年间接受头颈部癌症治疗的2763例患者，发现10例鼻前庭肿瘤，发病率为0.36%。所有患者均为男性，平均年龄64.8岁（范围58至72岁）。根据1992年美国癌症联合委员会（AJCC）皮肤癌分类系统以及国际抗癌联盟（UICC）颈部转移分类，3例患者为T2期，3例患者为T3期，4例患者为T4期肿瘤。3例患者出现淋巴结转移。9例患者以手术作为主要治疗方法。1例患者在放疗失败后接受了挽救性手术。平均随访期为3.65年（范围6个月至12年）。
3例颈部转移患者和4例晚期肿瘤患者分别接受了根治性颈清扫术和选择性肩胛舌骨上颈清扫术。7例患者采用正中前额皮瓣（n = 3）、鼻唇沟皮瓣（n = 2）、耳复合移植或断层皮瓣进行重建。包括放疗失败的1例患者在内，2例患者在术后第一年内因局部和颈部复发死亡。另1例患者在术后第三年因肺转移性鳞状细胞癌死亡。早期病变患者未观察到美容或功能方面的问题。2例晚期肿瘤患者存在鼻通气问题，其中1例需要二次修复手术。
手术是治疗鼻前庭癌的一种成功治疗方式，尤其是与适当的重建技术以及必要时的颈部清扫手术联合应用时。
