Goldman Alberto, Wollina Uwe
Goldman Clinic and Moinhos de Vento Hospital, Porto Alegre, Brazil.
Department of Dermatology and Allergology, Skin Cancer Center, Dresden Municipal Clinic, Dresden, Germany.
Acta Dermatovenerol Alp Pannonica Adriat. 2020 Dec;29(4):209-214.
Malignant keratinocyte tumors-that is, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)-are commonly found on sun-exposed body areas such as the nose. The primary aim of tumor surgery is complete excision. Due to anatomical, functional, and aesthetic issues, reconstruction of such defects remains a challenge.
We report on a series of 52 patients that were treated from 2015 to 2019 at the Goldman Clinic in Porto Alegre, Brazil. The mean age was 63 years (range 28-82 years, standard deviation 14.25 years). Thirty-nine (75%) patients were male and 13 (25%) female. The histological diagnosis was BCC in 49 patients and SCC in three.
Nasal defect closures were located on the nasal dorsum, tip, alar nose, and nasion. The nasal dorsal and alar region were the regions most commonly involved. All tumor specimens were 3D histologically investigated. A nasolabial flap was the reconstructive option in 40 subjects (76.9%). A bilobed flap was used in six patients (11.5%). Other flaps used for defect closure were a Rintala flap (n = 2), tunneled island flap (n = 1), and frontal flap (n = 1). Adverse events were rare and manageable. Three relapses were noted during follow-up.
Nasal reconstruction requires an armamentarium of surgical techniques to tailor the procedures based on tumor localization, size, and depth, and patients' needs.
恶性角质形成细胞肿瘤，即基底细胞癌（BCC）和鳞状细胞癌（SCC），常见于身体暴露于阳光的部位，如鼻子。肿瘤手术的主要目标是完整切除。由于解剖、功能和美学问题，此类缺损的重建仍然是一项挑战。
我们报告了2015年至2019年在巴西阿雷格里港戈德曼诊所接受治疗的52例患者。平均年龄为63岁（范围28 - 82岁，标准差14.25岁）。39例（75%）为男性，13例（25%）为女性。组织学诊断为49例基底细胞癌和3例鳞状细胞癌。
鼻缺损修复位于鼻背、鼻尖、鼻翼和鼻根。鼻背和鼻翼区域是最常受累的区域。所有肿瘤标本均进行了三维组织学研究。40例患者（76.9%）选择鼻唇瓣进行修复。6例患者（11.5%）使用了双叶瓣。用于缺损修复的其他皮瓣包括林塔拉皮瓣（n = 2）、隧道岛状皮瓣（n = 1）和额部皮瓣（n = 1）。不良事件罕见且可控。随访期间发现3例复发。
鼻重建需要一系列手术技术，以便根据肿瘤的位置、大小、深度和患者需求来调整手术方案。
