- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Serviço de Cirurgia Plástica - São Paulo - SP - Brasil.
- Instituto do Câncer do Estado de São Paulo, Serviço de Cirurgia Plástica - São Paulo - SP - Brasil.
Rev Col Bras Cir. 2022 Sep 2;49:e20223034. doi: 10.1590/0100-6991e-20223034-en. eCollection 2022.
nose is the central point of the face and vulnerable to the occurence of non-melanoma skin cancer (NMSC), impacting on appearance. The paramedian forehead flap (PMFF) is considered the best option to treat extensive nasal defects. The objective of this study is to present the experience on PMFF for nasal reconstruction in the treatment of NMSC of a cancer referral center.
retrospective study was carried out through data from medical records of patients who underwent nasal reconstruction with PMFF due to NMSC at the Cancer Institute of the State of São Paulo (ICESP).
111 patients were identified, mostly ederly, with comorbidities and on initial tumors (T1 and T2). Basal cell carcinoma (BCC) was the predominant histological type. Dorsum and tip were the most affected subunitis. In addition to skin coverage, reconstruction of the lining and structural framework was also performed in half of the cases. Second intention healing was the technique of choice in closing the donor area. Pedicle division ocurred predominantly in the second operation and the median time to complete reconstruction was 6 months. There were low complication rates.
the PMFF is safe and effective to treat nose NMSC, even in cases of high complexity. Since the treatment time can be prolonged and impact on quality of life, it is essential to emphasize and discuss this aspect with the patients before surgery.
鼻子是面部的中心点，容易发生非黑色素瘤皮肤癌（NMSC），影响外观。正中额部皮瓣（PMFF）被认为是治疗广泛鼻缺损的最佳选择。本研究旨在介绍治疗癌症转诊中心 NMSC 中 PMFF 用于鼻重建的经验。
通过在圣保罗州癌症研究所（ICESP）因 NMSC 接受 PMFF 鼻重建的患者的病历数据进行回顾性研究。
共确定了 111 名患者，主要为老年人，伴有合并症和初始肿瘤（T1 和 T2）。基底细胞癌（BCC）是最主要的组织学类型。背部和鼻尖是最常受影响的亚单位。除了皮肤覆盖外，一半的病例还进行了衬里和结构框架的重建。二期愈合是关闭供区的首选技术。蒂部切断主要发生在第二次手术中，完全重建的中位时间为 6 个月。并发症发生率较低。
PMFF 治疗鼻部 NMSC 是安全有效的，即使是在高复杂性的情况下。由于治疗时间可能会延长并影响生活质量，因此在手术前必须与患者强调并讨论这一方面。
