Microvascular nose reconstruction after extended tumor resection.

Abstract

<jats:p>Introduction: The nose is the central and probably the most important anatomical region of the face. Reconstructive surgery after tumor resection in this anatomical region requires from the surgeon knowledge of the anatomy, due to the three-dimensional shape and variety of tissues. Materials and methods: In the years 2010-2019, 48 patients were treated in the Oncological and Reconstructive Surgery Clinic for extended nasal tumors , who required the use of free microvascular flaps after resection for functional and aesthetic supply of anatomical structures of the nose. Results: In 48 patients, a total of 92 free microvascular flap were used for nasal reconstruction including: radial forearm free flap in 24 patients, radial forearm free flap with radial bone in 14 patients, auricle free flap in 16 patients, radial forearm free flap in combination with auricle free flap in 7 patients, double auricle free flap in 6 patients, radial forearm free flap in combination with double auricle free flap in 4 patients. Total necrosis of the free flap was noted in 4 cases, partial in 6 patients. Conclusions: Presented surgical techniques using the microvascular free flaps constitute a recognized method of treatment in the world and should be used in everyday surgeon practice. Discussion: In the reconstructive nose surgery after extended tumor resections due to cancer, there are no uniform treatment standards and algorithms . The surgeon is often dependent on his knowledge, skills and creative thinking . Presented results in this article allows to obtain optimal functional and aesthetic effects. </jats:p>

Reconstructive Options after Oncological Rhinectomy: State of the Art

“…No complications were described in the 12 patients who underwent ALTFF. In seven of the studies examined, the aesthetic result was analyzed using different questionnaires, with good results achieved in all cases [ 1 , 3 , 4 , 7 , 10 , 13 , 14 ].…”

“…Several techniques of surgical reconstruction are described in the literature, all with better aesthetic and functional results. Based on the available literature, it is difficult to assess which reconstructive method is preferable, as each surgeon makes adaptations to standard techniques based on his or her own experience and the resources available at the center where he or she works [ 1 , 3 , 4 , 7 , 10 , 12 , 14 ]. However, all the articles unanimously agree that reconstruction of a total nasal defect should include the reconstitution of each of the three layers of nasal tissue: the inner mucosal layer, the support layer and the outer skin [ 1 , 3 , 4 , 7 , 10 , 12 , 14 , 29 , 30 , 31 , 32 ].…”

“…After title and abstract screening, 33 papers were left. At the end of the full-text review, 17 studies were included for a total number of 447 cases [ 1 , 2 , 3 , 4 , 6 , 7 , 8 , 10 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

“…About 2000 cases of nasal tumors are diagnosed in the USA per year and account for 3% of all head and neck cancers [ 1 , 5 ]. The most frequent histologies are basal cell carcinoma and squamous cell carcinoma [ 5 , 6 , 7 , 8 ]. Nasal reconstruction is one of the oldest techniques in plastic surgery.…”

Implementation of Cone Beam Computed Tomography, Digital Sculpting and Three-Dimensional Printing in Facial Epithesis—A Technical Note

“…Surgical reconstructions of extensive maxillofacial defects are often multi-stage procedures associated with the risk of donor and recipient site morbidity [1]. Maxillofacial defects can be reconstructed with local and free flaps [3][4][5]. However, it is difficult to achieve satisfactory results after surgical reconstruction of extensive defects.…”