Reconstruction algorithm for nasal basal cell carcinoma with skin involvement only: analysis of 221 cases repaired by minor surgery

Kim, Y. J.; Cho, H. H.; Kim, S. O.; Lee, J. B.; Lee, S. C.

doi:10.1111/ced.12676

Cited by 10 publications

(13 citation statements)

References 25 publications

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“…On postoperative 12th to 14th days, granulation tissue forms on approximately 80% of the defect base. 17 Moreover, this granulation tissue forming on 12th to 14th days, which is vascularized and nonnecrotic, increases the graft success Fig. 2 Appearance of the region before excision.…”

Section: Discussionmentioning

confidence: 99%

“…The most important determinants of the choice of repair method are the defect size and its localization. 17 On the other hand, tissue loss at the donor sites for flaps and skin grafts should be kept to minimum, and while repairing the primary defect area occurrence of unwanted cosmetic results at the donor area should be avoided. For these reasons, it is important to reduce the size of the defect after tumor excision.…”

Section: Discussionmentioning

confidence: 99%

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Delayed Reconstruction with Full-Thickness Skin Grafts Following Defect Size Reduction in Head and Neck Nonmelanoma Skin Cancer

et al. 2020

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Different treatment modalities have been applied for nonmelanoma skin cancers (NMSCs) of the head and neck area. One of the most important points after surgical treatment is the selection of appropriate reconstruction methods. The aim of this study is to investigate the efficacy and feasibility of the use of both defect size reduction with sutures and secondary healing with delayed reconstruction with full-thickness skin grafts in NMSC patients. In total, 18 (42.8%) male and 24 (57.2%) female patients with NMSC were operated. Defect size was measured both after excision and just before repair, and the approximate defect area was calculated with ImageJ software. Reconstruction was performed after 14 days in all patients in the second session, using free skin grafts. There were 18 (42.8%) male and 24 (57.2%) female patients. The mean age was 70.5 (45–82) years. The mean follow-up period was 40.3 (16–68) months. The mean defect area measured after excision was 8.44 ± 1.91 cm2. After 14 days of delay, the mean defect area was 5.51 ± 1.28 cm2 (34.8% reduction) (p < 0.05). Defect-reduction methods applied during the first session, together with proper interval prior to placement of graft, have been shown to be beneficial and acceptable methods, providing an advantage in reconstruction with free skin graft.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Delayed Reconstruction with Full-Thickness Skin Grafts Following Defect Size Reduction in Head and Neck Nonmelanoma Skin Cancer

et al. 2020

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“…Functional and aesthetic nasal problems may arise following surgery [23]. Established guidelines for nasal reconstruction are still lacking [24,25]. HRQoL scores are increasingly indispensable for measuring aesthetic and functional rehabilita-…”

Section: Discussionmentioning

confidence: 99%

Tumor Control and Quality of Life in Skin Cancer Patients With Extensive Multilayered Nasal Defects

Plath

Thielen

Baumann

et al. 2020

Clin Exp Otorhinolaryngol

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Objectives. The reconstruction after nasal skin cancer (NSC) resection is often practiced differently. The objective of this study is to evaluate the influence of patient-, tumor- and management-related factors on the role of surgery and choice of reconstruction.Methods. This was a monocentric retrospective study of patients who were diagnosed with a NSC (squamous cell or basal cell carcinoma) and suffered from an extended defect after ablative surgery between 2003 and 2013. Twenty-five patients were included. Tumors were staged using the Union for International Cancer Control (eighth edition) TNM classification for primary cutaneous skin cancer of the head and neck. Preferred treatment was surgery in all patients. Health-related quality of life (HRQoL) measurement was evaluated by one generic (36-Item Short Form Health Survey [SF-36]) and two organ-specific questionnaires (Rhinoplasty Outcome Evaluation [ROE] and Functional Rhinoplasty Outcome Inventory 17 [FROI-17]) after therapy. Survival data were estimated by the Kaplan-Meier method and statistical analysis was performed by log-rank, analysis of variance, Levene’s and t-tests. The median follow-up time was 2.1 years.Results. According to the Union for International Cancer Control classification, 13 of 25 tumors were staged as pT1 (52%), four as pT2 (16%), seven as pT3 (28%) and one as pT4a (4%). Seventy-two percent of patients (n=18) chose plastic reconstruction, and for the remaining 28% (n=7) of the patients opted for an implant-retained prosthesis. The overall survival was 69.5% after 5 years, the 5-year recurrence-free survival was 90.9% and the 5-year disease-specific survival was 100%. There was no significant difference in the HRQoL outcome between both rehabilitation methods.Conclusion. Surgery in NSC gives an excellent oncologic prognosis. Nasal reconstruction and prostheses are both very viable options depending on tumor stage and biology, the patient’s wishes as well as the experience of the surgeon.

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“…Mohs mikrografik cerrahinin uygulanamadığı merkezlerde cerrahi sınır güvenliği ile ilgili şüpheler varsa flep alternatiflerinin ilk ameliyatta harcanmasının doğru olmadığını savunuyoruz ve bu nedenle böyle durumlarda greft ile onarım yapıyoruz. Değişik yayınlara göre burun bölgesi defektlerinde 1.5 cm ve üzeri defektler büyük defekt olarak kabul edilir (11). Bu algoritmada biz farklı olarak 1 cm ve altındaki defektleri küçük, 1-4 cm arasındaki defektleri orta ve 4 cm üzeri defektleri büyük olarak kabul ettik.…”

Section: şEkil 3c Ameliyat Sonrası 3 Ay Görüntüsüunclassified

“…Burget ve arkadaşlarının yaptığı başka bir çalışmada 1.5 cm altı defektler küçük, 2.5 cm ve üstü defektler büyük olarak kabul edilmiştir (10). Başka bir makalede Kim ve arkadaşları 1 cm altı burun defektlerini küçük, 1-2 cm arası defektleri orta ve 2 cm üstü defektleri büyük kabul etmişler ve küçük defektlerde primer kapama, orta defektlerde ada pediküllü flepler, büyük defektlerde burun üst kısmı için transpozisyon flepleri ve alt kısmı için interpolasyon fleplerinin kullanımını ilk tercih olarak sunmuşlardır (11).…”

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A Simple Algorithm For The Reconstruction Of Nasal Defects: A Single Center Study

Koçak¹

2018

Van Med J

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Burun defektleri yüz bölgesinde onarımı hem estetik açıdan hem de fonksiyonel açıdan zor olan defektlerdir. Bu defektler deri, kıkırdak, kemik iskelet ve mukozayı içerecek şekilde tam kat olabileceği gibi sadece deriyi içerecek şekilde basit olabilir. Özellikle kanser cerrahisi sonrası oluşan burun defektleri travma ve enfeksiyonlara (lepra) bağlı da oluşabilir (1). Burun defektlerinin onarımında rekonstrüktif merdivendeki gibi en basitten en komplekse doğru yol izlenir. Sekonder iyileşme, primer kapama, deri ÖZET Amaç: Burun defektleri çoğunlukla kanser cerrahisi sonrası oluşan ancak travma sonrasında da gelişebilen ve rekonstrüksiyonu önem arz eden defektlerdir. Burnun yüzün ortasında konumlanması nedeni ile burun defektlerinin onarımının kozmetik sonuçlarının kişinin sosyal hayatını etkilemesinin kaçınılmaz olduğu unutulmamalıdır. Gereç ve Yöntem: Kırk erkek 36 kadın hasta burunda çeşitli nedenlerle oluşan defektler sonucu opere edildi. Defekt boyutları, defektin yerleşim yeri, cerrahi sınır güvenliği gibi faktörlere bağlı olarak burun defektlerinde kullanılabilecek basit, kolay ve güvenilir bir algoritma oluşturuldu. Bulgular: Hastaların en küçüğü üç yaşında kseroderma pigmentosum tanısı alan ve burunda bazal hücreli kanseri bulunan kız çocuk, en büyüğü 92 yaşında burun ucunda bazal hücreli kanseri bulunan kadın hastaydı. Ortalama yaş 57,75 di. Cerrahi sonrası oluşan en büyük defekt 10x7 cm (kitle 8x5 cm) di. Bu defektin kapatılması için radial ön kol serbest flebi uygulandı. Oluşan en küçük defekt 0.6 cm (6 mm-lezyon 3mm) di ve bu defekt primer kapatıldı. En büyük lezyonun tanısı bazosquamöz hücreli karsinom, en küçük lezyonun tanısı bazal hücreli kanserdi. Sonuç: Burun dorsum, yan nazal duvarlar, tip. alar kanatlar, soft triangle, kolumella gibi subunitlerden oluşan kompleks bir yapıdır. Bu alt birimlerde oluşan defektler belirli bir algoritma içerisinde değerlendirilip rekonstrüksiyon yapıldığında sonuçlar daha iyi olacaktır.

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Reconstruction algorithm for nasal basal cell carcinoma with skin involvement only: analysis of 221 cases repaired by minor surgery

Abstract: We have proposed an algorithm to select the optimal technique for repairing nasal BCC surgical defects according to their size and location.

Cited by 10 publications

References 25 publications

Delayed Reconstruction with Full-Thickness Skin Grafts Following Defect Size Reduction in Head and Neck Nonmelanoma Skin Cancer

Delayed Reconstruction with Full-Thickness Skin Grafts Following Defect Size Reduction in Head and Neck Nonmelanoma Skin Cancer

Tumor Control and Quality of Life in Skin Cancer Patients With Extensive Multilayered Nasal Defects

A Simple Algorithm For The Reconstruction Of Nasal Defects: A Single Center Study

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