外鼻恶性肿瘤58例临床分析

Clinical analysis of external nose malignant tumor in 58 cases

目的研究外鼻恶性肿瘤的治疗方法,以及在手术彻底切除肿瘤的基础上同期修复的疗效。方法分析近10年58例外鼻恶性肿瘤,其中基底细胞癌37例,鳞状细胞癌19例,恶性黑色素瘤1例,恶性纤维组织细胞瘤1例;术中彻底切除肿瘤,以切缘冰冻切片决定安全界;同时56例选择了不同的修复方法(直接缝合7例,邻近皮瓣36例,耳后复合瓣2例和植皮11例)。术后7例接受放射治疗。结果49例患者目前无复发征象,失访5例,死亡4例(死于老龄和心血管疾病);56例同期修复的患者中2例对外鼻形态不满意。结论在彻底切除恶性肿瘤时应重视安全界的概念,并尽可能应用各种方法进行I期修复。

Objective To investigate the curative method for external nose malignant tumor and the effect of synchronous repair on the basis of a thorough resection. Methods Fifty-eight cases of external nose malignant tumor in the past 10 years were retrospectively analysed, among whom 37 were basal cell carcinoma, 19 squamous cell carcinoma, one malignant melanoma and one malignant fibrous histiotoma. The tumor was thoroughly resected during the operation and the safety limit was determined according to the pathological findings of the cutting edge. Fifty-six cases were performed repair with different methods （ direct suture, n = 7; local pedicle flap, n = 36; post aurem compound flap, n =2; dermatoplasty, n = 11）. Seven cases received radiotherapy postoperatively. Results No sign of relapse was observed in 49 cases, 5 cases were unavailable for follow up, and 4 cases died of cardiovascular diseases and oldness. Two cases were not satisfied with the appearance of nose after operation. Conclusion Great importance shall be attached to the concept of safety limit when performing the thorough resection of the tumor, and Ⅰ-stage repair with all kinds of methods is well advised.