Objective:The aim of the study was to present our experience in reconstruction of complex defects of the nose.Methods:Fourteen patients presenting with large composite defects of the nose were anatomically reconstruct...Objective:The aim of the study was to present our experience in reconstruction of complex defects of the nose.Methods:Fourteen patients presenting with large composite defects of the nose were anatomically reconstructed after full tumor clearance of a skin cancer.The aesthetic outcome was assessed subjectively and objectively while the functional outcome was only assessed subjectively in 13 patients.Results:Basal cell carcinoma(BCC),represented the tumor excised in 10 patients while the remaining 4 patients suffered from squamous cell carcinoma(SCC).One patient died of extensive local recurrence of SCC after 6 months.The commonest flap used for inner lining was the septal flap while the forehead paramedian flap provided the external coverage for the majority of patients.All flaps survived completely except in one patient who developed distal paramedian forehead flap necrosis.Two patients developed multiple abscesses and sinuses discharging parts of cartilage grafts through the flaps’skin with one patient suffering from total extrusion of the costal cartilage grafts.Two other patients suffered from severe nostril stenosis.All patients had variable degree of difficulty in airway passage,while most patients were satisfied with the total nasal appearance.The objective assessment of the overall appearance of the nose scored less than the subjective satisfaction.Conclusion:Reconstruction of complex nasal defects has a high learning curve.Intranasal flaps are usually of limited size and nostril asymmetry is likely to occur.Local or regional skin flaps if available are still considered a good choice for inner as well as outer lining.展开更多
Background: Reviewing and analyzing the Clinico-pathologic aspects of non-melanoma skin cancer of the head and neck (NMSCHN), type of management, prognostic factors, and disease-free survival (DFS) in a period of 5 ye...Background: Reviewing and analyzing the Clinico-pathologic aspects of non-melanoma skin cancer of the head and neck (NMSCHN), type of management, prognostic factors, and disease-free survival (DFS) in a period of 5 years at the National Cancer Institute—Cairo University—Egypt. Materials and Methods: A retrospective study of two hundred patients with NMSCHN was treated at the National Cancer Institute—Cairo University—Egypt from January 2008 to December 2012. The mean follow-up was 6 months (1 - 84 months). Results: 117 males and 83 females with 90% ≥ 50 years old. The scalp (27.5%), the periorbital region (13%), the cheek (12.5%) and the nose (12.5%) are the main anatomical sites affected. BCC represented 71.5% with nodular type (79%) predominance;SCC represented 21% with GII (61.1%) the commonest grade. Surgery was the main modality of treatment (93%) with local flaps only (63.9%) and primary closure (14.7%) were the main surgical options following wide local excision. Positive and close margins were detected in 23.5% of excised specimens. No significant association was found between disease-free survival (DFS) and pathology, treatment modality, the occurrence of complications or safety margin status. Conclusion: NMSCHN lesions should be surgically excised in specialized high volume centers with readily available peripheral margin control and should be operated by senior experienced surgeons.展开更多
文摘Objective:The aim of the study was to present our experience in reconstruction of complex defects of the nose.Methods:Fourteen patients presenting with large composite defects of the nose were anatomically reconstructed after full tumor clearance of a skin cancer.The aesthetic outcome was assessed subjectively and objectively while the functional outcome was only assessed subjectively in 13 patients.Results:Basal cell carcinoma(BCC),represented the tumor excised in 10 patients while the remaining 4 patients suffered from squamous cell carcinoma(SCC).One patient died of extensive local recurrence of SCC after 6 months.The commonest flap used for inner lining was the septal flap while the forehead paramedian flap provided the external coverage for the majority of patients.All flaps survived completely except in one patient who developed distal paramedian forehead flap necrosis.Two patients developed multiple abscesses and sinuses discharging parts of cartilage grafts through the flaps’skin with one patient suffering from total extrusion of the costal cartilage grafts.Two other patients suffered from severe nostril stenosis.All patients had variable degree of difficulty in airway passage,while most patients were satisfied with the total nasal appearance.The objective assessment of the overall appearance of the nose scored less than the subjective satisfaction.Conclusion:Reconstruction of complex nasal defects has a high learning curve.Intranasal flaps are usually of limited size and nostril asymmetry is likely to occur.Local or regional skin flaps if available are still considered a good choice for inner as well as outer lining.
文摘Background: Reviewing and analyzing the Clinico-pathologic aspects of non-melanoma skin cancer of the head and neck (NMSCHN), type of management, prognostic factors, and disease-free survival (DFS) in a period of 5 years at the National Cancer Institute—Cairo University—Egypt. Materials and Methods: A retrospective study of two hundred patients with NMSCHN was treated at the National Cancer Institute—Cairo University—Egypt from January 2008 to December 2012. The mean follow-up was 6 months (1 - 84 months). Results: 117 males and 83 females with 90% ≥ 50 years old. The scalp (27.5%), the periorbital region (13%), the cheek (12.5%) and the nose (12.5%) are the main anatomical sites affected. BCC represented 71.5% with nodular type (79%) predominance;SCC represented 21% with GII (61.1%) the commonest grade. Surgery was the main modality of treatment (93%) with local flaps only (63.9%) and primary closure (14.7%) were the main surgical options following wide local excision. Positive and close margins were detected in 23.5% of excised specimens. No significant association was found between disease-free survival (DFS) and pathology, treatment modality, the occurrence of complications or safety margin status. Conclusion: NMSCHN lesions should be surgically excised in specialized high volume centers with readily available peripheral margin control and should be operated by senior experienced surgeons.
