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

Abstract

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.

Systematic Review of Clinical Applications of CAD/CAM Technology for Craniofacial Implants Placement and Manufacturing of Nasal Prostheses

“…Treatment options to rehabilitate these patients include surgical reconstruction or prosthetic rehabilitation [ 4 , 5 , 6 , 7 , 8 , 9 ]. Surgical reconstruction can be done with a bilobed flap, nasolabial flap, forehead flap, septal mucosal flap, S-shaped rotation flap, croissant-shaped flaps, modified V-Y flaps, radial forearm free flaps, and titanium mesh [ 10 ]. However, surgical reconstruction involving the entire nasal cavity poses significant challenge to reconstructive surgeons; therefore, it is currently only performed with satisfactory results in a few specialized medical centers around the world [ 11 ].…”

“…NextEngine, Santa Monica, CA, USA;9 . SimPlant, Dentsply implant Hasselt Belgium;10 . ZBrush Software; Pixologic Inc., Los Angeles, CA;11 .…”

The Impact of Socioeconomic Status on Hospital Accessibility in Otorhinolaryngological Disease in Korea

“…Particular clinical importance lies in the ENT diseases such as hearing loss, rhinosinusitis, oral ulcer, and neoplasm because of the type of morbidities that they cause due to impairment of the inherent physiologic functions that usually take place in the head and neck region. 15,16 However, less study has investigated the correlation between patients’ SES and health care accessibility in the field of otorhinolaryngology. We hypothesized that lower SES might limit access to health care and, in turn, contribute to massive social inequalities in patients with ENT diseases.…”

Three-Dimensional Printed Nasal Prostheses After Oncologic Rhinectomies: Workflow and Patients’ Satisfaction

“…1,2 Rehabilitation after partial or complete rhinectomy is obtained either by reconstructive plastic surgery or by definitive, silicone, bone-anchored prostheses, depending on the importance of the facial defect, patients' co-morbidities, and preferences. 3 At the time of this writing, there is no clear consensus on the timing of the surgical reconstruction. However, it is usually recommended to wait at least 1 year after primary resection to allow for potential reoperation for tumor-free margins, adjuvant therapies, and clinical follow-up of early recurrence.…”

“…Rehabilitation after partial or complete rhinectomy is obtained either by reconstructive plastic surgery or by definitive, silicone, bone-anchored prostheses, depending on the importance of the facial defect, patients’ co-morbidities, and preferences 3 . At the time of this writing, there is no clear consensus on the timing of the surgical reconstruction.…”