Cancer in tip of nose


The sun gives 3 types of ultraviolet radiation: - UVC radiation nm, completely absorbed by the ozone layer and does ce pește nu există paraziți deloc affect the skin; - UVB radiation affects the epidermis and is the main agent responsible for sun burns. Both UVA and UVB radiation can cancer in tip of nose skin damage 5 : wrinkles, cancer in tip of nose immunity against infection, aging skin desorders and cancer.

The possible mecanisms for UV skin demage are collagen breakdown in the dermis, the formation of free radicals, interfering with DNA repair ensime T4 endonuclease N5 and inhibiting the immune system.

Depending on their size, the defects can be clas­sified as 2 : A. Total lip reconstruction - bilateral cheek advancement, bilateral nasolabial flaps.

Diagnosis of basal cell carcinoma is done of histopathologycal exam. The bilobed nasal flap is a useful technique for reconstructing defects of the nose following removal of basal-cell cancers, and it consist of two lobes of skin and subcutaneous tissue based on a common pedicle. V-Y flap is used in dorsum reconstruction in lateral nostril and for small defects of the ala nasi.

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Nasolabial and cheek skin flap is the ideal sources for partial nasal reconstruction and can be used for coverage of defects of any part of the nose. Zygomatic flap is used for reconstruction of the lip and nose, especially of the tip and columella.

Axial paramedian forehead flap is the donor tissue of choise for nasal reconstruction.

The patients were between 50 and 90 years old. The author performed Recostructive Rhinoplasty, using varied local skin flaps in 19 cases, free cartilage graft septum nasal or auricle as support for local skin flaps in 4 cases, composite graft skin and cartilage ofconcha and cancer in tip of nose rim in 6 cases, and in 1 case with recurrent invasive basal cell carcinoma to face and left eye basiloma or ulcus terebrans it is used musculocutaneus free flap.

Results There were 31 tumours BCC20 cases were male, 21 caseswere female. T he average was 70 cancer in tip of nose with a range of 50 to 90 years. Tumours presentation was following Fig.

In this study the anatomic distribution Fig. The surgical approach in basal cell carcinoma of the nose consist in excise of tumor in safety tissue margin from 0, 5 to 1 cm.

In 22 cases the cancer in tip of nose tissue margin were more than 0, 5 cm, in 9 cases were less than 0, 5 cm, and in the case with basalioma terebrans was 1cm extended to midface, and left orbital exenteration.

Reconstructive tehniques were: - Local skin flaps 11 cases have many advantages as they have their own blood supply and heal well. There are best for reconstructing the convex subunits of the nose but they are limited in length and size.

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Local flaps are subdivided in to advancement flaps 3 casesrotation flaps 5 cases and transposition flaps 3 casessliding flaps 3 casesbilobed flaps ; - Dorsal nasal flap 3 cases used to cover a defect of lower third of the cancer in tip of nose - Nasolabial flap 6cases used in the alar subunit; - Paramedian forehead flap 4cases the best choise for reconstructing major nasal defects; - Free cartilage grafts, septal 4cases and conchal bowl 5cases were the good support for the skin flap in lateral wall and nasal tip reconstructing.

The composite grafts have been used to correct small defects of the alar margins and the donors site is often helical rim 4 cases as its contour is similar to the rim of the nostril 8,10, Discussions In our study the treatment of basal cell carcinoma was radical surgical excision with histologic control. The radical surgery has psyhosocial consequences for the pacient, after this surgery resulting the loss of facial function and aesthetic integrity.

The facial cancer in tip of nose and reconstructive surgery contribut to correct this loss, the cancer in tip of nose have after surgery an acceptable quality of life for several years an outcome aesthetically and functionally, satisfying for the pacient.

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Repair of defects of proximal and intermediate parts of nasal dorsum and nasal sidewall For small defects of the nose was used flaps advancement, sliding, cancer in tip of nose and rotation flapsharverseted from nasal skin, forehead and ckeek. Glabela flap used for defects in the intermediate and caudal nasal dorsum 6, The paramedian forehead flap was used in large and nasal tip defects.

Reconstrucţia defectelor faciale post-rezecţie tumorală cu lambouri locale

For nasal sidewall defects a good choise was Fig. Repair of defects of distal parts of nasal sidewall and nasal wing Most used was the caudally pedicled nasogenian flap with or without free septal and conchal support cartilage graft Fig. In cases with defects to all layers of the nasal wing  skin, cartilage was used composite graft from helical rim Fig.

The secondary defect at the donor site was closed by a retroauriculary pedicled island flap.

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Forehead flap was used to correct defects of nasal tip and columella 6, Possible secondary corrections are performed after 6 month post-operator by the patients with stable wound and not recurrence.

Conclusions - Basal cell carcinoma is the most common type of the skin cancer in malingnant tumoral pathologie of the nose; - It spreads locally and does not metastasize; - It grows very slowly but in condition with incorrect treatment, after a period can expand rapidly to the midface, eye basalioma tenebrans ; - The most frecvernt location for BCC was the nasal ala; - In this study the majority of the tumours were new presentations; - Treatment options depend from the tumor location and extension.

Reconstructive rhinoplasty in cases with basal cell carcinoma of the nose

The therapeutic success or failure : to have or not a safety margin when excise the tumour. Facial plastic and reconstructive surgery correct with good results the loss of facial function and aesthetic integrity after radical surgical excision. The good aesthetic and functional outcome offer an acceptable quality of patients life for several years.

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References References 1. Cottel WI. Skin tumors I: basal celland squamous cell carcinoma. Sel Readings Plast Surg. Conley J. Cancer of the skin of the nose.

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Ann Otol Rhinol Laryngol. Basal cell carcinoma: a statistical approach to rational management. Plast Reconstr Surg. Trends in the presentation and treatment of basal cell carcinomas. J Dermatol Surg Oncol.

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Brrannon H. About com. Dermatology, Updated. Baker R. S Local flaps in facial reconstruction, second edition.

Reconstruction of facial defects after tumor resection with local flaps

Mosby; Management of nasal cutaneous malignant neoplasms. An interdisciplinary approach.

Mohs Surgery for Skin Cancer Treatment

Arch Otolaryngol. Soft tissue reconstruction of the nose.

Reconstrucţia defectelor faciale post-rezecţie tumorală cu lambouri locale

Facial Plast Surg. Epub May Matarasso A, Strauch B. Bilobed nasal skin flaps, vol.