Abstract
While evidence concerning the effectiveness of IRT in the treatment of the local lesion in nose vestibule SCC already supports its acceptance as a new standard for primary (previously untreated cases), the same evidence is lacking in case of recurrence, especially if the patient has already been irradiated. Therefore, surgical treatment after recurrences in nasal vestibule cancers, which is reported to increase local control of the disease up to 96%, remains the standard in these cases, and it is worthwhile, whenever possible. While the surgical strategy is straightforward in case of neck recurrence, it poses unique problems in terms of demolition and reconstruction at the level of T, owing to the complex anatomy of the area and to the pattern and location of the recurrence. The options for salvage treatment and in particular for salvage surgery are discussed in this chapter, with regard to the preoperative evaluation and surgical planning, based on the subunits of the nasal vestibule and an accurate evaluation of the extent of the lesion. The issue of timing of the reconstructive phase is discussed as well as the influence of previous treatments on the availability of different surgical options. Finally, available reconstructive techniques are described.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bussu F, Tagliaferri L, Piras A, Rizzo D, Tsatsaris N, De Corso E, Parrilla C, Paludetti G. Multidisciplinary approach to nose vestibule malignancies: setting new standards. Approccio multidisciplinare ai tumori maligni del vestibolo del naso: verso la definizione di nuovi standard. Acta Otorhinolaryngologica Italica. 2021;41(Suppl. 1):S158–S165. https://doi.org/10.14639/0392-100X-suppl.1-41-2021-16.
Bussu F, Tagliaferri L, Crescio C, Rizzo D, Gallus R, Parrilla C, Fionda B, Lancellotta V, Mattiucci GC, Galli J. New standards for the management of nose vestibule malignancies. Acta Oto-Laryngologica. 2023;143(3):215–22. https://doi.org/10.1080/00016489.2023.2179662.
Czerwinski MD, van Leeuwen RGH, Kaanders J, Zwijnenburg EM, Lipman D, Takes RP, et al. Image guided brachytherapy for cancer of the nasal vestibule: local control and cosmesis. Int J Radiat Oncol Biol Phys. 2019;103(4):913–21.
Bussu F, Tagliaferri L, Mattiucci G, Parrilla C, Dinapoli N, Micciche F, et al. Comparison of interstitial brachytherapy and surgery as primary treatments for nasal vestibule carcinomas. Laryngoscope. 2016;126(2):367–71.
Zaoui K, Plinkert PK, Federspil PA. Primary surgical treatment of nasal vestibule cancer - therapeutic outcome and reconstructive strategies. Rhinology. 2018;56(4):393–9.
Langendijk JA, Poorter R, Leemans CR, de Bree R, Doornaert P, Slotman BJ. Radiotherapy of squamous cell carcinoma of the nasal vestibule. Int J Radiat Oncol Biol Phys. 2004;59(5):1319–25.
Bussu F, Tagliaferri L, De Corso E, Passali GC, Lancellotta V, Mattiucci GC, et al. Functional results of exclusive interventional radiotherapy (brachytherapy) in the treatment of nasal vestibule carcinomas. Brachytherapy. 2020;20:178.
Tagliaferri L, Fionda B, Bussu F, Parrilla C, Lancellotta V, Deodato F, et al. Interventional radiotherapy (brachytherapy) for squamous cell carcinoma of the nasal vestibule: a multidisciplinary systematic review. Eur J Dermatol. 2019;29(4):417–21.
Bussu F, Tagliaferri L, Mattiucci G, Parrilla C, Rizzo D, Gambacorta MA, Lancellotta V, Autorino R, Fonnesu C, Kihlgren C, Galli J, Paludetti G, Kovács G, Valentini V. HDR interventional radiotherapy (brachytherapy) in the treatment of primary and recurrent head and neck malignancies. Head Neck. 2019;41(6):1667–75.
Burget GC, Menick FJ. The subunit principle in nasal reconstruction. Plast Reconstr Surg. 1985;76(2):239–47.
Burget GC, Menick FJ. Nasal support and lining: the marriage of beauty and blood supply. Plast Reconstr Surg. 1989;84(2):189–202.
Burget GC, Menick FJ. Nasal reconstruction: seeking a fourth dimension. Plast Reconstr Surg. 1986;78(2):145–57.
Burget GC, Walton RL. Optimal use of microvascular free flaps, cartilage grafts, and a paramedian forehead flap for aesthetic reconstruction of the nose and adjacent facial units. Plast Reconstr Surg. 2007;120(5):1171–207; discussion 208–216.
Gary C, Burget FJM. Aesthetic reconstruction of the nose. St. Louis, MO: Mosby; 1994.
Menick F. Nasal reconstruction: art and practice. Philadelphia, PA: Saunders; 2008.
Menick FJ. A 10-year experience in nasal reconstruction with the three-stage forehead flap. Plast Reconstr Surg. 2002;109(6):1839–55; discussion 56-61.
Menick FJ, Salibian A. Microvascular repair of heminasal, subtotal, and total nasal defects with a folded radial forearm flap and a full-thickness forehead flap. Plast Reconstr Surg. 2011;127(2):637–51.
Qian C, Yaodong X, Xiaoming H, Shaochong F, Yiqing Z. Repair of full-thickness alar defects. Dermatol Surg. 2012;38(10):1639–44.
Malard O, Lanhouet J, Michel G, Dreno B, Espitalier F, Rio E. Full-thickness nasal defect: place of prosthetic reconstruction. Eur Ann Otorhinolaryngol Head Neck Dis. 2015;132(2):85–9.
Rubino C, Sanna M, Figus A, Farace F, Bocchiotti MA. Three-dimensional prelaminated forehead flap: two cases of composite nasal reconstruction. Rivista Italiana di Chirurgia Plastica. 2004;36:39–44.
Romo T III, Pearson JM. Nasal implants. Facial Plast Surg Clin North Am. 2008;16(1):123–32, vi.
Romo T III, McLaughlin LA, Levine JM, Sclafani AP. Nasal implants: autogenous, semisynthetic, and synthetic. Facial Plast Surg Clin North Am. 2002;10(2):155–66.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Rubino, C. et al. (2023). Malignancies of the Nose Vestibule: Salvage Strategies. In: Bussu, F. (eds) Malignancies of the Nasal Vestibule. Springer, Cham. https://doi.org/10.1007/978-3-031-32850-3_15
Download citation
DOI: https://doi.org/10.1007/978-3-031-32850-3_15
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-32849-7
Online ISBN: 978-3-031-32850-3
eBook Packages: MedicineMedicine (R0)