Oncological results of surgical treatment of malignant tumors of the nasal vestibule

Yıl 2007, Cilt: 17 Sayı: 3, 133 - 137, 23.05.2007

Bora Başaran İsmet Aslan Mehmet Emin Tınaz Nermin Başerer Engin Yazıcıoğlu

Öz

Objectives: We evaluated functional results of surgical treat­ ment for squamous celi carcinoma of the nasal vestibule.Patients and Methods: A retrospective review of 2,763 patients treated for head and neck cancers betvveen 1991 and 2000 revealed 10 cases of nasal vestibule tumors, with an incidence of 0.36%. Ali the patients were males with a mean age of 64.8 years range 58 to 72 years . Based on the classification system of the AJCC 1992 for skin cancers, and the UICC classification for neck metastasis, three patients had T2 , three patients had T3 , and four patients had T4 tumors. Lymph node metastasis was present in three patients. Nine patients were treated with surgery as the pri- mary treatment. One patient undervvent surgical salvage fol- lowing radiotherapy failure. The mean follow-up period was 3.65 years range 6 months to 12 years .Results: Three patients with metastatic neck disease and four patients with advanced tumors undervvent radical neck dis- section and selective supraomohyoid neck dissection, respec- tively. Seven patients undervvent reconstruction vvith parame- dian forehead flap n=3 , nasolabial flap n=2 , aural compos- ite graft, or split thickness flap. Including the one vvith radio­ therapy failure, tvvo patients died vvithin the first postoperative year due to local and neck recurrences. Another patient died in the postoperative third year due to metastatic squamous celi carcinoma of the lung. No cosmetic or functional com- plaints vvere observed in patients vvith early stage lesions. Tvvo patients vvith advanced tumors had nasal ventilation problems and a secondary revision procedure vvas required in one.Conclusion: Surgery is a successful therapeutic modality for carcinoma of the nasal vestibule, especially vvhen applied in conjunction vvith proper reconstruction tech- niques and, vvhen necessary, neck dissection procedures.

Anahtar Kelimeler

Carcinoma, squamous cell/surgery, nose neoplasms/ surgery

Nazal vestibül malign tümörlerinin cerrahi tedavisinde onkolojik sonuçlar

Öz

Amaç: Nazal vestibül yassı epitel hücreli karsinomunda cerrahi tedavinin fonksiyonel sonuçları değerlendirildi.Hastalar ve Yöntemler: 1991-2000 yılları arasında başboyun kanseri nedeniyle tedavi edilen 2763 hastanıngeriye doğru taranmasında, 10 hastada nazal vestibültümörü nedeniyle cerrahi tedavi uygulandığı görüldü sıklık %0.36 . Tüm hastalar erkekti; ortalama yaş 64.8 idi. AJCC 1992 deri kanserleri için sınıflandırma sistemi ve boyun metastazı için UICC sınıflandırma sistemine göre, üç hastada T2, üç hastada T3,dört hastada T4tümör; üç hastada ise boyun metastazıvardı. Dokuz hastada primer tedavi yöntemi cerrahi idi;bir hastada ise radyoterapi başarısızlığı nedeniyle kurtarma cerrahisi uygulandı. Ortalama takip süresi 3.65 yıl dağılım 6 ay-12 yıl idi.Bulgular: Boyun metastazı saptanan üç hastaya radikal boyun diseksiyonu, ileri evre tümörü olan dört hastaya supraomohiyoid selektif boyun diseksiyonu uygulandı. Yedi hastanın rekonstrüksiyonunda paramedian alın flebi n=3 , nazolabial flep n=2 , aural kompozit greft ya da split thickness ciltgrefti kullanıldı. Radyoterapi başarısızlığı nedeniyle tedaviedilen hasta da dahil, iki hasta lokal ve boyun nüksleri nedeniyle ameliyat sonrası ilk yıl içinde, bir hasta ise üçüncü yılda metastatik yassı epitel hücreli akciğer karsinomu nedeniyle kaybedildi. Erken evre tümörü olan hastalarda kozmetik ve fonksiyonel yakınma görülmedi. İleri evre tümörü olaniki hastada ciddi nazal ventilasyon sorunu yaşandı; bunlardan birinde sekonder revizyon girişimine ihtiyaç duyuldu.Sonuç: Nazal vestibül tümörlerinde cerrahi, özellikle beraberinde uygun rekonstrüksiyon tekniği ve gerektiğinde boyun diseksiyonu uygulandığında başarılı bir tedavi yöntemidir

Anahtar Kelimeler

Yassı hücreli karsinom/cerrahi, burun neoplazileri/cerrahi

Kaynakça

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