Epithetic nasal reconstruction after total rhinectomy: Oncologic outcomes, immediate and long-term adverse effects, and quality of life

J Plast Reconstr Aesthet Surg. 2021 Mar;74(3):625-631. doi: 10.1016/j.bjps.2020.10.013. Epub 2020 Oct 24.

Abstract

Introduction: Total rhinectomy for tumors of the nasal cavity substantially alters patients' appearance and requires local reconstruction. While full nasal epitheses are well-established for this purpose, potential long-term adverse effects and impact on patients' quality of life are not fully understood.

Methods: Sixteen patients who underwent total rhinectomy with ensuing nasal reconstruction with a full nasal epithesis were included in the study. Oncologic outcomes were assessed, and adverse effects and quality of life analyses were performed based on a patient-reported outcomes tool.

Results: In patients with squamous cell carcinomas of the nasal cavity, total rhinectomy led to excellent local tumor control. Immediate and long-term adverse effects of total rhinectomy and placement of a nasal epithesis were predominantly limited to the immediate nasal region. While patients were satisfied with their nasal appearance, they reported a worse assessment of their facial appearance and a measurable long-term effect on their psychological well-being.

Conclusion: Total rhinectomy and reconstruction with a full nasal epithesis is a safe and oncologically sound treatment approach. However, its effects on patients' overall appearance and psychological well-being need to be considered during treatment planning and follow-up.

Keywords: FACE Q; Nasal carcinoma; Nasal epithesis; Total rhinectomy.

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Female
  • Humans
  • Long Term Adverse Effects* / psychology
  • Male
  • Mental Health
  • Middle Aged
  • Nose / surgery*
  • Nose Neoplasms / pathology
  • Nose Neoplasms / surgery*
  • Patient Reported Outcome Measures
  • Physical Appearance, Body
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / etiology
  • Postoperative Complications* / psychology
  • Quality of Life*
  • Rhinoplasty* / adverse effects
  • Rhinoplasty* / methods
  • Rhinoplasty* / psychology
  • Surgical Flaps
  • Treatment Outcome