Bilateral Interpolated Paramedian Forehead Flaps Open image in new window
The patient was a 66-year-old man with type II diabetes mellitus who developed an adenoid cystic carcinoma of the left posterior nasal passage. Computerized axial tomography demonstrated that the epicenter of the tumor was arising from the deep surface of the left nasal bone. The nasal bones and posterior superior bony septum were eroded by the tumor. The cribriform plate appeared intact; however, the tumor extended into the posterior ethmoid cells. The neoplasm was removed by a craniofacial resection through a bicoronal approach. Surgery included an ethmoidectomy, partial medial maxillectomy, and resection of the cribriform plate and posterior superior bony septum. Full-thickness resection of the left bony and cartilaginous nasal sidewall was performed. A portion of the bony dorsum was also removed. The patient refused postoperative radiotherapy because of the small risk of blindness.