Reconstruction of Nasal Sidewall and Dorsum Open image in new window
A 56-year-old man presented with progressive swelling over the bridge of the nose during the preceding 3 years. Eighteen years earlier, an adenoid cystic carcinoma was removed from the right nasal passage in the area of the upper lateral cartilage. Examination revealed a 3 × 2.5 cm immobile mass in the area of the rhinion (Fig. 25.1). There was no visible mass noted on inspection of the nasal airway. Biopsy of the tumor revealed an adenoid cystic carcinoma. Computerized axial tomography demonstrated only limited erosion of the nasal septum. There was no apparent involvement by tumor of the ethmoid cells or nasal bones. Tumor resection necessitated a partial rhinectomy that included resection of the right upper lateral cartilage, both nasal bones, portions of the dorsal cartilaginous and bony nasal septum, and all of the skin covering the upper and middle nasal vaults. Surgical margins were free of malignancy.