Nasal reconstruction.

The management of nasal defects following tumour surgery is influenced by multiple factors. These include tumour histology, location, extent of disease and previous treatment regimens employed. These characteristics define the degree of tumour control and therefore the method of reconstruction. The size and location of the defect as well as the availability and condition of adjacent skin are further factors to consider. Nasal surface contours and skin covering varies in texture, colour and appearance and it are these unique characteristics that present the surgeon with reconstructive challenges. To add to these considerable variables, the patients’ age, general fitness and aesthetic goals must be included in the decision making process. These multifactorial problems can, however, be approached with a variety of reconstructive options, ranging from primary closure, healing by secondary intention and skin grafting to local or regional skin flaps. This paper reviews various aspects of reconstructive rhinoplasty after tumour surgery including pertinent surface anatomy, type of nasal skin malignancies and the principles of nasal reconstruction.