Technical Innovation: Intra-Operative Obturator For Nasal Lining With Skin Graft

Abstract

Squamous cell carcinoma, arising in nasal mucosa, is rare and is estimated to be less than 1% of cases of head and neck cancer. Surgical treatment for aggressive intranasal squamous cell carcinoma (SCC) requires a multidisciplinary team approach to ensure optimal patient outcomes. Surgical procedures for the removal of intranasal malignancies may include rhinectomy, palatectomy, and maxillectomy. These procedures leave patients with significant facial defects. However, in rare cases surgery may preserve nasal skin. In these cases, one needs to reconstruct nasal lining and support. Complex nasal reconstruction is often staged and therefore may delay complementary oncologic therapy [1,2]. As a rule, we would initially like to keep reconstruction as simple as possible, while preserving valuable tissue from scaring and shrinkage due to radiotherapy. Lining the nose with a full-thickness skin graft may serve this purpose well [3,4]. In order to assist skin graft adherence in the immediate post operative stage as well as prevent later shrinkage, we constructed a nasal obturator.