Cancer of the nasal vestibule
- Roi Dagan, MD
Roi Dagan, MD
- Assistant Professor, Radiation Oncology
- University of Florida, College of Medicine
- Robert J Amdur, MD
Robert J Amdur, MD
- Department of Radiation Oncology
- University of Florida College of Medicine
- Peter T Dziegielewski, MD, FRCS(C)
Peter T Dziegielewski, MD, FRCS(C)
- Assistant Professor
- Chief of Head & Neck Surgical Oncology and Microvascular Reconstructive Surgery
- University of Florida
- Section Editors
- Bruce E Brockstein, MD
Bruce E Brockstein, MD
- Section Editor — Cancer of the Head and Neck
- Clinical Professor of Medicine
- University of Chicago Pritzker School of Medicine
- Marshall R Posner, MD
Marshall R Posner, MD
- Section Editor — Cancer of the Head and Neck
- Professor of Gene and Cell Medicine
- The Tisch Cancer Institute
- Icahn School of Medicine at Mount Sinai
- David M Brizel, MD
David M Brizel, MD
- Section Editor — Radiation Therapy
- Leonard R Prosnitz Professor of Radiation Oncology
- Professor of Otolaryngology Head & Neck Surgery
- Duke University Cancer Institute
- Marvin P Fried, MD, FACS
Marvin P Fried, MD, FACS
- Section Editor — Head and Neck Surgery
- Professor and University Chairman, Department of Otorhinolaryngology - Head and Neck Surgery
- Montefiore Medical Center, Albert Einstein College of Medicine
Cancers of the nasal vestibule are rare and account for less than 1 percent of all tumors of the head and neck . The nasal vestibule is separated anatomically from the nasal cavity by the limen nasi. Cancers originating from the nasal vestibule behave like squamous cell carcinomas of the skin and are distinct histological and clinical cancers compared with tumors arising from the nasal cavity. Thus, these tumors are considered separately for diagnosis and treatment.
The presentation and treatment of nasal vestibule cancers are discussed here. Cancers arising in the nasal cavity and paranasal sinuses are discussed separately. (See "Tumors of the nasal cavity" and "Paranasal sinus cancer".)
Anatomy and pathology — The nasal vestibule is a pear-shaped opening that functions as the entrance to the nasal cavity. Its borders are the nasal septum and columella medially, the lower lateral nasal cartilage laterally, and the premaxilla inferiorly. The vestibule terminates posteriorly at the limen nasi, the junction of the lower and upper lateral cartilages (scroll region), as well as the transition from skin to mucosa (figure 1 and figure 2). The vestibule is lined by skin bearing hair follicles, sebaceous glands, and sweat glands.
The majority of nasal vestibule cancers are squamous cell carcinomas that have a natural history similar to that of squamous cell skin cancer. Other types of skin cancers such as basal cell carcinoma and melanoma can also arise in the nasal vestibule. (See "Treatment and prognosis of cutaneous squamous cell carcinoma".)
Epidemiology and risk factors — The incidence of nasal vestibule cancers has been estimated to be 0.32 per 100,000 in a Danish national registry . The average age of patients with nasal vestibule cancer is between 60 and 70 years [2,3]. Nasal vestibule cancer is more common in men, who constitute 55 to 70 percent of cases. Risk factors include sun exposure and, potentially, smoking [2,4].
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- Anatomy and pathology
- Epidemiology and risk factors
- Clinical presentation and diagnosis
- - Tumor resection
- - Defect reconstruction
- Radiation therapy
- Locally advanced lesions
- Management of the neck
- POSTTREATMENT SURVEILLANCE
- SUMMARY AND RECOMMENDATIONS