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].To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Patel P, Tiwari R, Karim AB, et al. Squamous cell carcinoma of the nasal vestibule. J Laryngol Otol 1992; 106:332.
- Agger A, von Buchwald C, Madsen AR, et al. Squamous cell carcinoma of the nasal vestibule 1993-2002: a nationwide retrospective study from DAHANCA. Head Neck 2009; 31:1593.
- Jeannon JP, Riddle PJ, Irish J, et al. Prognostic indicators in carcinoma of the nasal vestibule. Clin Otolaryngol 2007; 32:19.
- 't Mannetje A, Kogevinas M, Luce D, et al. Sinonasal cancer, occupation, and tobacco smoking in European women and men. Am J Ind Med 1999; 36:101.
- Mendenhall WM, Stringer SP, Cassisi NJ, Mendenhall NP. Squamous cell carcinoma of the nasal vestibule. Head Neck 1999; 21:385.
- Langendijk JA, Poorter R, Leemans CR, et al. Radiotherapy of squamous cell carcinoma of the nasal vestibule. Int J Radiat Oncol Biol Phys 2004; 59:1319.
- Dowley A, Hoskison E, Allibone R, Jones NS. Squamous cell carcinoma of the nasal vestibule: a 20-year case series and literature review. J Laryngol Otol 2008; 122:1019.
- Kraus DH, Lydiatt WM, Patel SG, et al. Nasal Cavity and Paranasal Sinuses. In: AJCC Cancer Staging Manual, 8th, Amin MB. (Ed), Springer, New York 2017. p.137.
- Wang CC. Treatment of carcinoma of the nasal vestibule by irradiation. Cancer 1976; 38:100.
- Talmi YP, Ferlito A, Takes RP, et al. Lymph node metastasis in nasal vestibule cancer: a review. Head Neck 2011; 33:1783.
- Wallace A, Morris CG, Kirwan J, et al. Radiotherapy for squamous cell carcinoma of the nasal vestibule. Am J Clin Oncol 2007; 30:612.
- Evensen JF, Jacobsen AB, Tausjø JE. Brachytherapy of squamous cell carcinoma of the nasal vestibule. Acta Oncol 1996; 35 Suppl 8:87.
- Burget GC, Walton RL. Optimal use of microvascular free flaps, cartilage grafts, and a paramedian forehead flap for aesthetic reconstruction of the nose and adjacent facial units. Plast Reconstr Surg 2007; 120:1171.
- Wray J, Morris CG, Kirwan JM, et al. Radiation therapy for nasal vestibule squamous cell carcinoma: a 40-year experience. Eur Arch Otorhinolaryngol 2016; 273:661.
- Lipman D, Verhoef LC, Takes RP, et al. Outcome and toxicity profile after brachytherapy for squamous cell carcinoma of the nasal vestibule. Head Neck 2015; 37:1297.
- Vanneste BG, Lopez-Yurda M, Tan IB, et al. Irradiation of localized squamous cell carcinoma of the nasal vestibule. Head Neck 2016; 38 Suppl 1:E1870.
- 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