Saturday, January 14, 2006

cancer, nose

Cancer of the nose is seen most commonly in adults over 60 years of age, probably due to a lifetime of excessive exposure to sunlight. Overexposure to X-rays and chronic skin ulcers may also increase the risk of cancer of the nose. Squamous cell carcinoma is the most common malignant tumor of the nose and paranasal sinuses. Clinical manifestations of these tumors are not consistent. There may be pain or no pain. Nasal discharge may be serous (watery) or purulent (pussy). If pain is present, it is apt to be worse at night. Symptoms may involve the upper teeth or an upper denture may become ill-fitting. Swelling may occur on the affected side of the face, the side of the nose, or at the inner comer of the affected eye. Orbital manifestations are often found such as proptosis (bulging of eyeball in the orbit) or enophthalmos (eyeball back in the orbit).
Surgery is the usual form of treatment. Often, radiation therapy is conducted preoperatively to shrink the size of the lesion and block the regional lymphatics. Surgery is then performed six weeks after completion of the radiation. At this time there has been maximum regression of the tumor, the radiation reaction in normal tissue is subsiding and secondary changes in the normal tissue that interfere with healing have not occurred. Postoperative management is necessary to closely watch for any recurrence. Prosthesis may be constructed to minimize the cosmetic defect.
Ballenger, J. J. Diseases of the Nose, Throat, Ear, Head and Neck, 13th ed. Philadelphia: Lea & Febiger, 1985.
Steinberg, F. U. Care of the Geriatric Patient, 6th ed. St. Louis: C. V. Mosby Co., 1983.

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