Lateral Rhinotomy Approach for Mohs Micrographic Surgery of the Anterior Septum

BACKGROUND. Neoplasms of the nasal septum and internal alar surface are very difficult to treat. This is because of the complicated surface, proximity to important anatomic structures, and technical difficulty—both to resection and follow up. Mohs micrographic surgery might be the ideal mode of treatment for such tumors; however, it is very difficult to accomplish through the nostril. OBJECTIVE. To resect the tumor on the nasal septum and internal alar surface using Mohs micrographic surgery. METHODS. Lateral rhinotomy was performed as a preparatory stage to Mohs micrographic surgery of the anterior septum and intranasal alar surface. RESULTS. The ala nasi was detached from the cheek, thus exposing the anterior nasal cavity — enabling direct access to the neoplasms and allowing excellent visualization. CONCLUSION. Lateral rhinotomy, as described in this article, is a simple office procedure and in most cases heals with no visible scar. 1993 American Society for Dermatologic Surgery, Inc.