The purpose of the study was to develop a system of measures aimed at increasing the efficiency of diagnosis, surgical treatment, prevention of relapses, control of cure and improving the quality of life of patients with malignant lesions of the skin of the external nose. Objectives: To evaluate the results of diagnosis and treatment of patients with tumor lesions of the skin of the external nose based on the data of the archive of the Odesa Clinical Hospital (OCH) 11 for the period 2012 - ¬¬¬¬¬¬2017; to study the possibility of using the photosensitizer Chlorine E6 for fluorescence diagnostics of the boundary of tumor lesions before radical surgical treatment; 112 primary patients with malignant tumors of the skin of the external nose and 20 patients with recurrence of cancer of the skin of the external nose were under observation (archive of the OCH 11 from 2012 to 2017) who received chemoradiotherapy. Of the 112 patients, there were 53 women (47.3%) + 11 patients with relapse and 59 men (52.7%) + 9 with relapse. The age of the patients ranged from 58 to 80 years. Patients were divided into two groups depending on the choice of the method of visualization of the tumor lesion boundary during surgical treatment. The main group of patients was 55, the control group was 57 patients. Malignant tumors of the skin of the external nose were diagnosed in 112 patients studied, among which 43 (38.4%) had basal cell carcinoma of the skin (BCC) and 69 (61.6%) patients had squamous cell carcinoma of the skin (SCC). For the examination of patients, the following were used: general blood parameters, medical history and heredity, clinical signs of neoplasms and instrumental research methods: microscopy (dermatoscopy), thermodifferential test, morphological diagnostic indicators, immunohistochemical study, intraoperative and postoperative semiotics, biostatistics methods. Surgical removal of the tumor in patients was carried out using fluorescence visualization of the lesion border Chlorine E6, which was administered before surgery, as well as Klein's solution in order to prevent prolongation and recurrence of the malignant process, the tumor lesion was removed under visual control, within healthy tissues, receding 1.2-1.5 cm from the edges of the tumor. It has been shown that the use of fluorescence imaging, Klein's solution during surgical treatment had a proven positive effect already in the first five years of the study - the absence of relapses. Effectiveness was rated on a scale: significant improvement, slight improvement, and no effect. The effectiveness of surgical treatment of tumor lesions of the skin of the external nose within healthy tissues and under visual control was 61.4% compared to HZ, where 100% (p>0.05). For the first time, it was established: 1. Comprehensive diagnostics of external nasal skin cancer significantly increases the effectiveness of surgical treatment. 2. On the basis of clinical semiotics, dermatoscopy, thermodifferential test and fluorescence study, a multifactorial assessment of the diagnostic signs of malignant neoplasms of the external nose at the pre-treatment stage was carried out. 3. The photodynamic effect of the photosensitizer Chlorine E6 in the complex diagnosis and treatment of patients with malignant neoplasms of the external nose based on infrared irradiation was studied. 4. The practical significance of fluorescence visualization of the tumor lesion boundary based on local intrafocal injection of a photosensitizer for radical removal of the neoplasm has been established. 5. The degree and time of photosensitizer accumulation in healthy and tumor tissues have been studied and determined, depending on the method of administration for timely treatment. 6. An assessment of the effect of the photosensitizer Chlorine E6 on the volume of surgical removal and during photodynamic therapy of malignant neoplasms of the external nose on the number of recurrence and quality of life of patients was established. The obtained results became the basis for: - supplementing scientific knowledge in the field of medicine, oncootorhinolaryngology regarding the role and place of modern diagnostics of clinical signs of skin cancer and the choice of the optimal approach to surgical treatment; - development of the method and choice of tactics of surgical treatment; - increasing the effectiveness of treatment of patients with cancer of the skin of the external nose due to the use of reasonable individual treatment planning based on the assessment of clinical signs, which makes it possible to identify groups of patients who can use the technique of fluorescence visualization of the boundary of tumor lesions; - the use of the developed method of surgical treatment of skin cancer to improve the efficiency of medical care, which will significantly reduce the number of relapses without negatively affecting the quality of life.
