“Glad to see the back of my ‘Malteser’ nose”
5 April 2023
A woman with a cancerous tumour growing inside and outside her nose has praised surgeons at the Royal Free Hospital for helping her to face the world again.
Patricia Gosling, 76, who lives in Colindale, is celebrating as she nears the end of 33 cycles of immunotherapy and sees her surgeons for what she hopes is the last time.
In 2019 Patricia visited her GP as she was worried about a cold she couldn’t shift. But the GP told Patricia she was more concerned about a grey scab on her nose.
At first a cream was prescribed but a few months later the skin flared up and Patricia attended Barnet Hospital for a biopsy.
The biopsy confirmed cancer and Patricia underwent surgery to remove a squamous cell carcinoma tumour at the beginning of 2020.
Unfortunately the tumour grew back even bigger complete with a large circular lump at the end which Patricia began describing as her ‘Malteser’ nose.
The extent of regrowth of the tumour meant that almost all of her nose had to be removed by surgeon Dariush Nikkhah.
But thankfully, just a week later Patricia underwent a painstaking six-hour operation to reconstruct her nose.
Her surgeons Mr Nikkhah, who specializes in microvascular surgery and Allan Ponniah, who specializes in craniofacial surgery, work together as part of the Royal Free Hospital’s facial plastics team.
The reconstructive surgery involved taking a tissue from the arm and using it to rebuild the inner lining of the nose. In addition, cartilage was taken from the ear for structural support, as well as a flap of tissue from the forehead to reconstruct the external nasal skin. Patricia subsequently had two more smaller surgeries to refine her newly reconstructed nose.
Patricia, a former care worker for people with disabilities, said: “I called it my ‘Malteser’ nose and was glad to see the back of it. Everyone who has looked after me has been wonderful. I think everyone should get a medal! I’m really pleased with what they have been able to do for me and although I will miss everyone at the hospital it will also be good to finally complete my treatment and surgery and give me back more time to spend with my family.”
(Inset: Patricia pictured prior to surgery to remove her 'Malteser' growth and the large tumour also growing inside her nose. Main pic: Patricia pictured with Mr Dariush Nikkhah (left) and Mr Allan Ponniah (right) prior to final surgery to even up the shape of her nostrils)
Mr Nikkhah said: “Patricia was concerned about the lump on the outside of her nose but the problem went much deeper with that as there was a large tumour extending inside the nose. This resulted in a resection (removal) of the majority of her nose. It is brilliant that we were able to reconstruct a new nose for Patricia that ticks the boxes both aesthetically and functionally using the very latest modern facial surgery techniques. Microsurgical techniques that enable us to transfer a patient’s own tissue from a donor site to a recipient site have revolutionised how we manage complex defects like Patricia’s. I’m very proud of the team at the Royal Free Hospital, this case is testament to the wonderful staff we have in our department.”
Mr Ponniah added: “We’ve just brought Patricia back in for final revision surgery to even up the shape of her nostrils. We tend to leave the nose a bit bulky so we can go back and thin things as after a big surgery like this the way the skin heals can be slightly unpredictable. But we are extremely happy with the outcome.”
The two surgeons have worked together for over ten years and say it is the combination of their skills which make them so effective.
Mr Ponniah concluded: “We are a great team and have also published a lot of research together. We’re both 100% committed to helping patients recover from severe facial disfigurement and can often offer hope to people who think that nothing more can be done.”
(Pictured L-R: Mr Dariush Nikkhah, Patricia Gosling and Mr Allan Ponniah)