Abstract: Objective The objective of this study was to analyse the clinical and pathological characteristics of external nasal lesions, and to explore the associations of pathological type, lesion location, and reconstructive method with prognosis. Theultimate aim of this study is to provide a reference for standardised diagnosis, treatment, and comprehensive reconstruction. Methods A retrospective analysis was conducted on patients with external nasal lesions who were treated in the department of otorhinolaryngology at Jiangsu Provincial People's Hospital from January 2019 to December 2025 and had pathological confirmation. The data set encompasses variables such as patient sex, age, the nature of the lesion(non-neoplastic lesions, benign tumours, and malignant tumours), pathological type, lesion location, surgical approach, and postoperative reconstructive method. The analysis of prognosis was conducted in conjuction with follow-up data. The intergroup comparisons were conducted utilising the chi-square test, the Kruskal-Wallis test, and the Mann-Whitney U test. Results The study population comprised 129 patients with external nasal lesions, including 69 males(53.5%)and 60 females(46.5%), yielding a male-to-female ratio of 1.15∶1.00. The age of the subjects ranged from 6 to 99 years, with a mean of 60.02±16.73 years. The study identified a total of 14 non-neoplastic lesions, 32 benign tumours, and 83 malignant tumours. A statistically significant variation in the distribution of sexual activity was observed among the three distinct groups(χ2=8.22, P=0.016). A significant disparity in age distribution was observed among the non-neoplastic, benign, and malignant groups(χ2=23.12, P<0.001). Patients with malignant tumours were found to be significantly older than those with benign tumours(P<0.001). Among benign neoplasms, intradermal nevus was the most prevalent type(43.8%). The tumours were predominantly epidermal in origin, with basal cell carcinoma and squamous cell carcinoma accounting for 63.9% and 26.5% of cases, respectively. In general, external nasal lesions were most prevalent in exposed regions of the nose, such as the nasal ala and dorsum. The location of the lesions was not found to be significantly associated with the benignity or malignancy of the tumours(P>0.05). All patients underwent complete excision, followed by reconstruction with direct closure, nasolabial flap, forehead flap, or adjacent local flaps according to defect extent and the three-dimensional nasal structure. Conclusion The external nasal lesions observed in this cohort were predominantly present in older patients and were primarily malignant epithelial tumours, most commonly involving the nasal ala and nasal dorsum. In cases where lesions are suspected of malignancy or have ill-defined margins, it is imperative that they are meticulously excised. This should befollowed by three-dimensional reconstruction and flap repair, with both function and aesthetics taken into consideration. Special types, such as lymphoma and soft tissue tumours, require increased clinical vigilance, timely systemic evaluation, and comprehensive treatment.

Key words: External Nose, Skin Tumors, Surgical Reconstruction, Prognosis