Faculty Collaboration Database

The Cyrano nose: refinements in surgical technique and treatment approach to hemangiomas of the nasal tip. Plast Reconstr Surg 2010 Oct;126(4):1291-1299

Date

10/05/2010

Pubmed ID

20885249

DOI

10.1097/PRS.0b013e3181ea44c5

Scopus ID

2-s2.0-77958617009 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

BACKGROUND: Nasal tip hemangiomas cause significant parental distress and can negatively affect the psychological development of a child. Treatment is controversial, with numerous modalities available for reconstruction. The authors outline their combined medical and surgical approach to treating nasal tip hemangiomas and describe their preferred surgical technique.

METHODS: A retrospective review was performed of all nasal tip hemangiomas presenting to the Multidisciplinary Vascular Anomalies Clinics at the Children's Hospital of Wisconsin and Children's Hospital of Michigan from 1999 to 2007. Parameters for review included onset age, symptoms, medical therapies (laser with or without steroid) used, age and status of lesion at time of surgery, outcomes, and complications.

RESULTS: Twenty-five patients met inclusion criteria, with a mean onset age of 1.43 months. Most received steroids and pulsed dye laser therapy (mean no. of laser treatments, 3.5) during the proliferative and plateau phases of the tumor's natural history. Surgical resection after involution has been performed using an open rhinoplasty technique on 15 patients thus far. Eleven of them had surgical correction in the postinvolutional phase, and at parental request, four had early surgical correction during the proliferative-plateau phases. In the early treatment cohort, one child developed a hematoma postoperatively; the same patient required a revision rhinoplasty for alar rim asymmetry. Acceptable aesthetic results were obtained in both groups.

CONCLUSIONS: A combined medical and surgical approach offers the best method to treat the Cyrano nose. The authors' treatment algorithm uses early medical management to accelerate involution of the lesion, providing optimal conditions for excision. Early surgical treatment also allows satisfactory results but may require secondary correction. An open rhinoplasty approach with skin resection is the authors' preferred technique.

Author List

Arneja JS, Chim H, Drolet BA, Gosain AK

MESH terms used to index this publication - Major topics in bold

Cohort Studies
Combined Modality Therapy
Esthetics
Female
Follow-Up Studies
Hemangioma
Humans
Infant
Male
Nose
Nose Neoplasms
Otorhinolaryngologic Surgical Procedures
Retrospective Studies
Rhinoplasty
Treatment Outcome
Wound Healing