Evaluation of surgical treatment of rhinophyma with tangential shear of the lesion

Abstract

A Ad dd dr re es ss s f fo or r c co or rr re es sp po on nd de en nc ce e: : Prof. Henryk Witmanowski MD, PhD, Department of Plastic, Reconstructive and Aesthetic Surgery, Nicolaus Copernicus University, Collegium Medicum, 9 M. Original paper A b s t r a c t I In nt tr ro od du uc ct ti io on n: : Tuberosity of the nose is a slow, progressive, gentle process, leading to distortion and dysfunction of the nose. Underlying the change is perifollicular hypertrophy of the sebaceous glands, fibrous tissue proliferation and vascular changes of telangiectasia type. It is believed that it is the final stage of rosacea. A Ai im m: : To evaluate the effectiveness of surgical treatment using the method of tangential shear, based on a medical examination and subjective assessment of the effects of treatment by the patient. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : In the years 1998 to 2008 nine patients with moderate degree of rhinophyma were treated surgically by tangential shear, followed by electrocoagulation. The results were assessed according to a 4-point scale as very good, good, fair and poor. We evaluated the presence of postoperative complications (bleeding, infection, or other), healing time, the shape of the nose (size and symmetry), improved patency, reduction in the number of inflammatory conditions, widening of the field of view and long-term effects of treatment: disfiguring scars, uneven surface of the nose, nasal deformity and recurrence. R Re es su ul lt ts s: : Among the 9 patients studied in 2 cases a very good result was achieved, in 5 good and in 2 satisfactory; no poor result was observed. Healing took an average of 6 weeks (1-15 weeks). None of the patients had postoperative complications. Seven patients were satisfied with both the size and symmetry of the nose, one unsatisfied with the size and 1 dissatisfied with the symmetry. Following the operation, 1 patient had disfiguring scars, 3 uneven surface of the nose, nasal deformity was observed in 2 cases and there was 1 recurrence. Of the 2 patients with a satisfactory result, 1 has been re-operated on, while the other was set an additional term of treatment. C Co on nc cl lu us si io on ns s: : Surgical treatment of nasal tuberosity by tangential shear followed by electrocoagulation is effective, and burdened by low rates of complications. To achieve a good aesthetic and functional effect, a very experienced operator is recommended. K Ke ey y w wo or rd ds s: : rhinophyma, nasal tuberosity surgical treatment, rhinophyma treatment effects.

Prevalence of Demodex spp. in eyelash follicles in different populations

“…Most studies on demodicosis have been focused on the skin, but there is little information in the literature on the prevalence of Demodex in eyelashes of the general human population. Some authors consider Demodex to be an innocuous organism living in the skin, while others believe that it may play a role as an important pathogen in the development of demodicosis, rosacea or chronic blepharitis and contribute to ocular surface irritation [ 5 , 6 , 12 ]. As the pathologic relevance of Demodex infestation in blepharitis is still controversial [ 13 , 14 ], we would like to share our data on this subject, hoping that they will add further information on this interesting topic.…”

Early Cosmetic Results and Midterm Follow-up Findings of Rhinophyma Patients Treated With High-Frequency Electrosurgery and a Discussion on the Severity Assessment of the Disease

“…2,3,[6][7][8][9][10][11][12][13][14][15] Several case reports describe using a combination of some treatments mentioned above. 6,[15][16][17][18] There is currently no consensus among researchers with regard to which is the most ideal treatment. 10 The following anaesthetic methods have been reported in the surgical treatment of rhinophyma: general anaesthesia with or without paranasal nerve blocks, intravenous deep sedation with local infiltrative anaesthesia, local regional infiltrative anaesthesia with or without ring fashion, bilateral infraorbital and infratrochlear block with local infiltrative anaesthesia, and tumescent anaesthesia.…”

“…10 The following anaesthetic methods have been reported in the surgical treatment of rhinophyma: general anaesthesia with or without paranasal nerve blocks, intravenous deep sedation with local infiltrative anaesthesia, local regional infiltrative anaesthesia with or without ring fashion, bilateral infraorbital and infratrochlear block with local infiltrative anaesthesia, and tumescent anaesthesia. 3,[7][8][9][10][11][12][13][14][15][16][17]19 The anaesthetic techniques were not discussed in these reports. To achieve a painless procedure of local infiltrative anaesthesia, reduced bleeding during the surgical procedure, and a prolonged anaesthesia period, the following method seems the most appropriate anaesthesia technique for the high-frequency electrosurgical treatment of rhinophyma: first infraorbital block with lidocaine plus adrenaline and bupivacaine, then local infiltration of lidocaine plus adrenaline into the rhinophyma lesion.…”