Use of the Microdebrider in the Surgical Management of Rhinophyma

Abstract

Rhinophyma is a disfiguring end-stage manifestation of acne rosacea. It is characterized by a painless hyperplasia of the sebaceous glands and connective tissues of the nose. Numerous surgical modalities-including scalpel surgery, dermabrasion, CO 2 laser ablation, and electrocautery-have been reported with varying results. We describe our experience with using a microdebrider to treat 2 patients-a 65-year-old man and a 74-year-old man-who presented with rhinophyma. The instrument we used was the Medtronic Straightshot M4 Microdebrider. Using a low revolution speed, we easily excised the bulky superficial tissue. At higher revolution speeds with the use of a small shaver tip, we were able to achieve delicate contouring of the nasal tip and ala without causing scarring. Postoperatively, both patients exhibited an excellent cosmetic outcome and expressed a high degree of patient satisfaction. We conclude that the microdebrider is an excellent surgical tool for treating rhinophyma lesions. Its ease of use and its availability at most surgical centers makes it a favorable surgical option.

A Surgical Management for Severe Rhinophyma With Five-Blade Scratcher

“…People tried a variety of surgical methods and attempted with good results, including carbon electrocautery, cryotherapy, carbon dioxide laser vaporization, or a combination of these. [3][4][5] However, often the use of electrocautery has caused long healing time and also damage or exposure of the cartilaginous skeleton of the nose. And some of these, such as ablative laser surgery or pulsed dye lasers, are not always available.…”

“…Treatment of severe rhinophyma can be challenging. People tried a variety of surgical methods and attempted with good results, including carbon electrocautery, cryotherapy, carbon dioxide laser vaporization, or a combination of these 3–5 . However, often the use of electrocautery has caused long healing time and also damage or exposure of the cartilaginous skeleton of the nose.…”

Rosacea treatments: Current standards and additional options

“…Bipolar electrocautery (10–12 W) has been used to achieve hemostasis after excision in three cases 120–122 . Successful phyma correction has been reported with microdebrider contouring (3000 rpm) after excision (300 rpm) with a straight microdebrider handpiece (Medtronic Straightshot M4 Microdebrider) 123,124 . Fractional CO 2 laser, ablative CO 2 laser + 595 nm dye laser, and copper vapor laser have also been described with good results 125–128 …”