ABSTRACT
El rinofima, a pesar de no ser una entidad común, sí es una patología que altera en forma importante la estética facial del individuo; por tal razón, su entendimiento, adecuado diagnóstico y terapia precisa son de gran relevancia para lograr la mejor recuperación posible. Entre las opciones de manejo existen múltiples herramientas, que van desde la prevención hasta procedimientos quirúrgicos agresivos. A pesar de lo anterior, los pacientes con rosácea, condición patológica inicial, avanzan por los diferentes estadios de la evolución de la enfermedad sin tratamiento médico adecuado, y terminan en el rinofima, condición final del proceso patológico. El objetivo de este artículo fue realizar una revisión de la literatura actual del tema.
The Rhinophyma isn´t a common disease, however it´s a condition that significantly disturbs the facial aesthetics of people; for that reason, its understanding, appropriate diagnosis and precise management are so relevant to achieve the best possible recovery. Between the management options are numerous tools, since prevention to aggressive surgical procedures. Despite this, patients with rosacea, initial pathological condition, move through different stages of disease´s evolution without adequate medical treatment, causing rhinophyma, final condition of rosacea process. The aim of this paper was to review the current literature about this subject.
Subject(s)
Humans , Nose Diseases , Nose/abnormalities , Nose/injuries , Rhinophyma , Rhinophyma/etiology , Rhinophyma/rehabilitation , Rhinophyma/therapy , RosaceaABSTRACT
BACKGROUND: Rhinophyma is an uncommon progressively disfiguring process of the nose which occurs most often in middle-aged white men. The supposed association with increased alcohol abuse often leads to psychological problems for the person concerned. PATIENTS AND METHODS: We describe ten cases of patients with slowly progressive tumorous deformation of the nose. They were treated with a stepwise surgical approach consisting of tangential excision for debulking, sculpting with scissors, and finally contouring by dermabrasion. RESULTS: An esthetically pleasing result was achieved in all cases, making social reintegration for the patients possible. In the follow-up of at least 12 months no recurrence was seen and no scars occurred.
Subject(s)
Dermabrasion/methods , Esthetics , Rhinophyma/rehabilitation , Rhinoplasty/methods , Combined Modality Therapy , Follow-Up Studies , Humans , Male , Middle Aged , Nose/pathology , Reoperation , Rhinophyma/pathology , Skin/pathologyABSTRACT
Rhinophymas are characterized by slowly progressive enlargement of the nasal skin that will not resolve spontaneously. The usual indication for treatment has plastic cosmetic and functional reasons, above all in advanced cases with an obstruction of the nasal respiration or reduction of the visual field. Treatment of rhinophyma consists of surgical removal of the hyperplastic alterations. It should always be carried out by an experienced rhinosurgeon, because of possible complications and injury to the more deeply situated nasal structures. Different surgical procedures have been described, such as excision with primary suture or extirpation with plastic covering of the defect by free transplants, subcutaneous rhinophyma resection, as well as decortication with peeling off the proliferations, dermal abrasion, or dermal shaving. In addition, there are various abrasion procedures with abrasive cylinders, burrs, or wire brushes. The methods of exfoliation and abrasive polishing can be effectively combined. Care should be taken to preserve follicular epidermal islets from the more deeply situated layers of the skin. The follicular epithelium left behind is the point of departure for re-epithelization of the wound surface. If decortication is too deep, injuries to the perichondrium or the nasal cartilage may arise, leading to cosmetically unattractive scar formations and necessitate plastic surgery. The author's own method, which involves a combined procedure with peeling or dermal abrasion, remodeling with abrasive cylinders, as well as preoperative injection into the nasal tumor masses and a subsequent covering of the wound area with fibrin glue, is shown with reference to several examples of more than 60 cases. The cosmetic and long-term results are excellent.
