Hemangiomas are the most common benign tumors of the infancy and its location on the nasal tip poses particularly as a challenge. A recent study published by out group defined an algorithm for surgical approach to hemangiomas.
Nasal tip hemangiomas carry a high risk for growth related deformities and is a usual indication for surgery.
The best approach must warrant a result at least similar or even better to spontaneous involution.
In this video we present a case where an open rhinoplasty approach was designed to remove the tumor, reposition the anatomic structures and reduce visible scars.
Contributors
Dov Charles Goldenberg, MD Phd, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School
Vania Kharmandayan, MD, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School
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Surgical Treatment of Nasal Tip Hemangioma Using Open Rhinoplasty Approach
Proliferative or involutive nasal tip hemangioma with deformity or risk for growth related deformity
Failure of pharmacologic therapy
Parental concerns
General anesthesia through oral intubation.
Marking of the transcolumellar incision and hemangioma limits
Infiltration with local anesthetics and vasoconstrictor
Prep area with betadine
Eye protection
History and
Clinical Exam
Demarcation of the limits of the tumor
Identification of lower lateral cartilages, domus, medial crura and nasal septum
N/A
Nasal hematoma
Skin necrosis
Temporary skin excess (do not remove)
None
Fernando Rosas Brito for video and image editing
Goldenberg DC, Hiraki PY, Marques TM, Koga A, Gemperli R. Surgical Treatment of Facial Infantile Hemangiomas: An Analysis Based on Tumor Characteristics and Outcomes. Plast Reconstr Surg. 2016 Apr;137(4):1221-31. doi: 10.1097/PRS.0000000000002016.
Review Surgical Treatment of Nasal Tip Hemangioma Using Open Rhinoplasty Approach.