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Open rhinoplasty for treatment of nasal tip haemangioma

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Abstract

Haemangiomas are the most common tumours of infancy. They typically proliferate then involute with considerable variation as regards to their rates of proliferation and involution. Haemangioma of the nasal tip is a lesion of special characteristics. During proliferation, it expands, contracts and deviates the nasal cartilages. Particularly, it regresses slowly and frequently involutes incompletely. That is why excision of the lesion is frequently suggested. The present study was conducted to evaluate open rhinoplasty after initial non-excision treatment modalities namely, intra-lesional corticosteroid injections and laser treatment, as a protocol of treatment for nasal tip haemangiomas. Twelve patients with nasal tip haemangiomas were included in the present study. Patients of both sexes, of different ages, with deep and mixed haemangiomas were studied. Disfigurement was the constant presenting symptom. Initial non-excision treatment reported different responses as denoted by the regression of the lesions’ size. Haemangiomas constantly extended between the medial crura of the alar cartilages as noted by the constant widening of the columella pre-operatively and the obvious separation of the nasal cartilages intra-operatively. This separation was constantly found to require approximation by sutures. The results of the present study concluded that whenever an early presentation with nasal tip haemangioma could be established, initial non-excision treatment followed by open rhinoplasty could be a useful protocol of treatment. Within the limitations of the present study, this protocol could achieve an early, safe and effective treatment for nasal tip haemangiomas with provisionally acceptable cosmetic outcomes so far.

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References

  1. Achauer BM, Chang C, Vander Kam VM (1997) Management of hemangioma of infancy: review of 245 patients. Plast Reconstr Surg 99:1301

    Article  PubMed  CAS  Google Scholar 

  2. Denk MJ, Ajkay N, Yuan X, Rosenblum RS, Freda N, Magee WP (2002) Surgical treatment of nasal hemangiomas. Ann Plast Surg 48:489

    Article  PubMed  Google Scholar 

  3. Frieden IJ (1997) Which hemangiomas to treat—and how? Arch Dermatol 133(12):1593

    Article  PubMed  CAS  Google Scholar 

  4. Jackson IT (1988) Vascular anomalies. In: Jackson IT, Mustarde JC (eds) Plastic surgery in infancy and childhood, 3rd edn. Churchill Livingstone, Edinburgh

    Google Scholar 

  5. Jackson IT, Sosa J (1998) Excision of nasal tip hemangioma via open rhinoplasty—a skin sparing technique. Eur J Plast Surg 21:265

    Article  Google Scholar 

  6. Marler JJ, Mulliken JB (2005) Current management of hemangiomas and vascular malformations [Review]. Clin Plast Surg 32(1):99, ix

    Article  Google Scholar 

  7. McCarthy JG, Borud LJ, Schreiber JS (2002) Hemangiomas of the nasal tip. Plast Reconstr Surg 109:31

    Article  PubMed  Google Scholar 

  8. Mulliken JB (1988) Diagnosis and natural history of hemangiomas. In: Mulliken JB, Young AE (eds) Vascular birthmarks: hemangiomas and vascular malformations. Saunders, Philadelphia, p 41

    Google Scholar 

  9. Mulliken JB, Enjolras O (2004) Congenital hemangiomas and infantile hemangioma: missing links. J Am Acad Dermatol 50(6):875

    Article  PubMed  Google Scholar 

  10. Mulliken JB, Fishman SJ, Burrows PE (2000) Vascular anomalies. Curr Probl Surg 37(8):517

    Article  PubMed  CAS  Google Scholar 

  11. Mulliken JB, Glowacki J (1982) Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 69(3):412

    Article  PubMed  CAS  Google Scholar 

  12. Olofsson B, Jeltsch M, Eriksson U, Alitalo K (1999) Current biology of VEGF-B and VEGF-C. Curr Opin Biotechnol 10(6):528

    Article  PubMed  CAS  Google Scholar 

  13. Paavonen K, Horelli-Kuitunen N, Chilov D, Kukke E, Pennanen S, Kallioliemi OP, Pajusola K, Olofsson B, Eriksson U, Joukov V, Palotie A, Alitalo K (1996) Novel human vascular endothelial growth factor genes VEGF-B and VEGF-C localize to chromosomes 11q13 and 4q34, respectively. Circulation 93(6):1079

    PubMed  CAS  Google Scholar 

  14. Pitanguy I, Machado BH, Radwanski HN, Amorim NF (1996) Surgical treatment of hemangiomas of the nose. Ann Plast Surg 36:586

    Article  PubMed  CAS  Google Scholar 

  15. Silvestre JS, Tamarat R, Ebrahimian TG, Le-Roux A, Clergue M, Emmanuel F, Duriez M, Schwartz B, Branellec D, Levy BI (2003) Vascular endothelial growth factor-B promotes in vivo angiogenesis. Circ Res 93(2):114

    Article  PubMed  CAS  Google Scholar 

  16. Thomson HG, Lanigan M (1979) The Cyrano nose: a clinical review of hemangiomas of the nasal tip. Plast Reconstr Surg 63:155

    Article  PubMed  CAS  Google Scholar 

  17. Van der Meulen JC, Gilbert PM, Roddi R (1994) Early excision of nasal haemangiomas: the L-approach. Plat Reconstr Surg 94:465

    Article  Google Scholar 

  18. Walter JW, North PE, Waner M, Mizeracki A, Blei F, Walker JW, Reinisch JF, Marchuk DA (2002) Somatic mutation of vascular endothelial growth factor receptors in juvenile hemangioma. Genes Chromosomes Cancer 33(3):295

    Article  PubMed  CAS  Google Scholar 

  19. Waner M, Suen JY (1999) Hemangiomas and vascular malformations of the head and neck. Willey-Liss, New York, p 298

    Google Scholar 

  20. Warren SM, Longaker MT, Zide BM (2002) The subunit approach to nasal tip hemangiomas. Plast Reconstr Surg 109(1):25

    Article  PubMed  Google Scholar 

  21. Werner JA, Dunne AA, Folz BJ, Rochels R, Bien S, Ramaswamy A, Lippert BM (2001) Current concepts in the classification, diagnosis and treatment of hemangiomas and vascular malformations of the head and neck. Eur Arch Otorhinolaryngol 258(3):141

    Article  PubMed  CAS  Google Scholar 

  22. Yu Y, Fuhr J, Boye E, Gyorffy S, Soker S, Atala A, Mulliken JB, Bischoff J (2006) Mesenchymal stem cells and adipogenesis in hemangioma involution. Stem Cells 24(6):1605

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Tarek F. Elwakil.

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Amer, T.A., Elwakil, T.F. & Elbasiouny, M.S. Open rhinoplasty for treatment of nasal tip haemangioma. Eur J Plast Surg 30, 67–73 (2007). https://doi.org/10.1007/s00238-007-0152-8

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  • DOI: https://doi.org/10.1007/s00238-007-0152-8

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