Plastic and Reconstructive Surgery Unit, Hospital of Pisa, Italy.
J Craniomaxillofac Surg. 2013 Jul;41(5):429-36. doi: 10.1016/j.jcms.2012.11.009. Epub 2012 Dec 8.
Rhinophyma is characterized by slowly progressive tumour-like enlargement of the nasal skin that will not resolve spontaneously. Though its treatment consists of surgical removal of the hyperplastic alterations, in the literature there is not general agreement about the best method. We presented our experience with two different treatment modalities such as decortication by scalpel and CO2 laser treatment.
The authors reviewed the long-term results of 67 patients affected by rhinophyma treated with two different methods between 1996 and 2011. Outcomes were determined by case notes, clinical review and patient satisfaction questionnaire.
Forty-five cases were treated with tangential excision and 22 with a CO2 laser. Minor complications, including scarring and hypopigmentation, were seen in 6 patients. All patients were satisfied with their outcomes at the follow-up visit, and no major complications were detected during follow-up.
Both tangential excision and carbon dioxide laser are well-established, reliable procedures for rhinophymaplasty that preserve the underlying sebaceous gland fundi allowing spontaneous re-epithelialization without scarring with similar outcomes and high patient satisfaction. The original nose shape and nearly normal skin surface texture are preserved by quickly removal of the hypertrophic tissue sparing the pilosebaceous tissue. The CO2 laser is more capital intensive and results in higher fees compared with the simpler cold blade tangential excision. In our experience the ease of use, accuracy and precision of the lasers offer is not justified by the increased costs.
酒渣鼻是一种以鼻部皮肤进行性肿瘤样增大为特征的疾病，通常不会自发消退。虽然其治疗方法包括外科切除增生组织，但文献中对于最佳治疗方法尚未达成共识。我们介绍了我们使用两种不同治疗方法的经验，包括手术刀削除和 CO2 激光治疗。
作者回顾了 1996 年至 2011 年间使用两种不同方法治疗的 67 例酒渣鼻患者的长期结果。通过病历、临床检查和患者满意度问卷调查来确定结果。
45 例患者采用切线切除，22 例患者采用 CO2 激光治疗。6 例患者出现轻微并发症，包括瘢痕和色素减退。所有患者在随访时对治疗结果均满意，随访期间未发现严重并发症。
切线切除和二氧化碳激光都是成熟可靠的酒渣鼻整形手术方法，可保留底层皮脂腺基底，实现无瘢痕的自发性再上皮化，且具有相似的效果和高患者满意度。通过快速去除增生组织而保留毛囊皮脂腺组织，可以保留原有鼻子形状和几乎正常的皮肤表面纹理。与更简单的冷刀切线切除相比，CO2 激光的资本投入更高，费用也更高。根据增加的成本，我们认为激光的易用性、准确性和精确性没有得到充分证明。
