Surgical Treatment of Nasal Tip Hemangioma Using Open Rhinoplasty Approach

Video Type: CVideo
  • 2-5 min videos of a particular surgery or technique. These again show major events in the surgery
  • Clearly annotated and narration is a must in these videos
  • These have clear but concise abstracts are not able to be indexed in PubMed
  • Distributed in newsletters, featured on our website and social media
  • Peer reviewed

Author: Dov Goldenberg
Published:
Specialties: Craniofacial and Pediatric Plastic Surgery, Plastic Surgery, Reconstructive
Schools: Hospital Municipal Infantil Menino Jesus
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Basic Info

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

Advanced

Procedure

Surgical Treatment of Nasal Tip Hemangioma Using Open Rhinoplasty Approach

Indications

Proliferative or involutive nasal tip hemangioma with deformity or risk for growth related deformity
Failure of pharmacologic therapy

Contraindications

Parental concerns

Instrumentation

Setup

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

Preoperative Workup

History and
Clinical Exam

Anatomy and Landmarks

Demarcation of the limits of the tumor
Identification of lower lateral cartilages, domus, medial crura and nasal septum

Advantages/Disadvantages

Complications/Risks

Nasal hematoma
Skin necrosis
Temporary skin excess (do not remove)

Disclosure of Conflicts

None

Acknowledgements

Fernando Rosas Brito for video and image editing

References

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.

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