Nasal tip haemangiomas: Guidelines for an early surgical approach

Hamou, Cynthia; Diner, P.A.; Dalmonte, Pietro; Vercellino, Nadia; Soupre, V.; Enjolras, O; Vazquez, M.-P.; Picard, A.

doi:10.1016/j.bjps.2009.05.020

Cited by 23 publications

(26 citation statements)

References 15 publications

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“…Eivazi et al classified nasal tip hemangiomas as "limited" or "advanced" [25]. Hamou et al identify three types of nasal hemangiomas that lead to three distinct surgical approaches: -Type A (mild cases): no cutaneous involvement, no misalignment of the cartilages an mild nasal volume increase -Type B (moderate cases): partial cutaneous infiltration, misalignment of the cartilages and moderate nasal volume increase -Type C (severe cases): cutaneous infiltration, misalignment of the cartilages and severe nasal volume increase [31]. They are usually subcutaneous or mixed superficial and subcutaneous lesions that occupy the space between the skin and the nasal tip and lower lateral cartilages [15].…”

Section: Nasal Hemangiomasmentioning

confidence: 99%

“…The treatment of nasal hemangiomas is extremely difficult because of its location and possible complications [31]. In most of these cases expectation is not a treatment option.…”

Section: Treatment Optionsmentioning

confidence: 99%

“…Because of the possible complications (skin atrophy) Hochman and Mascareno have moved away from using local steroid injections for nasal hemangioma [22]. Because of convincing results, beta blockers are preferred as the first treatment option for proliferating hemangioma [25,28,29,31]. Proponents of early surgery suggest that aesthetic and functional improvement during a critical period in child development can be achieved [13][14][15][16][17].…”

Section: Treatment Optionsmentioning

confidence: 99%

“…Hamou et al advocate early surgery and the operative technique was chosen based on the size of the lesion and the presence or absence of cutaneous infiltration. [31].…”

Section: Surgical Treatmentmentioning

confidence: 99%

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Surgical Management of Nasal Hemangiomas

Vlahovic¹

2011

Rhinoplasty

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Section: Nasal Hemangiomasmentioning

confidence: 99%

“…The treatment of nasal hemangiomas is extremely difficult because of its location and possible complications [31]. In most of these cases expectation is not a treatment option.…”

Section: Treatment Optionsmentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

“…Hamou et al advocate early surgery and the operative technique was chosen based on the size of the lesion and the presence or absence of cutaneous infiltration. [31].…”

Section: Surgical Treatmentmentioning

confidence: 99%

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Surgical Management of Nasal Hemangiomas

Vlahovic¹

2011

Rhinoplasty

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“…Management of nasal tip hemangiomas is challenging and controversial. Current treatment modalities include corticosteroids, laser, and sur-gical procedures [6,7,8,9,10]. Each of these approaches has limitations in therapeutic benefit and inherent risks.…”

Section: Introductionmentioning

confidence: 99%

Hemangiomas of the Nasal Tip Treated with Propranolol

Ben‐Amitai

Halachmi²,

Zvulunov³

et al. 2012

Dermatology

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Background: Infantile hemangioma is the most common tumor of infancy. There are recent reports of the efficacy of propranolol in the treatment of these hemangiomas. Nasal tip hemangiomas pose a particularly sensitive concern aesthetically and functionally. The treatment of nasal tip hemangiomas is controversial. We assessed the effect of propranolol therapy in hemangiomas of the nasal tip. Objectives: To evaluate the response of nasal tip hemangiomas to systemic propranolol. Methods: During 2008-2010 ten infant with nasal tip hemangiomas presented to our tertiary care center. All underwent comprehensive evaluation by a multidisciplinary team and were then treated with oral propranolol at 2 mg/kg/day, with continuous clinical follow-up until age 14-16 months, or in older infants until the proliferative phase resolved. Results: Eight patients demonstrated good clinical improvement. Two patients had partial improvement. One patient discontinued treatment due to wheezing. Three patients had mild sleep disturbance which did not warrant discontinuation of treatment. No rebound was noticed after cessation of treatment. Limitations: Children presented by referral at variable ages. It is possible that routine initiation of propranolol in neonates at the first sign of nasal hemangioma may reduce the required treatment duration or dose. Conclusions: Early treatment of hemangiomas of the nasal tip with propranolol prevents lesion proliferation, reduces lesion volume, and prevents nasal and facial deformation. Propranolol appears to be a safe and effective treatment. Its efficacy and safety profiles, relative to other accepted therapies, suggest that it should be considered as the first-line treatment when intervention is required.

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Modern Management of Nasal Hemangiomas

Keller

Stevens

Hochman³

2017

JAMA Facial Plast Surg

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here is a wealth of literature dedicated to the pathogenesis, diagnosis, and clinical behavior of infantile hemangiomas (IHs), which are the most common benign tumors of infancy. Therapeutic strategies, however, are less well studied, and continue to evolve as laser, surgical, and medical interventions are refined to attain the best cosmetic and functional outcomes. Infantile hemangiomas of the nose (IHNs) comprise a special subset of these tumors owing to their effect on a structure with known functional, aesthetic, and psychosocial importance. Because of the relatively low incidence of IHNs, the timing, type, duration, and extent of treatment are topics of debate. Recently, a more aggressive approach for a wider range of tumors has been gaining strength because of the excellent efficacy and safety profile of β-blockers and the availability of a US Food and Drug Administration-approved formulation for infants with IHs. [1][2][3] The paucity of outcomes data for management of IHN, however, makes planning of generalized treatment difficult. Because of this difficulty, we hypothesized that a standardized therapeutic protocol for IHNs that is capable of achieving acceptable aesthetic and functional outcomes by 2.5 to 3 years of age (when a sense of self begins to form) could be developed from consensus literature reports and personal experience. 1,4 To address this hypothesis, we performed a retrospective record review of treatment approaches and outcomes in our patient population and compared this experience with that in the literature. Methods Primary StudyWe performed a retrospective review of all patients with IHNs treated by a single surgeon (M.H.) in a tertiary referral private practice between January 1, 1999, and December 31, 2015. Inclusion criteria were diagnosis of IHN, documentation of medical and/or surgical interventions, and duration of follow-up of 1 year or more. Patients were excluded if management consisted solely of observation for tumors or anomalies other than IHNs and if the IHN was confined solely to the glabella. Patient records were mined for demographic data, tumor-specific variables, clinical data, therapeutic interventions, and outcomes. Tumor-specific variables were as follows: (1) depth of involvement, characterized as superficial lesions extending to the dermis only, deep lesions confined to the subcutaneous or subdermal tissue, and compound lesions with simultaneous superficial and deep components; (2) tumor distribution, characterized as focal tumors involved in solitary nasal subunits and segmental tumors involved in multifocal and/or dermatomal distributions; and (3) tumor life IMPORTANCE Current treatment approaches for infantile hemangiomas of the nose include observation, pharmacologic agents, surgery, and/or laser therapy. Because of the known functional, social, and cosmetic effect of nasal deformities, obtaining the best possible result is critical. Optimal timing, type, duration, and extent of therapy remain unclear.OBSERVATIONS Results of a review of 86 patients (64 female...

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Nasal tip haemangiomas: Guidelines for an early surgical approach

Cited by 23 publications

References 15 publications

Surgical Management of Nasal Hemangiomas

Surgical Management of Nasal Hemangiomas

Hemangiomas of the Nasal Tip Treated with Propranolol

Modern Management of Nasal Hemangiomas

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