Method of treating rhinophyma

FIELD: medicine.

SUBSTANCE: invention refers to otorhinolaryngology and can be applied for treating rhynophyma. Rhinophyma nodes are excised by a stretched string electrode in the tip Parus of the electric destruction apparatus Photec-80. Hypertrophied skin areas are cut in layers to be uniformly covered with the amorphous powder Bismuth Subgallate to form on the surface a layer of thickness 1-3 mm. 6-8 days after the operation, Bepanthen ointment is applied for 17-20 days. In the postoperative period, Phlebodia is administered for 60 days.

EFFECT: method allows reducing traumatism and risk of recurrence.

1 ex, 3 dwg

 

The invention relates to the ENT, and in particular to methods of treatment of chronic skin diseases of the nose, in particular rhinophyma.

There is a method of surgical treatment of rhinophyma, including under local anesthesia execution of the anterior vestibular incision of the skin of the nose, which usepreview with the underlying tissues from krylnyh cartilage, cartilage and bone parts of a nose, perform subcutaneous excision modified the newly formed tissue to a healthy high-intensity laser radiation from a diode laser with wavelength of 0.97 μm, the capacity of 5-8 watts in continuous mode, then the wound surface cover saved the flap and suture (RF patent No. 2272589, MCL AV 17/24, AV 18/20, 2004).

The disadvantages of this method are significant trauma because of the vast ofseparate soft tissues of the external nose from krylnyh cartilage and bone of the pyramid, as well as the risk of deformation of the external nose at the age of patients, associated with a decrease in the reference function of the cartilage of the nose.

The closest technical solution is a method of surgical removal of rhinophyma, including infiltration anesthesia tumors 1% solution of novocaine, excision, and coagulation inopinatus nodes with a directed beam of high-energy carbon dioxide laser apparatus "Scalpel-1" thick vs the ka 10-4 - 10-5 watts/cm2, evaporation and coagulation hypertrophied skin areas with well-developed vascular network, the absorption of the evaporated particles by suction, the processing of the wound surface gioxizone ointment and covering aseptic bandage (annals of otorhinolaryngology, No. 1, 1989, p.65).

The disadvantages of this method are the trauma and the possibility of recurrence of the disease.

The task of the invention is to increase the effectiveness of treatment of rhinophyma at different volumetric processes in the field of external nose and improved cosmetic effect.

This object is achieved in that in the method of treatment of rhinophyma, including excision of the modified newly formed tissue under local anesthesia, it is new that the pre-electrode in the form of a stretched string at the tip Parus apparatus of electrogastrogram "Photek-80" excised rhinopomatidae nodes, then cut in layers to healthy tissue, hypertrophic skin, which evenly cover the amorphous powder of Bismuth subgallate" with the formation of the surface layer with a thickness of 1-3 mm, which after 6-8 days after surgery put the ointment "Bepanthene" within 17-20 days in the postoperative period enter drug "Phlebodia" within 60 days.

Electrode in the form of a tightly stretched string at the tip of the "Sail" of the apparatus of electrogastrogram "Photek-80 allows you to dissect hypertrophied skin layer after layer of uniform thickness without damaging healthy skin, which evenly cover the amorphous powder of Bismuth subgallate" with the formation of the surface layer of a thickness of 1-3 mm

The powder of Bismuth subgallate" has an astringent, drying and anti-inflammatory action, which leads to compaction of colloids extracellular fluid and exudate cell membranes. The formed layer significantly reduces the irritation of sensitive nerve endings and prevents the development of edema. In addition, the Bismuth subgallate" causes local vasoconstriction, reduces their permeability, reduces exudation, reduces the intensity of the inflammatory process that contributes to the prevention of relapse. Experimentally it is established that the layer of smaller thickness does not provide an airtight cover the wound surface scab, and a layer of greater thickness is not retained on the surface of the external nose.

Since 8 days after surgery process formed a crust in the area of the external nose softening ointment "Bepanthene" less traumatic for desquamative, causing a thin layer of ointment - 2 mm, 2 times a day.

The drug "Phlebodia has onotonicity effect (reduces the compliance of the veins, improves their tone, reduces venous stasis), improves lymphatic drainage, improves tone and frequency of contractions of the lymphatic capillaries, increases their function the national density, reduces lymphatic pressure, improves circulation, increases capillary resistance, reduce their permeability, reduces the adhesion of leukocytes to the venous wall and their migration in paravenously tissue, improves oxygen diffusion and perfusion in the skin, has anti-inflammatory action. The drug "Phlebodia increases the vasoconstrictor action of Bismuth subgallate", blocks the production of free radicals, synthesis of prostaglandins and thromboxane, which is important for the prevention of recurrence of rhinophyma.

The method is as follows.

A method of surgical treatment of rhinophyma performed under local wiring and infiltration anesthesia, which additionally secures the skin and helps to reduce bleeding. Pre electrode in the form of a stretched string at the tip Parus apparatus of electrogastrogram "Photek-80" excised rhinopomatidae nodes, then cut in layers hypertrophied skin to healthy skin. If there is bleeding conduct directed coagulation of a bleeding vessel.

After the destruction of the skin of the external nose wound surface evenly cover the amorphous powder of Bismuth subgallate" with the formation of the surface layer of a thickness of 1-3 mm in 6-10 days after surgery, a thin layer, 2 mm put the ointment "Bepanthene" for 17-20 the ducks. Spontaneous rejection scab and complete epithelialization occurs within 18-20 days.

In the postoperative period for the prevention of venous stagnation is carried out course receive winprotector "Phlebodia" within 60 days. The method is confirmed by an example.

Example:

Patient K., aged 57, was admitted to the regional hospital with marked hypertrophy of the skin of the external nose with 5 rhinopomatidae nodes in the area of the wings of the nose.

Diagnosis: rhinophyma.

Under local wiring and infiltration anesthesia with 1% lidocaine solution 20 ml of pre-dissected rhinopomatidae nodes, then layers cut hypertrophied skin to healthy tissue, the electrode in the form of a stretched string at the tip Parus apparatus of electrogastrogram "Photek-80". When the bleeding was performed aimed coagulation of a bleeding vessel. After the destruction of the skin evenly coated amorphous powder of Bismuth subgallate" layer thickness of 2 mm To soften the crust on the skin of the external nose applied the ointment "Bepanthene" for 18 days. Spontaneous rejection scab and complete epithelialization occurred on the 18th day.

In the postoperative period for the prevention of venous congestion was conducted treatment vasoprotection "Phlebodia" 2 tablets once a day for 60 days.

The technical result. This way JW is aetsa malotravmatichnye, bloodless treatment of rhinophyma that reduce pollingperiod period, to avoid deformation of the external nose, to get the maximum aesthetic result, and also to reduce the risk of recurrence development of rhinophyma.

At the Regional clinical hospital, on the basis of the ENT Department, we treated between 2007 and 2009 7 patients diagnosed with rhinophyma. Postoperative disease recurrence in patients was not recorded.

The method of treatment of rhinophyma, including excision of the modified newly formed tissue under local anaesthesia, wherein the pre-electrode in the form of a stretched string at the tip Parus apparatus of electrogastrogram "Photek-80" excised rhinopomatidae nodes, then cut in layers to healthy tissue, hypertrophic skin, which evenly cover the amorphous powder of Bismuth subgallate" with the formation of the surface layer with a thickness of 1-3 mm, which after 6-8 days after surgery mark ointment Bepanthene within 17-20 days in the postoperative period enter product "Phlebodia" within 60 days.



 

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