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Treatment of facial haemangiomas: the present status of surgery
E C Demiri1, P Pelissier, T Genin-Etcheberry
1Department of Plastic, Reconstructive, Hand Surgery and Microsurgery, Hôpital du Tondu, Bordeaux, France.
Insights
Surgical treatment for facial hemangiomas is recommended when complications arise, even in infants. Early intervention for facial hemangiomas can prevent severe issues and yield excellent outcomes.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Dermatology
Background:
- Facial hemangiomas, though often managed conservatively in infants, can lead to significant complications.
- Surgical intervention is indicated for facial hemangiomas presenting with severe complications or functional disturbances.
Purpose of the Study:
- To evaluate the outcomes of surgical treatment for facial hemangiomas in a cohort of 35 patients.
- To determine the optimal timing for surgical intervention based on hemangioma location, size, and associated complications.
Main Methods:
- Retrospective review of 35 patients (23 female, 12 male) aged 2.5 months to 35 years who underwent surgical treatment for facial hemangiomas.
- Surgical techniques were tailored to lesion location and size, focusing on tumor resection and reconstruction.
- Patients were categorized based on the age at surgery: early (before 2 years), intermediate (2-5 years), and late (older age).
Main Results:
- 35 patients underwent surgical treatment for facial hemangiomas.
- Early surgery (before 2 years) was performed in 6 patients due to complications like visual occlusion and bleeding.
- 16 patients had surgery between 2-5 years, and 13 patients were treated at an older age.
- Postoperative outcomes were highly satisfactory across all age groups.
Conclusions:
- Early surgical intervention is crucial for periocular hemangiomas to prevent amblyopia and for labial tumors causing feeding difficulties.
- Surgical treatment for nasal-tip hemangiomas is recommended to prevent cartilaginous distortion.
- Facial hemangiomas causing functional impairment or psychological distress warrant surgical excision before expected spontaneous regression for excellent results with minimal morbidity.
Abstract:
Although conservative management is usually proposed for haemangiomas occurring in infancy, the presence of these tumours on the face may result in severe complications and provide an indication for treatment. In this paper, we report 35 patients who underwent surgical treatment for facial haemangiomas. The series consists of 23 females and 12 males, ranging in age from 2.5 months to 35 years. In six patients early surgery, before the age of 2 years, was performed because of severe complications, including visual occlusion, repeated bleeding and distortion of adjacent structures. In 16 children surgical resection of haemangiomas was carried out between 2 and 5 years of age, before complete involution. In 13 patients persisting haemangiomas were surgically treated at an older age. The operative technique depended on the location and size of the lesion, and focused on resection of the tumour and reconstruction of the adjacent structures when necessary. The postoperative outcomes were very satisfactory. Early surgery is mandatory in the management of large periocular haemangiomas, to prevent secondary amblyopia, and proliferative labial tumours, which are prone to bleeding and cause difficulty while eating. Early surgical treatment is also recommended for nasal-tip haemangiomas, which regress very slowly and may result in severe distortion of the cartilaginous framework. In conclusion, facial haemangiomas causing functional disturbance or serious psychological distress deserve surgical excision before the age of expected spontaneous regression; surgery can provide active treatment with excellent results and minimal morbidity.
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