Persistent Nasal Infantile Hemangioma: A Surgical Treatment Algorithm

Area of Science:

• Plastic Surgery
• Pediatric Dermatology
• Otolaryngology

Background:

• Infantile hemangiomas often require medical treatment, but persistent nasal lesions with fibro-fatty components may necessitate surgical intervention.
• The nose is a critical aesthetic and functional facial unit, making surgical management of hemangiomas crucial for optimal outcomes.
• Mixed infantile hemangiomas show a higher propensity for persistence, impacting nasal aesthetics and function.

Purpose of the Study:

• To analyze the surgical treatment outcomes for persistent nasal hemangiomas.
• To review the literature and propose an algorithm for surgical management of nasal hemangiomas.
• To evaluate the aesthetic results and complications associated with surgical nasal hemangioma treatment.

Main Methods:

• Retrospective analysis of 23 patients with persistent nasal hemangiomas treated surgically between 1996 and 2014.
• Data collected included hemangioma subtype, evolution phase, affected nasal subunit, prior treatments, surgical technique, complications, and follow-up.
• Postoperative aesthetic results were assessed using the Strasser scale.

Main Results:

• The average age of patients was 6.8 years; mixed hemangioma was the most common subtype (83%).
• Surgery was predominantly performed during the involution phase (87%), with the nasal tip being the most affected subunit (44%).
• The open rhinoplasty approach was the most frequent surgical technique, yielding acceptable aesthetic results (3 excellent, 15 good, 5 regular) with no reported complications.

Conclusions:

• Surgical treatment is effective for persistent nasal hemangiomas, offering acceptable aesthetic results and a low complication rate.
• Mixed infantile hemangiomas may require surgical intervention more frequently due to their persistence.
• Further research is needed to fully understand the surgical management nuances and long-term outcomes of nasal hemangiomas.