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Rinofima severo
Tronocoso R,Antonio; Torrealba P,Ramón; Bozán S,Fernando; Lazo C,ángel;
Revista chilena de cirugía , 2012, DOI: 10.4067/S0718-40262012000200015
Abstract: rhinophyma is a progressively growing benign tumor that has the ability to distort the nasal form. even though, it is considered a rare subtype of rosacea, it is of great importance for the ability to create: psychic, aesthetic and functional disorders. this report describes a severe case of rhinophyma in a 52 years old male patient, the medical treatment and the surgical technique used for removal.
Tratamiento del rinofima con láser de CO2: Presentación de un caso Treatment of rhinophyma with CO2 laser: A case report  [cached]
J.L. Cebrián Carretero,G. Demaría Martínez,J.L. del Castillo Pardo de Vera
Revista Espa?ola de Cirugía Oral y Maxilofacial , 2006,
Abstract: Introducción. El rinofima es una alteración cutánea de la región nasal que produce problemas estéticos importantes. Describimos nuestra experiencia en un caso de rinofima avanzado y su resolución por medio de una técnica sencilla. Material y métodos. Previa desinfección cutánea se realizó anestesia infiltrativa y bloqueo troncular de nervios infraorbitarios y etmoidales. A continuación se realizó la resección de casi todo el espesor cutáneo con un láser de CO2 Lumenis Sharplan conservando la dermis profunda para permitir la curación por segunda intención. Posteriormente se aplicó vaselina y se realizaron curas y lavados diarios. El paciente fue dado de alta al día siguiente de la intervención. Resultados. Los resultados estéticos fueron muy buenos. El dolor postoperatorio fue controlado con analgesia habitual. En la primera semana se objetivaba un buen grado de cicatrización. A los 2 meses la reepitelización fue completa y ya no se observaban costras ni eritema. Conclusión. La utilización del láser de CO2 en el tratamiento del rinofima avanzado logra unos excelentes resultados estéticos con una morbilidad y riesgo operatorio mínimos. Introduction. Rhinophyma is a skin alteration of the nasal region that causes considerable aesthetic problems. We describe our experience with a case of advanced rhinophyma and its resolution by means of a simple technique. Materials and methods. The skin area was disinfected beforehand, anaesthesia infiltration and the infraorbital and ethmoidal nerve trunks were blocked. Then, using a Lumenis Sharplan CO2 laser almost the complete skin thickness was resected while preserving the deep dermis layer so as to allow second intention healing. Later, Vaseline was applied and the area was treated daily. The patient was discharged the day after the intervention. Results. The aesthetic results were very good. Postoperative pain was controlled with standard analgesics. Adequate healing was observed during the first week. Two months later the epithelization was complete and no scabs or erythema remained. Conclusion. The use of the CO2 laser for the treatment of advanced rhinophyma is an adequate therapy that provides excellent aesthetic results, with minimal morbidity and surgical risk.
Trastorno mental severo = Severe mental disorder
Villa Pillado, L,Area Carracedo, R,Ferro Iglesias, V,González Domínguez-Viguera, L
TOG : Revista de Terapia Ocupacional de la APGTO , 2007,
Abstract: RESUMEN Este artículo trata sobre los programas de Trastorno Mental Grave ( o Severo). Se exponen los diferentes formas de abordaje para un tratamiento comunitario, el tipo de personal encargado de realizarlo, las características de la población a la cual se dirige, y los objetivos que se persiguen con la instauración de dicho programa.ABSTRACThis article treats on the programs of Serious Mental Disorder (or Severe). The different forms to develop a treatment on the community are exposed, and also the type of personnel in charge to make it, the characteristics of the population to which it is destinated, and the goals that we pretend to obtain with this program.
Basal Cell Carcinoma Masked in Rhinophyma  [PDF]
Daniele De Seta,Francesca Yoshie Russo,Elio De Seta,Roberto Filipo
Case Reports in Otolaryngology , 2013, DOI: 10.1155/2013/201024
Abstract: Rhinophyma, the advanced stage of rosacea, is a lesion characterized by progressive hypertrophy and hyperplasia of sebaceous glandular tissue, connective tissue, and blood vessels. Rhinophyma can lead to a significant facial disfigurement and severe emotional distress, but it is not only an aesthetic problem, since rare cases of simultaneous presence of malignant tissue are described in the literature. The case of an 84-year-old farmer affected by basal cell carcinoma (BCC) and diagnosed in the context of rhinophyma is presented. The anatomical distortion produced by the chronic inflammation and fibrous scarring makes the BCC diagnosis difficult and uncertain. The histological examination of the entire mass and its margins is fundamental. A partial biopsy can lead to a false negative result, and the histological examination must be repeated intra- or postoperatively. 1. Introduction Basal cell carcinoma (BCC) represents about 75–90% of skin cancers [1, 2]. 85% of these tumors are located in the head and neck area, the majority of these affecting the nose [3]. Fair skin phenotype and sun exposure are important risk factors for this kind of tumor unlike other skin lesions. Although slow growing and unlikely to metastasize, these tumors may have an indolent course and are prone to recur if inadequately treated [1, 2]. If neglected, tumor-related destruction of anatomic features may create difficult reconstructive challenges. In aggressive forms of BCC, associated with extensive dermal invasion and destruction of collagen, the identification of tumor borders can be difficult [4]. Clinical diagnosis can be difficult as the characteristics of the carcinomatous lesions may be masked by the background of soft tissue hypertrophy and distortion seen in gross rhinophyma. Rhinophyma is a rare condition caused by a progressive hypertrophy of sebaceous glandular tissue, connective tissue, and blood vessels. It is considered to represent the final stage of severe rosacea, although it may occur in patients with few or no features of rosacea [5]. Caucasian people between 45 and 60 years old, with a male-female ratio of 5/1–30/1, are more frequently affected by rhinophyma, while it is slightly present in the black people [6]. Its etiology remains unknown, even though several causes have been proposed, including vitamin deficiencies, stress, androgenic hormone influences, and chronic infections by the Demodex folliculorum mite [7]. Convincing evidence for a causal relationship between malignancy and rhinophyma is currently lacking [8]; nevertheless, some cases of BCC are
Rapid Treatment of Rhinophyma with Powered Microdebrider  [PDF]
C. Faris,J. G. Manjaly,H. Ismail-Koch,S. Caldera
Case Reports in Otolaryngology , 2013, DOI: 10.1155/2013/621639
Abstract: We describe here our experience in using sinus microdebrider to rapidly debulk and sculpt the tissues in cases of rhinophyma correction. We utilized the use of the 4?mm M4 Rotatable Cutting Straight Sinus Blade on a straight Straightshot M4 Microdebrider by Medtronic at 800 rpm oscillation which is normally utilised in our sinus surgery practice. The microdebrider is straightforward to use and is already stocked in most ENT departments. It requires no additional training or cost outlay for departments that perform endoscopic sinus surgery with microdebrider. In our experience it affords the surgeon the ability to rapidly and accurately sculpt the nose to an excellent aesthetic result. We feel it is a more precise tool than cold steel or Bovie cautery, quicker than CO2 laser techniques, and avoids the aerosol of dermabrasion. No complications occurred in our series, and all patients rated their cosmetic outcome as good to excellent. 1. Introduction Rosacea is a common condition with classic symptoms such as intermittent patchy flushing, erythema, and inflammation. It has a predilection for the face particularly on the cheeks, nose, forehead, and around the mouth. Rosacea typically appears between the ages of 30 and 50 and affects more women than men. It runs a chronic course with a small minority of patient progressing to phymas (Greek = swelling, mass). Rhinophyma occurs almost exclusively in men. In one study of 108 patients with rosacea only 14% of patients were suffering from rhinophyma and 93% were men [1]. The tumour-like phymas progressively enlarge in size causing increasingly overt deformity. Rhinophyma may lead to social stigmatisation as there is a frequent incorrect causal association with the condition being self-inflicted by excess alcohol intake, the “Whiskey nose”, or through facial deformity in severe cases. Over time as the rhinophyma enlarges the excess weight of the phymatous tissue on the alar can lead to collapse of the internal and external nasal valves with resulting functional nasal obstruction. Surgical reduction is indicated when there is significant enlargement of the soft tissues [2]. We describe our experience using rapid sculpting of the phymatous tissues of the nose using the Straightshot M4 Microdebrider normally utilized in sinus surgery in 3 patients. 2. Technique All cases were performed under general anaesthesia. The surgical field was prepared with Betadine an aqueous solution of 10% povidone-iodine. The nose is injected with local anesthetic lignocaine 2% with 1 in 80,000 adrenaline. Initially a ring block around
Do we really need high technology for excision of rhinophyma?  [cached]
Ozkiris Mahmut,Kubilay Utku,Unver Seref
Journal of Oral and Maxillofacial Pathology , 2007,
Abstract: Rhinophyma is a rare disease that primarily affects Caucasian men in the fifth to seventh decades of life, characterized by a progressive thickening of nasal skin, which produces a disfiguring soft-tissue hypertrophy of the nose. Severe cosmetic deformity and impairment of breathing may coexist, making surgical treatment necessary. A 64-year-old patient who had diagnosis of rhinophyma is discussed, along with the surgical modalities.
Use of laser therapy in the treatment of rhinophyma. Zastosowanie laseroterapii w leczeniu rhinophyma.
Magdalena Kiedrowicz,Anita Huryń,Andrzej Królicki,Stanis?awa Bielecka-Grzela
Clinical Dermatology , 2009,
Abstract: Rhinophyma is the most advanced stadium of rosacea. The presented case report concerns a 68-year-old patient treated due to rhinophyma with the use of CO2 laser. Satisfactory aesthetic and curative effect was obtained after the procedure. The carbon dioxide laser therapy is a safe and efficient method of the treatment of rhinophyma lesions with a low risk of complications.
Tumor carcinoide de ovario asociado con estre imiento severo Ovarian carcinoid tumor associated to severe constipation
Mario Arturo González Mari?o,ángela Jaramillo,Rocío López
Revista Colombiana de Obstetricia y Ginecología , 2002,
Abstract: Se describe el caso de una paciente con estre imiento severo, refractario al tratamiento médico, a quien se realizó laparotomía por hallazgo de masa anexial que fue reportada como tumor tipo carcinoide estrumal de ovario. En el posoperatorio hubo mejoría de su cuadro de estre imiento, lo cual posiblemente esté explicado por la remoción del tumor productor del péptido YY. Se presentan datos clínicos, patológicos y se hace una revisión de la literatura. We present a patient with severe constipation, unresponsive to medical treatment, who was operated because of a pelvic mass which was reported as an ovarian strumal carcinoid on pathology examination. At the postoperative period, stools were more frequent, possibly because of resection of the peptide YY producing tumor. The clinical features and pathologic findings are presented here. A review of the literature is made.
Presentación de dos casos de traumatismo palpebral severo Presentation of two cases of severe palpebral traumas  [cached]
Alexander Pérez Llanes,Francis Yalile Cárdenas Pérez,Yaima Hernández Sánchez,Bárbara Estrada Amador
Revista Cubana de Oftalmolog?-a , 2012,
Abstract: Los traumatismos de los anejos oculares son frecuentes, debido a la ubicación anatómica de estas estructuras y cumplir con una de sus principales funciones de protección del globo ocular. Se pueden clasificar en afecciones traumáticas de párpados, conjuntiva, órbita y traumas del aparato lagrimal. Según los datos aportados por el United States Eye Injury Registry, las lesiones de los anejos oculares constituyen el 5 % de todos los traumas oculares y las más frecuentes con 81 % son las laceraciones canaliculares. Se presentan dos casos de pacientes masculinos con diagnóstico de trauma palpebral severo (avulsión palpebral) que fueron atendidos en el servicio de urgencia y recibieron tratamiento quirúrgico con evolución satisfactoria. El reporte de estos casos nos permite un mejor manejo en el diagnóstico y tratamiento de los traumas palpebrales severos. The ocular adnexal traumas are common due to the anatomical location of these structures, and the fulfilling of one of its main duties, that is, the protection of the eyeball. They are classified into traumatic conditions of the eyelids, the conjunctiva, the orbit, and lachrymal system traumas. According to data provided by the United States Eye Injury Registry, the ocular adnexal injuries account for 5 % of all ocular traumas, and the most common are canalicular lacerations with 81 %. Two cases of male patients diagnosed with severe eyelid trauma (eyelid avulsion) were presented. They had been treated in the emergency department; they had undergone surgical treatment with satisfactory results. The report of these cases allows us to better manage the diagnosis and treatment of severe palpebral traumas.
Características craneofaciales en pacientes con desgaste dentario severo Craniofacial characteristics in patients with severe toothwear
Raúl Frufone Z,Roberto Pantoja Parada
Revista Facultad de Odontología Universidad de Antioquia , 2010,
Abstract: INTRODUCCIóN: con la finalidad de contrastar la hipótesis nula "no existen diferencias significativas en las características arquitecturales y estructurales craneofaciales entre individuos con y sin desgaste dentario" se realizó un estudio analítico, no experimental de casos y controles en pacientes que consultaron por tratamiento prostodóncico u ortodóncico. MéTODOS: la muestra quedó conformada por 26 pacientes con desgate dentario severo (estudio) y 52 pacientes sin desgaste dentario (control). El grupo control se obtuvo por pareamiento según sexo, rango de edad y ángulo de la base de cráneo. Todos ellos poseían estabilidad oclusal y no presentaban tratamiento ortodóncico previo, procedimientos quirúrgicos maxilofaciales ni patologías de crecimiento y desarrollo. Se utilizó un cefalograma específicamente dise ado que incluyó los parámetros arquitecturales y estructurales del análisis de Delaire. Para el análisis de los datos fueron utilizados el t Test y el Chi cuadrado dependiendo de la naturaleza de los datos. RESULTADOS: diferencias significativas fueron encontradas particularmente a nivel del hueso basal maxilar y mandibular y en la posición del plano oclusal real respecto al plano oclusal teórico. CONCLUSIONES:se concluyó que en pacientes con desgaste dentario severo, se produce una modificación del hueso basal y mandibular por remodelación del proceso dentoalveolar que resulta en una rotación craneal del plano oclusal. Se observa aparente estabilidad de la altura facial y del ángulo mandibular a pesar del cambio obvio de la posición del plano oclusal. INTRODUCTION: in order to test the null hypothesis "there are no significant differences in the craniofacial architectural and structural characteristics among individuals with and without severe tooth wear", a non experimental analytic case control study was carried out with patients who consulted for prosthodontic or orthodontic treatment. METHODS: 78 patients between 22 and 55 years of age participated. The experimental group consisted of 26 patients between 29 and 55 years of age (9 women and 17 men). The control group consisted of 52 patients between 22 and 50 years of age (18 women and 34 men) matched by gender -age range and posterior cranium base angle. All of them had occlusal stability, without previous orthodontic treatment, surgery or growth and development alterations. The measuring instrument was a specifically designed cephalogram which included the architectural and structural parameters from Delaire’s Analysis, combined with some extra radiographic points defined by the authors for
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