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- W2324961586 abstract "Sir: We read with interest the article entitled “The Cyrano Nose: Refinements in Surgical Technique and Treatment Approach to Hemangiomas of the Nasal Tip.”1 We congratulate the authors on their impressive results and their treatment algorithm for this difficult problem. Aggressive treatment of nasal hemangioma is the key to improved cosmetic outcome, and propranolol is now our preferred first-line treatment.2 In our experience, propranolol causes not only an almost immediate halt in hemangioma proliferation but also significant regression in 87 percent of patients. It has a good safety profile. Early aggressive treatment often avoids the long-term sequelae of nasal deformity and thus the need for future surgery (Fig. 1).Fig. 1.: Appearance of the nose before (left) and after (right) treatment with propranolol. No surgery was needed to correct any residual deformity.If surgery is needed to correct a Cyrano nose, we prefer the use of the modified subunit approach.3 It is easy to perform, does not cause alar rim retraction, allows good surgical exposure, and, more importantly, enables control of the lateral excess skin of the nasal tip, resulting in a slimmer nose. The disadvantage of the approach is the external scar, which we find improves with time and is hidden in the nasal groove. PATIENT CONSENT Parents or guardians provided written consent for the use of the patient's images. Anuj Mishra, M.R.C.S. William J. M. Holmes, M.R.C.S. Sehwang Liew, F.R.C.S. Vascular Birthmark Centre Alder Hey Children's Hospital Liverpool, United Kingdom" @default.
- W2324961586 created "2016-06-24" @default.
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- W2324961586 date "2011-06-01" @default.
- W2324961586 modified "2023-10-17" @default.
- W2324961586 title "The Cyrano Nose: Different Treatment Approaches to Management of Hemangiomas of the Nasal Tip" @default.
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- W2324961586 doi "https://doi.org/10.1097/prs.0b013e318213a30b" @default.
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