Pacient: M. A., barbat, 59 de ani

Diagnostic: rinofima de dimensiuni medii.

Tratament preoperator. Tratament medicamentos (antibiotice, AINS si medicatie anti-virala) pentru reducerea portiunii inflamatorii. In locul vechii proceduri - decorticarea nasului - am preferat un laser cu CO₂ la o putere de 15 W cu unda continua si in mod defocalizat. Tehnica tratamentului laser: ablatie strat cu strat (vaporizare) a hipertrofiei glandelor sebacee sub anestezie locala (tronculara), dar nu prea adanca din cauza riscului de a produce o cicatrice inestetica.

Tratamentul postoperator: unguent cu antibiotic si pansament neaderent. Curatarea plagii cu peroxid (3x/zi).

Rezultate: reepitelizarea a fost completa in 4 saptamani. Eritemul reactiv si un mic grad de edem raman pentru 2 luni. Rezultatul estetic a fost perfect. Nasul a fost readus la forma initiala fara sa apara cicatrici.

Particularitatea cazului: tehnica speciala necesara acestei afectiuni si necesitatea unui operator antrenat.

Concluzii: laserul cu CO₂ utilizat in mod continuu si defocalizat este capabil sa indeparteze eficient, sigur si estetic intreaga leziune, in conditiile utilizarii tehnicii adecvate de catre un operator antrenat. Principalele avantaje ale tehnicii sunt: gradul mare de precizie si campul operator fara sange.

Patient: M. A., male, 59 years old

Diagnosis: moderate to large-sized rhinophyma.

Pre-treatment care: medical therapy (antibiotics, AINS and anti-viral medication) for clearing of the inflammatory portion. Instead of the old procedure - decortication of the nose - we prefered a CO₂ laser at 15 W with a continuous beam in a defocused mode. Laser treatment - technique: layer by layer ablation (vaporization) of the sebaceus gland hypertrophy under local anesthetic (nasal block), but not too deep due to the risks of a poor scar.

Post-treatment care: antibiotic ointment and non-adherent gauze. Cleaning of the wound with peroxide (3x/day).

Results: re-epithelialization was complet in 4 weeks. Reactive erythema and a small degree of swelling remain for 2 months. The aesthetic result was perfect, the nose was reshaped without scars.

particularity of the case: the special technique according with this condition and the necessity of a skilled operator.

Conclusions: CO₂ laser used in CW and defocused mode are able to remove effective, safe and aesthetic the entire lesion, with the right technique and by a skiled operator. The main advantages of the technique are the high degree of precision and the completely bloodless field.