RU2360635C1 - Method of treatment of rhinophyma - Google Patents

Abstract

FIELD: MEDICINE.

SUBSTANCE: invention concerns medicine and can be used for rhinophyma treatment. For this purpose the hypertrophied tissue is exsected by the 810 nanometres long wave surgical laser with 0.2-0.5 second duration of impulse of and 12 W power of radiation. Then 0.2 g of 0.1 % radachlorine gel is applied on the amazed surface on 1 cm² of a surface by a 2 hours exposition under a lightproof bandage. After excision of the gel, the surface is treated by light of the laser with wavelength of 662 nanometres and 200 J/cm² dose of light energy. Thus influence is carried out in a non-contact manner. As a source of laser radiation a diode laser apparatus for photodynamic therapy "LAHTA-MILON" can be used.

EFFECT: way allows reducing traumatism, to prevent cosmetic defects and postoperative complications, to reach fast and steady disappearance of inflammatory reaction, to stop hypertrophic growth of tissues and to avoid disease relapses.

2 cl, 2 ex

Description

The invention relates to medicine, namely to photodynamic therapy, and can be used to treat rhinophyma.

A known method of treating rhinophyma with surgical knife excision within healthy tissues. (Gyusan A.O. Two observations of rhinophyma // Journal of Ushn. Nose and mountains. - 1990; 5: 65-67; Mirinova L.G. Medical cosmetology. - M., 2000. - 217 p.) . However, with this method, the recurrence of the disease remains high, the appearance of a cosmetic defect in the form of a postoperative scar, and frequent complications in the form of a secondary infection.

The prototype of the invention is a method for the surgical treatment of rhinophyma, which consists in performing an anterior vestibular incision of the skin of the nose, after which the skin of the nose is separated from the underlying tissues from the wing cartilage of the nose, cartilage and bone of the nose, subcutaneous excision of the altered newly formed tissue is performed using high-intensity laser radiation a diode laser with a wavelength of 0.97 μm with a power of 5-8 W in a continuous mode, then the wound surface is covered with a saved skin flap and a w you (patent RU 2272589, 2006).

The technical result of the proposed method is to reduce the invasiveness of the method, the prevention of cosmetic defects and postoperative complications.

The specified technical result is achieved due to the fact that in the method of treating rhinophyma, including excision of hypertrophic tissue, the excision is performed with a surgical laser with a wavelength of 810 nm, a pulse duration of 0.2-0.5 seconds, a radiation power of 12 W, and then onto the affected surface 0.1% gel of radachlorin is applied in a dose of 0.2 g per 1 cm ² surface, exposure for 2 hours under a lightproof dressing, and after removing the gel, the entire surface is treated with laser light at a wavelength of 662 nm at a dose of light energy of 200 J / cm ² , this cart The action is carried out contactlessly.

The proposed method for the treatment of rhinophyma is as follows: after excision of hypertrophic skin areas with a surgical laser, a photosensitizer is applied to the affected surface - 0.1% radachlorin gel at a dose of 0.2 g per 1 cm ² surface and cover it with a lightproof dressing. After 2 hours of exposure, the light-tight bandage is removed, the gel residues are removed with a gauze and the surface is treated with laser light at a wavelength of 662 nm at a dose of light energy of 200 J / cm ² , the effect is contactless using a light guide with a microlens.

Dynamic monitoring is carried out after 1 week, 10 days, 1 month, 6 months and 12 months after treatment.

The authors in the patent and medical literature did not find information about the fame of the proposed method for the treatment of rhinophyma using photodynamic therapy. Thus, the claimed invention meets the criterion of "novelty."

The authors found for the first time that the above set of distinguishing features of the method causes a rapid and stable disappearance of the inflammatory reaction, the cessation of hypertrophic proliferation of tissues and the absence of relapse of the disease, which allows to obtain the specified technical result. Thus, the claimed invention meets the criterion of "inventive step".

The proposed method is illustrated by the following examples.

Example 1. Patient K., 48 years old. Complaints upon receipt of a significantly enlarged and deformed nose due to the tuberous growths of the bluish-red color of a soft consistency, as well as burning sensations in places of rashes. Considers himself ill for about 3 years. Based on the history and clinical picture, the patient was diagnosed with rhinophyma.

The patient underwent excision of hypertrophied nasal tissue with a surgical laser with a wavelength of 810 nm, a pulse duration of 0.2-0.5 seconds, and a radiation power of 12 W. Then, a photosensitizer — 0.1% radachlorin gel in a dose of 0.2 g per 1 cm ^{2 of the} surface — was applied to the entire affected surface. After that, the affected area was covered with a lightproof bandage. After 2 hours of exposure, the opaque dressing was removed and excess radachlorin gel was removed with a gauze. After that, the entire surface was treated with laser light at a wavelength of 662 nm at a dose of light energy of 200 J / cm ² , the effect was carried out non-contact using a fiber with a microlens. At the control examination 1 week after the treatment session, the patient does not show complaints. The area of the skin that underwent photodynamic therapy is covered with a serous-bloody crust, there is no discharge. Control inspection after 10 days. The patient does not show complaints. The crust on the skin became thinner and decreased in size, there is no detachable. A follow-up examination after 1 month - no complaints, the crust separated on the 18th day after photodynamic therapy, the entire treated surface without signs of inflammation and hypertrophic growths. At the follow-up examination after 6 months, the patient does not complain, the treated area is covered with delicate skin, slightly pink. Control examination 12 months after treatment - no complaints, the skin is clean, slightly whitish, with no signs of activation of the process and keloid growths.

Example 2. Patient S. 61 years. Complaints upon receipt of the presence of tuberous growths of bluish-red color of soft consistency on the nose. On the surface of the growths, numerous branched dark red telangiectasias are observed, as well as hemispherical pink-red papules with a diameter of 0.2-0.3 cm. Considers himself a patient for 4 years. Based on the history and clinical picture, the patient was diagnosed with rhinophyma.

The patient underwent excision of hypertrophied nasal tissue with a surgical laser with a wavelength of 810 nm, a pulse duration of 0.2-0.5 seconds, and a radiation power of 12 W. Then a photosensitizer was applied to the entire affected surface - 0.1% radachlorin gel at a dose of 0.2 g per 1 cm of surface. After that, the affected area was covered with a lightproof bandage. After 2 hours of exposure, the light-tight bandage was removed and excess gel was removed with a gauze. After that, the entire surface was treated with laser light at a wavelength of 662 nm at a dose of light energy of 200 J / cm ² , the treatment was carried out non-contact with a light guide. At the control examination 1 week after the treatment session, the patient does not show complaints. The area of the skin that underwent photodynamic therapy is covered with a serous-bloody crust, there is no discharge. Control inspection after 10 days. The patient does not show complaints. The crust on the skin became thinner and decreased in size, there is no detachable. A follow-up examination after 1 month - no complaints, the crust separated on the 18th day after photodynamic therapy, the entire treated surface without signs of inflammation and hypertrophic growths. At the follow-up examination after 6 months, the patient does not complain, the treated area is covered with delicate skin, slightly pink. Control examination 12 months after treatment - no complaints, the skin is clean, slightly whitish, with no signs of activation of the process and keloid growths.

This method treated 12 patients with various types of rhinophyma. In all cases, the specified technical result was achieved. The proposed method is easily reproducible in a hospital environment. Thus, the claimed invention meets the criterion of "industrial applicability".

Claims (2)

1. A method of treating rhinophyma, including excision of hypertrophic tissue, characterized in that the excision is performed with a surgical laser with a wavelength of 810 nm, a pulse duration of 0.2-0.5 s, a radiation power of 12 W, after which 0.1 is applied to the affected surface % radachlorin gel at a dose of 0.2 g per 1 cm ² surface, exposure 2 hours under a lightproof dressing, and after removing the gel, the surface is treated with laser light at a wavelength of 662 nm at a dose of light energy of 200 J / cm ² , while the effect non-contact. 2. The method according to claim 1, characterized in that as a source of laser radiation using a diode laser apparatus for photodynamic therapy "LAHTA-MILON".