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Laryngorhinootologie 2020; 99(11): 772-778
DOI: 10.1055/a-1208-5284
Übersicht

Übersicht und aktuelle Empfehlung zur Therapie des Rhinophyms

A systematic review and current recommendation for treatment of rhinophyma
Jamal Huseynov
1   HNO-Heilkunde, Kopf- und Halschirurgie, Schwarzwald-Baar-Klinikum Villingen-Schwenningen GmbH, Villingen-Schwenningen, Germany
,
Christian Mozet
2   HNO, Schwarzwald-Baar-Klinikum Villingen-Schwenningen GmbH, Villingen-Schwenningen, Germany
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Zusammenfassung

Als Rhinophym wird eine benigne Hautveränderung der äußeren Nase bezeichnet, die durch eine Hypertrophie der Talgdrüsen gekennzeichnet ist. Betroffen sind meistens männliche Kaukasier zwischen der 5. und 7. Lebensdekade. Die Ätiologie der Erkrankung ist bisher nicht vollständig geklärt, sie wird jedoch als Spätstadium der Acne rosacea betrachtet. Ein äthyltoxischer Zusammenhang, wie bisher vermutet wurde, ist bis dato nicht belegt worden. Der Artikel gibt einen Überblick über mögliche operative und konservative Therapieansätze. Die chirurgische Therapie stellt dabei den Goldstandard dar. Dabei erweist sich der Einsatz der Elektroschlinge zur subtilen Resektion und die Verwendung der monopolaren Kugel zur Feinmodulation als besonders vorteilhaft. Aufgrund einer möglichen Koinzidenz des Basalzell- oder Plattenepithelkarzinoms im Rhinophymgewebe, erscheint eine histopathologische Aufarbeitung des abgetragenen Gewebes sinnvoll.

Abstract

Rhinophyma is a benign disease involving the skin of the nose, which is characterized by skin thickening and hypertrophy of the sebaceous glands and connective tissue. It occurs predominantly by Caucasians in their fifth to seventh life decades and is 12–30 times more likely to affect males. The etiology and pathogenesis of Rhinophyma remains unclear, however it is generally stated to be the final stage of rosacea. A causative relationship between rhinophyma and alcohol consumption has not yet been proven. This review highlights the treatment options of rhinophyma. Surgery is gold standard for management of advanced rhinophyma. Each technique has pros and cons, but using surgical instruments with monopolar energy as loop and ball electrode seem to combine several goals best – first of all simultaneous removal and hemostasis followed by nasal contour refinement. Due to possible coincidence of skin cancer such as a basal- or squamous cell carcinoma, histopathological examination of all removed tissue is recommended.

Schlüsselwörter

Rhinophym - Rosazea - Hautkarzinome - Alkoholkonsum - Elektrochirurgie

Key words

rhinophyma - rosacea - skin cancer - alcohol consumption - electrosurgery


Publication History

Received: 18 September 2019

Accepted: 25 June 2020

Article published online:
27 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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