The Cyrano Nose: Refinements in Surgical Technique and Treatment Approach to Hemangiomas of the Nasal Tip
Bibliographic record
Abstract
BACKGROUND: Nasal tip hemangiomas cause significant parental distress and can negatively affect the psychological development of a child. Treatment is controversial, with numerous modalities available for reconstruction. The authors outline their combined medical and surgical approach to treating nasal tip hemangiomas and describe their preferred surgical technique. METHODS: A retrospective review was performed of all nasal tip hemangiomas presenting to the Multidisciplinary Vascular Anomalies Clinics at the Children's Hospital of Wisconsin and Children's Hospital of Michigan from 1999 to 2007. Parameters for review included onset age, symptoms, medical therapies (laser with or without steroid) used, age and status of lesion at time of surgery, outcomes, and complications. RESULTS: Twenty-five patients met inclusion criteria, with a mean onset age of 1.43 months. Most received steroids and pulsed dye laser therapy (mean no. of laser treatments, 3.5) during the proliferative and plateau phases of the tumor's natural history. Surgical resection after involution has been performed using an open rhinoplasty technique on 15 patients thus far. Eleven of them had surgical correction in the postinvolutional phase, and at parental request, four had early surgical correction during the proliferative-plateau phases. In the early treatment cohort, one child developed a hematoma postoperatively; the same patient required a revision rhinoplasty for alar rim asymmetry. Acceptable aesthetic results were obtained in both groups. CONCLUSIONS: A combined medical and surgical approach offers the best method to treat the Cyrano nose. The authors' treatment algorithm uses early medical management to accelerate involution of the lesion, providing optimal conditions for excision. Early surgical treatment also allows satisfactory results but may require secondary correction. An open rhinoplasty approach with skin resection is the authors' preferred technique.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".