Debulking external nasal cystic carcinoma vs subcutaneous tissue

michiboo

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Trying to figure this out, if anyone can help please.. going back and forth .. new to nasal procedures

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PREOPERATIVE DIAGNOSIS: Nasal adenoid cystic carcinoma

POSTOPERATIVE DIAGNOSIS: Same

PROCEDURE/SURGERY: Debulking of external nasal adenoid cystic carcinoma and intermediate layered closure, nasal endoscopy and control of bilateral epistaxis.

SURGEON: xxxx

ANESTHESIOLOGIST: xxxxx

ANESTHESIA TYPE: general anesthesia

ESTIMATED BLOOD LOSS: 30 mL

COMPLICATIONS: None

FINDINGS: 3 cm firm subcutaneous pale mass

SPECIMENS: nasal tumor

INDICATIONS FOR SURGERY: bulky tumor causing distortion of the external nose

SUMMARY OF PROCEDURE: - Under general anesthesia in the supine position after injecting local anesthesia to the nasal bridge, a 3 cm horizontal incision was created. The subcutaneous tissue and muscle was incised with electrocoagulation. A mushy, loosely aggregated tumor was identified. The tissue is friable and mildly bloody. It is debulked. A 3 x 2.5 cm portion of tumor was removed piecemeal. The dissection kept inferior to the medial canthus to avoid manipulating the skull base.  Bleeding was self-limited.  The subcutaneous tissue was closed with 4-0 chromic for the subcutaneous layer and 4-0 chromic subcuticular suture.

Applied topical oxymetazoline on cottonoids for 5 minutes.  Using a zero degree nasal endoscope, the nasal cavities were inspected.   There is mild-moderate superior nasal cavity tumors with dilated vessels.  The tumors and vessels were electrocoagulated with bipolar forceps at 10 Watts.   The procedure was the same for both sides.
 
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