RESUMO
Background: A few studies have been published on the clinical efficacy and safety of nasal tip defatting plus rhinoplasty, particularly among people with bulbous noses. Therefore, the present study aimed to assess the consequences of nasal tip defatting for skin thickness reduction. Methods: This quasi-experimental study was performed on 72 consecutive patients, candidates for aesthetic rhinoplasty. Twenty-seven patients were scheduled for nasal tip defatting with routine open rhinoplasty concomitantly. Besides, 45 patients underwent rhinoplasty without nasal tip defatting method. Tip and supra-tip skin thickness were assessed before and 12 months after the operation using ultrasonography. The patients' and surgeon's satisfaction with aesthetic results after the operation were also evaluated based on visual analog scaling (VAS). SPSS version 16.0 (SPSS Inc., Chicago, IL., USA) was used for the analyses. P values below 0.05 were considered statistically significant. Results: Seventy-two patients (4 men, 68 women; mean age 26.40 ± 4.61 years) entered the study. Twenty-seven candidates underwent rhinoplasty plus nasal tip defatting (group A). Open rhinoplasty alone was performed for the other 45 patients (group B). The mean nasal tip thickness was 3.98±0.84 mm in group A and 3.69±0.64 mm in group B before the surgery (p=0.059). Preoperative nasal supra-tip thickness of the patients was also assessed using ultrasonography (3.54±0.72 mm in group A versus 3.73±0.54 mm in group B; p=0.065). Both preoperative tip and supra-tip thickness did not statistically differ between the two groups. No significant difference in postoperative tip skin thickness was obtained between two groups after 12 months (3.24±1 mm in group A versus 3.25±0.625 mm in group B; p=0.960), while postoperative supra-tip skin thickness differed significantly according to ultrasonography assessments (2.86±0.60 mm in group A versus 3.25±0.71 mm in group B; p=0.016). Postoperative satisfaction of the candidates was obtained using theVAS scoring system 12 months after the operation in both groups (8±1 in group A, 7.5±1 in group B; p=0.021). Surgeon's satisfaction in terms of the aesthetic outcome was also assessed based on the VAS system which did not statistically differ between the two groups as well as the patients' satisfaction (7.84±1.42 in group A, 7±1.61 in group B; p=0.014). Conclusion: Nasal tip skin defatting is the main component in aesthetic rhinoplasty, but its significant effect on the reduction of tip skin thickness is controversial. However, in patients with moderate or thick nasal tip skin, such a procedure can result in higher postoperative satisfaction with the aesthetic outcome compared to rhinoplasty alone.
RESUMO
Monkeypox (Mpox), an uncommon zoonotic Orthopoxvirus, is commonly manifested by blisters on the skin and has a mortality rate of approximately 0-10%. Approximately two decades after the cessation of global smallpox vaccination, the number of confirmed cases of Mpox has been growing, making it the most common Orthopoxvirus infection. Therefore, in this narrative review, we aimed to shed light on recent advancements in the pathophysiology, transmission routes, epidemiology, manifestations, diagnosis, prevention, and treatment of Mpox, as well as the application of artificial intelligence (AI) methods for predicting this disease. The clinical manifestations of Mpox, including the onset of symptoms and dermatologic characteristics, are similar to those of the infamous smallpox, but Mpox is clinically milder. Notably, a key difference between smallpox and Mpox is the high prevalence of lymphadenopathy. Human-to-human, animal-to-human, and animal-to-animal transmission are the three main pathways of Mpox spread that must be considered for effective prevention, particularly during outbreaks. PCR testing, as the preferred method for diagnosing Mpox infection, can enhance early detection of new cases and thereby improve infection control measures. JYNNEOS and ACAM2000 are among the vaccines most commonly recommended for the prevention of Mpox. Brincidofovir, Cidofovir, and Tecovirimat are the primary treatments for Mpox cases. Similar to other viral infections, the best approach to managing Mpox is prevention. This can, in part, be achieved through measures such as reducing contact with individuals displaying symptoms, maintaining personal safety, and adhering to practices commonly used to prevent sexually transmitted infections.