Rhinectomy; partial
CPT4 code
Name of the Procedure:
Partial Rhinectomy
Common name(s): Partial Nose Removal
Technical/medical terms: Partial Nasal Resection
Summary
A partial rhinectomy is a surgical procedure where a portion of the nose is removed. This may involve removing part of the nasal structures including skin, cartilage, or bone.
Purpose
This procedure addresses conditions such as malignant or benign tumors, severe trauma, or chronic infections of the nasal tissues that cannot be resolved with less invasive treatments. The goal is to remove the problematic tissue while preserving as much of the nose's appearance and function as possible.
Indications
- Malignant nasal tumors (e.g., squamous cell carcinoma, melanoma)
- Benign tumors that are causing symptoms
- Severe trauma leading to nonviable tissue
- Chronic infections not responsive to medical treatment
Preparation
- Patients may be instructed to fast for at least 8 hours before surgery.
- Antibiotics may be prescribed to prevent infection.
- Imaging studies such as CT scans or MRIs are often performed to delineate the extent of disease.
- Pre-operative assessment including blood tests and a detailed medical history is required.
Procedure Description
- Anesthesia: General anesthesia is typically administered.
- Incision: The surgeon makes an incision to access the affected portion of the nose.
- Tissue Removal: The diseased tissue is carefully excised, taking care to minimize damage to surrounding healthy structures.
- Reconstruction: If necessary, the surgeon may perform reconstructive techniques to repair the nasal structure, using grafts or flaps.
- Closure: The incision is closed with sutures, and the area is dressed appropriately.
Tools/Equipment Used:
- Scalpel
- Electrocautery device
- Micro-instruments for precise tissue handling
- Possible use of imaging guidance
Duration
The procedure typically takes 2 to 4 hours, depending on the complexity and extent of tissue removal and reconstruction needed.
Setting
The procedure is usually performed in a hospital operating room or an outpatient surgical center.
Personnel
- Otolaryngologist (ENT surgeon) or specialized head and neck surgeon
- Anesthesiologist
- Surgical nurses
- Possibly a plastic surgeon for reconstructive work
Risks and Complications
- Infection
- Bleeding
- Anesthesia-related complications
- Scarring or deformity
- Numbness or altered sensation
- Difficulty breathing through the nose
- Need for further reconstruction
Benefits
- Removal of diseased tissue, potentially curing malignancy or alleviating symptoms.
- Improved breathing, if nasal obstruction was an issue.
- Potentially reduced risk of the disease spreading or recurring.
Recovery
- Postoperative care includes nasal packing, which may need removal in a few days.
- Pain management typically involves analgesics.
- Patients need to keep the surgical site clean and follow specific care instructions.
- Recovery can take several weeks, with possible restrictions on physical activity.
- Follow-up appointments are necessary to monitor healing and assess for complications.
Alternatives
- Radiation therapy or chemotherapy (for malignant tumors)
- Less invasive surgeries or endoscopic procedures, if applicable
- Palliative care for non-resectable conditions
Pros and Cons:
- Surgery offers definitive tissue removal but comes with surgical risks and potential need for reconstruction.
- Non-surgical treatments might control the disease but may not be curative.
Patient Experience
During the procedure, the patient will be under general anesthesia and will not feel any pain. Post-surgery, there may be discomfort, swelling, and bruising around the nose. Pain management strategies and support measures will help ensure comfort, and patients may experience nasal congestion due to swelling or packing.