| Background and ObjectiveSyringoma is a common benign tumor of the top gland ducts and more common in women. it occurs in the exposed parts, particularly around the eyes, affecting the patient’s appearance. As people’s living standards improved, the beauty treatment requirements of patients for syringoma around the eyes is increasing. Currently, although there are many therapy equipments and methods in clinical, such as topical1%atropine or Tretinoin acid, Chinese Herbs, excision, freezing, chemical peel, skin abrasion, radiofrequency, microwave, CO2laser, argon laser, Nd:YAG-KTP laser, bait laser, dot laser, high-frequency electric and joint therapy, every therapy method may have the side effects such as residual tumor, scar formation and postoperative inflammatory pigmentation, Because of equipment limitations and the handship of judging the therapy ending in surgical procedure, it is difficult to make the patient satisfy with the final treatment effects, Even if the dot laser, although having less side effects such as scarring postoperative, inflammatory and hyperpigmentation,what is more, is prone to leave residual tumor and require multiple surgical operation repeatedly, which also reduces the patient’s compliances. Most patients with syringoma or beauty consumers would like to get the most return on beauty only by withstanding a smaller pain, spending lowerly and in a easier way.We used improved high-frequency electrocautery treatment for syringoma around the eyes, hoping through one surgery and consequent treatment to achieve cosmetic results, as to resolve the current three clinical problems:scarring, residual tumor and pigmentation. Hence we can provide a more practical and effective treatment for clinical treatment of syringoma.Materials and Methods:1. subjects:effective in11cases, and all patients are females, ageing from17to48years。 There are a total of343lesions, the skin types are III to IV, of which diameter <1mm are84,>3mm are46. All patients did not receive any other forms of treatment.2. Diagnosis Basis:All patients, refusing clinical biopsy, were diagnosed based on clinical features, mainly scattering1～3mm dense yellowish papules around the eyes, some integration into small patches with unclear boundaries between them.3. Apparatus:LK-3-type high-frequency electrocautery was from Guilin Li Electronics Co., Ltd. The electrode tip curvature was changed to the size of acupuncture needles for cosmetology (size19um×13mm). The output mode is short-fire and the output voltage was the minimum of the device (1v).Fuji digital camera photo was selected (S2000HD, Fuji in Japan, produced in Vietnam,) and keep the supermicro distance photo of the lesions and facial micro-digital ones, respectively,.Normal shadowless lighting was used.4. Treatment techniques:Anesthetic techniques using local anesthesia under the skin. Use lml disposable syringes, local anesthetic drugs lidocaine2%, a single skin lesions around the injection of about0.1ml. Treatment using high frequency electric cauterization techniques to drill down to gasification, carbonization organization.5. The requirements for surgery:Familiar with the microscopic anatomy of the eye, including both physiological and pathological, and be familiar with normal and abnormal tissue in the physical properties (color and texture), to make sure to distinguish them quickly and accurately in the surgical process.6. Surgical Procedures:(DShadowless lamp lights the surgical field.alcohol disinfecs surgical site skinWe use lml disposable syringes to extract the appropriate amount of2%lidocaine for the injection of about0.1ml under the skin for anesthesia.Open high-frequency electrocautery instrument power switch, with the short fire output mode and the the minimum output voltage as to1v,Hold the pen-like treatment head, to gasificate or carbonize the tumor skin in a fulguration way and to wipe the carbonized skin tissue clean using a wet cotton swab moistened with lidocaine, revealing homogeneous white or pale white leather inside the tumor, and then clear the white light Individually time by time until the tumor tissue disappeared.Use Lanke to spray the skin2to3days after the surgery and do not touch water before the scab off.7. Statistical Methods:We applied to SPSS17.0package for statistical analysis. All data are averages (mean±standard deviation or median) to describe the general information, a single course of treatment and postoperative medical care and patient satisfaction scores. We use the methods of One-way ANOVA and Multiple pairwise comparisons between the mean to seek out the relationship among Scab off time, scars and recovery time with a different color and size of lesions.Results1.General data analysis:Observation cases were all women, whose average age is27.09±9.74years, the initial onset:14.50±1.61years, skin type:Ⅲ5cases, IV6, the median number of lesions is32, the median number of different sizes of the lesions:D<1mm=7,1mm <D>3mm=17,>3mm=0, and the median number of the cumulative surgeries is3.2.Effect of a single course of treatment:Observe the time of postoperative scarring, scar off time of three different sizes of skin lesions, temporary depression scab scars heal and the recovery time of color. Scab time:2.55±0.52; the time of the scab off:D<1mm=6.17±0.75,1mm <D>3mm=7.82±0.87,>3mm=9.40±0.89; temporary depressed scars healing and the color recovery time:D<1mm=32.50±4.64,1mm<D>3mm=64.91±5.82,>3mm=95.20±5.63..The statistical results of the relation among the scab off time, temporary depression of the scars heal, the recovery time of color and three different sizes of lesions separately are as follows:Through multiple comparing the means of scab off time of three different sizes of the lesions, the results are D<1mm group1mm<D<3mm group, P=0.001, D <1mm group D>3mm group P=0.000,1mm<D<3mm group D>3mm group, P=0.010. it suggests they all have statistical significant, According to the mean difference between the two groups and the means of scab off time:D<1mm=6.17,1mm<D<3mm=7.82,>3mm=9.40, it shows that the smaller the lesion diameter, the earlier the scab off, the larger the diameter lesions, the later the scab off.We use Post Hoc to analyze the time means of three groups of different sizes on temporary depressed lesions heal scars and the color recovery,the results:D<1mm group1mm<D<3mm group, P=0.000; D<1mm group D>3mm Group P=0.000;1mm<D<3mm group D>3mm group, P=0.000; have statistical significance, suggesting that the three comparison groups scars heal time and the color recovery time were significantly different. The mean difference of Scarring and color recovery time between the two groups are D<1mm=32.50,1mm<D<3mm=64.91,>3mm=95.20, showing that the smaller the lesion diameter, only about a month you can heal on scars and the color,while the larger the lesions diameter, recovery the later. It usually takes2months or so for lesions diameter between lmm and3mm to heal, while3months for those diameter more than3mm.3. Analysis of satisfaction of patients and surgeons:After the scab off, surgeries after1month,2to3months follow-up observation points,the median patient satisfaction scores were:3,3,4; the median score of surgeon satisfaction are:3,3,5.We use multiple related samples Friedman non-parametric tests and median line graph to analysis the patient and surgeon satisfaction scores at diferent follown-up points separately. The result is:Χ2=17.176, P=0.000, having statistical significance (P<0.05), Combining with the average ranks of patients satisfaction scores at three follow-up point:after the scab off,1month after surgery,2,3months after surgery,psl=1.27<ps2=1.91<ps3=2.82, it shows that, over time, patient satisfaction is increasing gradually, and that in the period of the scab off to1month after surgery,the elevation of patient satisfaction is not as obvious as to that after1month to2to3months.The result of the multiple related samples non-parametric Friedman tests for Surgeon satisfaction scores is:Χ2=18.000P=0.000it shows significantly different,combining with the surgeon after the three follow-up point of satisfaction rank, ds1=1.59<ds2=1.59<ds3=2.82, ds2-dsl=0<ds3-ds2=1.23, showing that in the period of scab off to1month after surgery, satisfaction of surgeon does not change significantly, while1month to2or3months after surgery,it increases significantly.The median line graph shows:surgeon, patient satisfaction scores both are3at the two follow-up point:after scab off time and1month after surgery, while at the third follow-up point,the patient’s is4, surgeon’s is5.1n a word,it is significantly increasing after1month to2-3month contrast to1month after surgery..4.Three cases of clinical observation of sweat on the tumor patients (including two cases up to9months), preoperative with postoperative follow-up observation points at different times during the photo has been found that by hand Guding implemented, after a low-energy micro-needle electrocautery surgery, most of the tumor has been completely cleared, no scar and pigmentation, striae and skin recovery ideal. Median line graph Tip:surgeon, patient satisfaction scores in the scab off after1month after the two follow-up time point, both3, and the third follow-up point for the patient4, patients who5, but after the scab off to after1month this time, do not see changes in satisfaction, after1month to2to3months after this time, doctors have a patient satisfaction increased.Conclusions1. Through the analysis of general information, we can initially think that the incidence of women is higher than men, and it have research and market value from the beauty point of view.2. Through the analysis of a single course of treatment, we initially considered the result of our surgery is associated with the size of the lesions (on the scab time, temporary depression of the scars heal and the color of recovery time)3Through the analysis of patient and doctor satisfaction, we can initially think that it is relative to the time for the skin recovery, calling for3months.4. Through the clinical photos contrast before and after surgery, we can realize that this set of treatment options may solve the three common clinical problems of syringoma treatment:scarring、residual tumor and pigmentation.5All above, we can initially consider:the design around the end of treatment, including anesthesia, surgical procedures, equipment, therapy selection, the end treatment judging of intraoperative and postoperative treatment, as reflected in the title,it can meet the beauty needs of syringoma patients, treatment purposes of the cosmetic surgeon,and it is effective, practical and easy to promote. |
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