Büyük Kommissür ve Alt Dudak Defekt Rekonstrüksiyonunda Zisser ve Bernard-Burovv Flep Modifikasyonu

Year 2007, Volume: 40 Issue: 1, 19 - 22, 01.04.2007

İbrahim Keskinöz Mehmet Turanlı Üstün Osma İskender Emre İnan Caner Kılıç Kadir Fırat Nalan Alev Alp

Abstract

After resection, because of lovver lip and commissure carcinoma, two cases were reconstructed by local flaps. İn the first case, in addition to modified Bernard-Burovv method, local rotation flap was applied. İn the second case, the modified Zisser flap was applied. İn the former case, the opposite cheek skin vvas used in order to make a lovver lip. Instead of the primer sutu-ration of upper lip remnant and lovver lip, the reconstruction of the defected area through nasolabial rotation flap vvas perfor-med. These surgical procedures lead to an appropriate oral entery. İn the latter case, the problems occured because of horizontal and vertical incision during the Zisser flap procedure were reconstructed by Z-plasty. İt is considered that better results can be accomplished when the modified Bernard-Burovv and Zisser methods were used in the cases which the reconstruction seems difficult t o be applied in large commissure and lovver lip defects.

Keywords

Lip reconstruction, commissure, rotational flap, lip flap, lovver lip carcinoma.

Bernard-Burow and Zisser Flap Modification in Large Commissure and Lower Lip Defect Reconstruction

Abstract

Alt dudak ve kommissür kanseri nedeniyle yapılan rezeksiyon sonrası geniş defekti olan 2 olgu lokal Heplerle rekonstrük-te edildi. Birinci olguda modifiye Bernard-Burovv yöntemi yanında lokal rotasyon flebi uygulandı. İkinci olguda Zisser flebi modi-fiye edilerek uygulandı. Birinci olguda karşı yanak cildi alt dudak oluşturulmasında kullanıldı. Üst dudak kalıntısının alt dudağa primer sütürasyonu yerine defekt tarafında oluşturulan nasolabial rotasyonel fleple rekonstrüksiyon yapıldı. Bu cerrahi müdahaleler uygun oral açıklığın oluşmasını sağladı, ikinci olguda Zisser flebinin oluşturulması sırasında horizontal ve vertikal insizyo-nun meydana getirmiş olduğu olumsuzluklar Z-Plasti ile düzeltildi. Rekonstrüksiyonu büyük zorluklar arz eden geniş kommissür ve alt dudak defektlerinde uygun seçimle Bernard-Burovv ve Zisser gibi tekniklerin modifikasyonlarla uygulanması daha iyi sonuçlar vereceği düşünülmektedir.

Keywords

Dudak rekonstrüksiyonu, kommissür, rotasyonel flep, dudak flebi, alt dudak kanseri.

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