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Repair of soft tissue defects of the nose

Year 2010, Volume: 20 Issue: 2, 64 - 70, 20.03.2010

Abstract

Objectives: Soft tissue defects of the nose resulting from lesions may cause aesthetic and functional problems if they are not properly repaired. Patients and Methods: In this study, a retrospective analysis was conducted of 104 patients 59 females, 45 males; mean age 53 years; range 33 to 89 years who were operated in our clinic between November 2005 and July 2009. Nasal soft tissue defects resulting from excision were closed with a primer closure for 16 patients, a procerius muscle skin flap for 11 patients, a nasolabial flap for 26 patients, a dorsal nasal flap for 12 patients, a forehead flap for three patients, an orbicularis oculi muscle skin flap for three patients, a V-Y advancement flap for seven patients, a bilateral V-Y advancement flap for one patient, a Banner flap for nine patients, a bilobe flap for eight patients, an interpolation flap for two patients, a skin graft for 10 patients. Results: We did not observe any occurances of flap necrosis in any of the patients being treated with skin and muscle skin flaps. After we recognised that two patients’ excision margins were positive, re-excision was performed on them. Tumor recurrence was observed in one patient, and was repaired with skin graft. Conclusion: In this study, we present our successful results in the treatment of soft tissue defects. Reconstructive strategy should be considered from simple to more complex planning. Skin flaps should be elevated according to nasal aesthetic units. Which reconstructive technique to employ should be decided with respect to the localization of the nasal defect.

References

  • Menick FJ. Nasal reconstruction. In: Thorne CH, editor. Grabb and Smith’s plastic surgery. 6th ed. Philadelphia: Lippincort-Raven; 2007. p. 389-96.
  • Millard DR Jr. Aesthetic reconstructive rhinoplasty. Clin Plast Surg 1981;8:169-75.
  • Burget GC, Menick FJ. The subunit principle in nasal reconstruction. Plast Reconstr Surg 1985;76:239-47.
  • Burget GC, Menick FJ. Aesthetic reconstruction of the nose. St. Louis: Mosby-Year Book; 1994.
  • Gonzalez-Ulloa M. Restoration of the face covering by means of selected skin in regional aesthetic units. Br J Plast Surg 1956;9:212-21.
  • Barton FE. Nasal reconstruction. In: Smith JW, Aston SJ, editors. Grabb and Smith’s plastic surgery. 4th ed. Boston: Little, Brown; 1991. p. 491-505.
  • Elliott RA Jr. Rotation flaps of the nose. Plast Reconstr Surg 1969;44:147-9.
  • McGregor JC, Soutar DS. A critical assessment of the bilobed flap. Br J Plast Surg 1981;34:197-205.
  • Olbourne NA, Kraaijenhagen JH. Rotation flap for distal nasal defects. Br J Plast Surg 1975;28:64-6.
  • Rigg BM. The dorsal nasal flap. Plast Reconstr Surg 1973;52:361-4.
  • Guéro S, Bastian D, Lassau JP, Csukonyi Z. Anatomical basis of a new naso-labial island flap. Surg Radiol Anat 1991;13:265-70.
  • Rohrich RJ, Muzaffar AR, Adams WP Jr, Hollier LH. The aesthetic unit dorsal nasal flap: rationale for avoiding a glabellar incision. Plast Reconstr Surg 1999;104:1289-94.
  • Marchac D, Toth B. The axial frontonasal flap revisited. Plast Reconstr Surg 1985;76:686-94.
  • Tellioglu AT, Tekdemir I, Saray A, Eker E. Reconstruction of proximal nasal defects with island composite nasal flaps. Plast Reconstr Surg 2005;115:416-22.

Burun yumuşak doku defektlerinin onarımı

Year 2010, Volume: 20 Issue: 2, 64 - 70, 20.03.2010

Abstract

Amaç: Burun lezyonlarının yumuşak doku defektleri uygun şekilde onarılmazsa hem estetik hem de fonksiyonel olarak önemli sorunlar yaratır.Hastalar ve Yöntemler: Bu çalışmada Kasım 2005 Temmuz 2009 tarihleri arasında kliniğimizde ameliyat edilen toplam 104 hastanın 59 kadın 45 erkek; ort. yaş 53 yıl; dağılım 33-88 yıl burun üzerindeki lezyonları geriye dönük olarak analiz edildi. Burun üzerindeki yumuşak doku lezyonların eksizyonu sonrası oluşan defektler 16 hastada primer olarak kapatılırken, 11 hastada procerus kas deri flebi, 26 hastada nazolabial flep, 12 hastada dorsal nazal flep, üç hastada alın flebi, üç hastada orbikularis okuli flebi, yedi hastada V-Y ilerletme flebi, bir hastada iki taraflı V-Y ilerletme flebi, dokuz hastada banner flebi, sekiz hastada bilobe flebi, iki hastada interpolasyon flebi ve 10 hastada deri grefti ile onarıldı.Bulgular: Deri ve kas deri flepleri kullanılarak tedavi edilen hastaların hiçbirinde flep nekrozu görülmedi. Histopatoloji sonucu cerrahi sınırda pozitif tümör dokusu olarak bildirilen iki hastada re-eksizyon yapıldı. Bir hastada tümör nüksü gözlendi ve deri grefti ile onarıldı.Sonuç: Bu çalışmada burun lezyonlarının eksizyonu sonrası oluşan yumuşak doku defektlerin tedavisi ve alınan başarılı sonuçlar sunuldu. Onarım stratejisi basitten daha karmaşığa doğru planlanmalıdır. Burun defektini örtmek için kaldırılan fleplerde burun estetik üniteleri dikkate alınmalı. Kullanılacak onarım tekniği, oluşan defektin burun üzerindeki yerine göre saptanmalıdır

References

  • Menick FJ. Nasal reconstruction. In: Thorne CH, editor. Grabb and Smith’s plastic surgery. 6th ed. Philadelphia: Lippincort-Raven; 2007. p. 389-96.
  • Millard DR Jr. Aesthetic reconstructive rhinoplasty. Clin Plast Surg 1981;8:169-75.
  • Burget GC, Menick FJ. The subunit principle in nasal reconstruction. Plast Reconstr Surg 1985;76:239-47.
  • Burget GC, Menick FJ. Aesthetic reconstruction of the nose. St. Louis: Mosby-Year Book; 1994.
  • Gonzalez-Ulloa M. Restoration of the face covering by means of selected skin in regional aesthetic units. Br J Plast Surg 1956;9:212-21.
  • Barton FE. Nasal reconstruction. In: Smith JW, Aston SJ, editors. Grabb and Smith’s plastic surgery. 4th ed. Boston: Little, Brown; 1991. p. 491-505.
  • Elliott RA Jr. Rotation flaps of the nose. Plast Reconstr Surg 1969;44:147-9.
  • McGregor JC, Soutar DS. A critical assessment of the bilobed flap. Br J Plast Surg 1981;34:197-205.
  • Olbourne NA, Kraaijenhagen JH. Rotation flap for distal nasal defects. Br J Plast Surg 1975;28:64-6.
  • Rigg BM. The dorsal nasal flap. Plast Reconstr Surg 1973;52:361-4.
  • Guéro S, Bastian D, Lassau JP, Csukonyi Z. Anatomical basis of a new naso-labial island flap. Surg Radiol Anat 1991;13:265-70.
  • Rohrich RJ, Muzaffar AR, Adams WP Jr, Hollier LH. The aesthetic unit dorsal nasal flap: rationale for avoiding a glabellar incision. Plast Reconstr Surg 1999;104:1289-94.
  • Marchac D, Toth B. The axial frontonasal flap revisited. Plast Reconstr Surg 1985;76:686-94.
  • Tellioglu AT, Tekdemir I, Saray A, Eker E. Reconstruction of proximal nasal defects with island composite nasal flaps. Plast Reconstr Surg 2005;115:416-22.
There are 14 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Esabil Eker This is me

Ali Teoman Tellioğlu This is me

Gülsüm Tetik Menevşe This is me

Salih Emre Uvegen This is me

Publication Date March 20, 2010
Published in Issue Year 2010 Volume: 20 Issue: 2

Cite

APA Eker, E., Tellioğlu, A. T., Tetik Menevşe, G., Uvegen, S. E. (2010). Burun yumuşak doku defektlerinin onarımı. The Turkish Journal of Ear Nose and Throat, 20(2), 64-70.
AMA Eker E, Tellioğlu AT, Tetik Menevşe G, Uvegen SE. Burun yumuşak doku defektlerinin onarımı. Tr-ENT. March 2010;20(2):64-70.
Chicago Eker, Esabil, Ali Teoman Tellioğlu, Gülsüm Tetik Menevşe, and Salih Emre Uvegen. “Burun yumuşak Doku Defektlerinin onarımı”. The Turkish Journal of Ear Nose and Throat 20, no. 2 (March 2010): 64-70.
EndNote Eker E, Tellioğlu AT, Tetik Menevşe G, Uvegen SE (March 1, 2010) Burun yumuşak doku defektlerinin onarımı. The Turkish Journal of Ear Nose and Throat 20 2 64–70.
IEEE E. Eker, A. T. Tellioğlu, G. Tetik Menevşe, and S. E. Uvegen, “Burun yumuşak doku defektlerinin onarımı”, Tr-ENT, vol. 20, no. 2, pp. 64–70, 2010.
ISNAD Eker, Esabil et al. “Burun yumuşak Doku Defektlerinin onarımı”. The Turkish Journal of Ear Nose and Throat 20/2 (March 2010), 64-70.
JAMA Eker E, Tellioğlu AT, Tetik Menevşe G, Uvegen SE. Burun yumuşak doku defektlerinin onarımı. Tr-ENT. 2010;20:64–70.
MLA Eker, Esabil et al. “Burun yumuşak Doku Defektlerinin onarımı”. The Turkish Journal of Ear Nose and Throat, vol. 20, no. 2, 2010, pp. 64-70.
Vancouver Eker E, Tellioğlu AT, Tetik Menevşe G, Uvegen SE. Burun yumuşak doku defektlerinin onarımı. Tr-ENT. 2010;20(2):64-70.