Our experience with surgery of non melanoma cutaneous malignancies of head and neck

Yıl 2009, Cilt: 19 Sayı: 3, 138 - 145, 08.06.2009

Uygar Levent Demir Fazıl Apaydın

Öz

Objectives: To evaluate the cases underwent surgery with the diagnosis of head and neck non melanoma skin malignancies. Patients and Methods: Clinical records of 89 patients 33 females, 56 males; mean age 65.4 years; ranges 41 to 87 years who underwent excision and reconstruction with the diagnosis of skin malignancy at ENT clinics of Ege University Hospital between April 2004 and March 2006 and 101 lesions were retrospectively reviewed. The patients who were diagnosed with non melanoma skin malignancy and whose surgical decisions were concluded at the common council of dermatology clinic, ear nose and throat clinic and oral diagnosis clinics were included in the study. In all cases pre- and postoperative pictures of lesions, pathological results and follow-up results were all evaluated. Results: The 32 of 101 lesions were located at nasal esthetical unit and 15 of these were at alar region subunit. The second most common location was lip with 29 lesions and 24 of them were located at lower lip. The evaluation of flap techniques performed for the reconstruction of excision defect revealed that extending flap was the second common method with 12 cases after primary closure with 23 cases. The pathological results of these lesions were found to be squamous cell carcinomas with 49 lesions and basal cell carcinomas with 41 lesions. In three cases the surgical margins were positive, meaning tumor still remains in normal tissue. Neck dissection was performed in seven patients. There was no patient with recurrent malignant lesion during the follow-up period mean=47.5 months range 37-57 months . Conclusion: Cutaneous malignancies are the most common malignancy type worldwide. Successful results are available if these lesions are diagnosed early, excised with correct methods and reconstructed with appropriate techniques.

Anahtar Kelimeler

Cutaneous malignancies, photographic documentation, reconstruction with flap

Baş boyun bölgesinin melanom dışı deri kanserlerinde cerrahi deneyimimiz

Öz

Amaç: Baş boyun bölgesinde melanom dışı deri kanseri tanısı ile cerrahi tedavi uygulanan olgular değerlendirildi.Hastalar ve Yöntemler: Bu çalışmada Ege Üniversitesi Tıp Fakültesi KBB kliniğinde Nisan 2004-Mart 2006 tarihleri arasında deri kanseri nedeniyle eksizyon ve onarım uygulanan 89 hastada 33 kadın, 56 erkek; ort. yaş 65.4 yıl; dağılım 41-87 yıl saptanan 101 lezyonun kayıtları geriye dönük olarak incelendi. Çalışmaya ameliyat öncesi melanom dışı deri kanseri tanısı konmuş ve dermatoloji, kulak burun boğaz ve oral diyagnoz kliniklerinin ortak konseyinde değerlendirilerek cerrahi kararı alınan hastalar dahil edildi. Olgularının tümünde cerrahi öncesi ve sonrası lezyon fotoğrafları, patoloji sonuçları, takip sonuçları değerlendirildi.Bulgular: Cerrahi uygulanan 101 lezyonun 32’sinin burun estetik ünitesinde olduğu ve bunların 15’inde lezyonun ala nazi yerleşimli olduğu tespit edildi. Burun bölgesini takiben ikinci sıklıkta 29 lezyon ile dudak bölgesi gelmekteydi ve bunların da 24’ü alt dudak yerleşimliydi. Eksizyon sonrasında 23 hastaya primer kapatma ve ikinci sıklıkla 12 hastaya ilerletme flebi uygulandı. Lezyonların patoloji raporları incelendiğinde 49 lezyonda skuamöz hücreli karsinom ve 41 hastada bazal hücreli karsinom olduğu belirlendi. Üç hastada patoloji raporunda cerrahi sınırda tümörün devam ettiği bildirildi. Yedi hastaya boyun diseksiyonu uygulandı. Hastalarda takip süresinde ortalama 47.5 ay dağılım 37-57 ay primer tümöral lezyon açısından yineleme gözlenmedi.Sonuç: Deri kanserleri tüm dünyada en sık görülen kanser türüdür. Bu tümörler erken tanı konarak uygun teknikle eksize edilirse, onarım uygulandığında oldukça başarılı sonuçlar alınmaktadır

Anahtar Kelimeler

Deri kanserleri, fotoğraf kayıtlama, fleple onarım

Kaynakça

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