Repair of soft tissue defects of the nose

Yıl 2010, Cilt: 20 Sayı: 2, 64 - 70, 20.03.2010

Esabil Eker Ali Teoman Tellioğlu Gülsüm Tetik Menevşe Salih Emre Uvegen

Öz

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.

Anahtar Kelimeler

Nose, repair, soft tissue, tumor

Burun yumuşak doku defektlerinin onarımı

Öz

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

Anahtar Kelimeler

Burun, onarım, yumuşak doku, tümör

Kaynakça

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