Superfisyal temporal arter bazlı fleplerle yüz defektlerinin rekonstrüksiyonu: Klinik araştırma
Küçük Resim Yok
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Yüz bölgesindeki defektlerin rekonstrüksiyonu plastik cerrahinin en önemli uğraşı alanlarından biridir. Malignite veya travma sonucu oluşan defektlerin rekonstrüksiyonu için çok sayıda yöntem tarif edilmiştir. Çalışmamızda diğer yöntemler yerine superfisyal temporal arter bazlı fleplerin kullanımıyla daha estetik bir görünüm ve fonksiyonel sonuçların elde edilmesi amaçlanmıştır. Ayrıca bu flebin özellikle yaşlı hastalardaki geniş defektlerin rekonstrüksiyonu için serbest flepler gibi uzun ve riskli cerrahi girişimler yerine daha güvenilir ve daha kısa süren prosedürler ile daha iyi sonuçların elde edilmesi amaçlanmıştır. Gereç ve Yöntem: 2009-2018 yılları arasında opere edilen 24 hasta retrospektif olarak değerlendirildi. Hastaların klinik notları ve ameliyat notları incelendi. İnceleme sonucunda hastaların yaş, cinsiyet, başvuru nedenleri, tümörün tipi, yapılan cerrahi işlem ve komplikasyonları, hastaların bilinen kronik hastalıkları belirlendi. Hastaların ameliyat öncesinde ve rekonstrüksiyon yapıldıktan sonraki dönemde çekilen fotoğrafları değerlendirildi. Hastaların fotoğrafları on ayrı plastik cerrahi uzmanı tarafından likert skalası kullanılarak estetik görünüm açısından değerlendirildi. Bulgular: Yaşları 20 ile 95 arasında değişen hastaların ortalama yaşı 70,75 olarak hesaplandı. Hastaların 12'si kadın, 12'si erkekti. 24 hastanın 14'ünde BHK eksizyonu, 8'inde SHK eksizyonu, birinde yanık skarı eksizyonu, birinde de travmaya bağlı defekt rekonstrükte edildi. Likert skalasının sonuçlarına göre estetik görünüm açısından tüm fleplerin kabul edilebilir, iyi ve çok iyi düzeyde çıktığı görüldü. Özellikle ada fleplerinin genel görünüm, flep konturu, renk uyumu ve doku uyumu açısından yüzdeki defektlere çok iyi uyum sağladığı sonucuna varıldı. Sonuçlar: STA bazlı fleplerin diseksiyonu kolay, dolaşımı güvenli, pedikülü uzun ve ince, rotasyon arkı geniştir. Flep renk, doku ve kalınlık açısından yüz bölgesi ile uyumludur. Flep kıllı veya kılsız olarak planlanabilmektedir. Bu nedenlerden dolayı yüz defektlerinin rekonstrüksiyonda ilk tercih olarak akılda tutulabilir. Anahtar kelimeler: Ada flebi, alın flebi, superfisyal temporal arter, yüz rekonstrüksiyonu.
Aim: The reconstruction of facial defects is one of the most important area of plastic surgery. Numerous methods have been described for the reconstruction of defects due to malignancy or trauma. In our study, it was aimed to obtain more aesthetic appearance and functional results by the use of superficial temporal artery based flaps instead of other methods. In addition, this flap is intended to achieve better results with more reliable and shorter procedures rather than long and risky surgical procedures such as free flaps for the reconstruction of large defects especially in elderly patients. Material and Method: 24 patients who were operated between 2009-2018 were evaluated retrospectively. Clinical notes and surgery notes of the patients were analyzed. Age, gender, reasons of admission, tumor type, surgical procedures and complications and chronic diseases of the patients were determined. The photographs of the patients were taken before and after the reconstruction surgery were evaluated. The photographs of the patients were evaluated by ten different plastic surgery specialists using the likert scale. Results: The mean age of the patients between the ages of 20 and 95 was calculated as 70,75. 12 patients were female and 12 were male. The defects due to BCC excision in 14 patiens and due to SCC excision in 8 patients were reconstructed. According to the results of the Likert scale, it was seen that all flaps were acceptable, good and very good in the evaluation of aesthetic appearance. It is concluded that the island flaps are very well adapted to the facial defects in terms of general appearance, flap contour, color matching and texture matching. Conclusion: STA-based flaps are easy to dissect, circulation is reliable, the pedicle is long and thin, rotation arc is wide. The flap is compatible with the face in terms of color, texture and thickness. The flap can be planned with or without hair. Hence STA based flaps should be kept in mind as the first choice in the reconstruction of facial defects. Key Words: Island flap, forehead flap, facial reconstruction, superficial temporal artery.
Aim: The reconstruction of facial defects is one of the most important area of plastic surgery. Numerous methods have been described for the reconstruction of defects due to malignancy or trauma. In our study, it was aimed to obtain more aesthetic appearance and functional results by the use of superficial temporal artery based flaps instead of other methods. In addition, this flap is intended to achieve better results with more reliable and shorter procedures rather than long and risky surgical procedures such as free flaps for the reconstruction of large defects especially in elderly patients. Material and Method: 24 patients who were operated between 2009-2018 were evaluated retrospectively. Clinical notes and surgery notes of the patients were analyzed. Age, gender, reasons of admission, tumor type, surgical procedures and complications and chronic diseases of the patients were determined. The photographs of the patients were taken before and after the reconstruction surgery were evaluated. The photographs of the patients were evaluated by ten different plastic surgery specialists using the likert scale. Results: The mean age of the patients between the ages of 20 and 95 was calculated as 70,75. 12 patients were female and 12 were male. The defects due to BCC excision in 14 patiens and due to SCC excision in 8 patients were reconstructed. According to the results of the Likert scale, it was seen that all flaps were acceptable, good and very good in the evaluation of aesthetic appearance. It is concluded that the island flaps are very well adapted to the facial defects in terms of general appearance, flap contour, color matching and texture matching. Conclusion: STA-based flaps are easy to dissect, circulation is reliable, the pedicle is long and thin, rotation arc is wide. The flap is compatible with the face in terms of color, texture and thickness. The flap can be planned with or without hair. Hence STA based flaps should be kept in mind as the first choice in the reconstruction of facial defects. Key Words: Island flap, forehead flap, facial reconstruction, superficial temporal artery.
Açıklama
Anahtar Kelimeler
Plastik ve Rekonstrüktif Cerrahi, Plastic and Reconstructive Surgery
