Rekonstrukcija postraničnog defekta donje usne kombinacijom dvaju klizajućih režnjeva

Marijan Kovačić, Ivan Kovačić

Uvod: Funkcionalni i estetski rezultat rekonstrukcije donje usne nakon uklanjanja tumora ovisi o pravilnom izboru operacijske tehnike. S obzirom na činjenicu da je njihov broj velik, izbor nije lak. Bolesnici i metoda: U ovom radu autori su uključili 5 bolesnika kojima su izvršili rekonstrukciju defekta donje usne s kombinacijom dvaju režnjeva, elastičnim vermilion režnjem i otočnim V-Y mentalnim klizajućim režnjem. Svi bolesnici su imali planocelularni karcinom postraničnog dijela donje usne ≥ 2 cm (T2). Primijenjen je vermilion elastični režanj po Goldsteinu i otočni V-Y klizajući režanj mentalne regije koji su uveli u kiruršku praksu Bayamicli i sur. Spajanjem ovih dvaju neurovaskularnih režnjeva postignut je kvalitetan nadomjestak donje usne, njena voluminoznost, dužina, visina, širina, prirodan izgled i potpuna funkcija. Zaključak: Ova kombinacija dvaju etabliranih režnjeva ozbiljna je alternativa drugim kirurškim tehnikama u rekonstrukciji defekta donje usne koji nije pogodan za izravnu sanaciju primarnim zatvaranjem. Kirurška tehnika formiranja režnjeva nije teška, može se izvesti pod lokalnom anestezijom i ne zahtijeva dugo kirurško vrijeme.

Introduction: The functional and esthetic result of the reconstruction of the lower lip after the removal of the tumor depends on the correct choice of surgical technique. Given the fact that their number is great, the choice is not easy. Patients and methods: In this study, the authors included five patients who underwent reconstruction of a lower lip defect with a combination of two lobes, an elastic vermilion lobe, and an island V-Y mental sliding lobe. All patients had squamous cell carcinoma of the lateral part of the lower lip ≥ 2cm (T2). An elastic vermilion flap popularized by Goldstein, and the well-known island V-Y advancement mental flap introduced
into the surgical practice by Bayamicli et al. were used. A very good esthetic and functional result was achieved. The formed lip has an appropriate natural look, quality volume, symmetry , matching width and height. Conclusion: This combination of two established flaps is a serious alternative to other surgical techniques in the reconstruction of a lower lip defect that is not suitable for direct remediation, primary closure. The surgical technique of flaps formation is not difficult, can be performed under local anesthesia, and does not require long surgical time.