Nejčastější příčinou defektu nosu vyžadující rekonstrukci je bazocelulární karcinom, dále skvamózní karcinom a melanom. Pro rekonstrukci defektu nosního křídla v plné síle, který vznikl po excizi bazaliomu, prezentujeme vlastní techniku místních laloků, do nichž je vložena nehtová ploténka, která slouží jako výztuž. U čtyř pacientů byla nehtová ploténka vložena do různých typů místních laloků a tyto laloky byly potom užity k rekonstrukci defektů nosního křídla v plné síle. Vnitřní výstelka nosních křídel byla vytvořena kožními štěpy. U žádného případu jsme nepozorovali ztrátu kožního štěpu ani obnažení nehtové ploténky. Použitý nehet brání kolapsu nosního křídla a zajišťuje průchodnost dýchacích cest. Tato technika eliminuje potřebu sekundárního výkonu.
The most common etiology of nasal defects that require reconstruction is basal cell carcinoma, as well as squamous cell carcinoma and melanoma. In reconstructing full-thickness ala nasi defects following excision of basal cell carcinomas, we present our technique of the nail enfolded local flaps which involves the harvesting of the nail plate and placing it to serve as a supporting component. In four patients, the nail plate grafts are inserted into various local flaps, and used for reconstruction of full-thickness ala nasi defects. Lining deficiencies of the alar lobule were resurfaced with skin grafts. None of the cases experienced skin graft loss or nail plate exposure. The nail graft prevented alar collapse by supporting the nasal airway. This technique discards the need for a second operation.
- MeSH
- lidé MeSH
- nádory nosu MeSH
- nehty chirurgie MeSH
- rinoplastika metody využití MeSH
- zákroky plastické chirurgie metody využití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
In 1918, Stout defined the lesion in which small round cells originating from the ulnar nerve formed a rosette as neuroepithelioma. It was claimed that this tumor originated from neuroectodermis and was different from the classical neuroblastoma (1, 2). The term primitive neuroectodermal tumor (PNET) involves a group of tumors of the soft tissue originating from neural crest and resulting from the brain, spinal cord and branches of the sympathetic nervous system. Extracranial primitive neuroectodermal tumors originate from neural crest cells outside the sympathetic and central nervous system. PNET also has some distinctive histological, immunohistochemical and ultrastructural features. It is usually encountered in children and young adults; most frequently located in thoracopulmonary region (Askin’s tumor). The second most commonly involved body part is the extremities. It is very rarely located on the face (3-8). PNET is an aggressive tumor. In fact, the disease has a rapid progression, causes local or distant metastases and 50% of the patients die within two years of the presentation (7). It is treated with aggressive surgery as well as chemotherapy and radiotherapy. In this report, we presented a case of PNET located on the right cheek with multiple distant metastases. Clinicians should be on alert when treating facial tumors, not to skip PNET, which is a very aggressive one.
- MeSH
- lidé MeSH
- primitivní neuroektodermové nádory diagnóza patologie MeSH
- tvář patologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Numerous appliances or methods have been used to manage perioral deep burns and resultant contractures, however, until now, no particular technique is considered to be the ”ideal technique”. In this article, a new modified design of an extraoral appliance, composed of polymethylmetacrylate and silicon sheet is introduced. Two female and one male patient of a mean age of 33 were included in the study. They had a common history of facial thermal injury and hypertrophic scar formation. All three had a history of failed preceding operations to release commissure contractures. The appliance was placed within 14 days following the operation and stretched continuously for 6 months. During 14 months of follow-up period, no recurrence was encountered and a relatively symmetrical and satisfactory mouth opening was obtained. Owing to the effect of the silicon sheet, a more smooth, flattened scar surface and pliable commissure was achieved. No ulcerations, or tissue breakdown was observed. Extraoral appliances composed of polymethylmetacrylate silicon sheet were considered to be practical, convenient and efficient for the postsurgical treatment of the oral commissure contractures complicated with hypertrophic scar formation.
