Uso de retalho cutâneo para reconstrução nasal após ressecção neoplásica

Abstract

Use of skin flaps for nasal reconstruction after neoplastic resection Use of skin flaps for nasal reconstruction after neoplastic resection Uso de retalho cutâneo para reconstrução nasal após ressecção neoplásica ABSTRACT Background: Nasal reconstruction is always a challenge for the plastic surgeon. Loss of nasal mass is mainly caused by resection of skin cancers. Among the several available alternatives for covering the skin, skin flaps are the first cosmetic and functional choice. This study has 2 objectives: (1) to report the experiences of the Plastic Surgery Service of São Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul (Porto Alegre, RS, Brazil) in the reconstruction of nasal mass losses that resulted from tumor resection and (2) to describe the most commonly used skin flaps used for defect repair according to the anatomic subunit. Methods: This study analyzed 103 nasal skin flaps used in the reconstruction of 102 nasal mass losses that resulted from tumor resection in 96 patients who underwent surgery between December 2008 and December 2011. Mass losses were mapped according to the anatomic subunits described by Burget and Menick. Moreover, the number of times each strategy was chosen for the reconstruction of the different subunits was recorded. Results: Most of the patients were men (51%), and the average age of the analyzed group was 64.7 years. Basal cell carcinoma was the most prevalent skin cancer (85.3%), followed by squamous cell carcinoma (5.9%). The bilobed flap was commonly used for nasal alar lobule reconstruction (44%); V-Y advancement for the lateral region (72%); extended glabellar for the nasal dorsum (59.2%); bilobed for the nasal tip (46.2%); and glabellar for the nasal roof as well as in the cases mentioned above. Conclusions: Several surgical procedures are used for nasal reconstruction following tumor resection. The most suitable strategy should be chosen according to the patient in order to maintain the contours and nasal anatomy, as described by Burget and Menick.

Tumor De Células Gigantes Em Arcos Costais: Um Relato De Caso

“…O diafragma, fixado às seis cartilagens costais inferiores e suas costelas adjacentes, foi acometido pelo TCG e parcialmente ressecado. Dada a excisão de apenas três costelas látero-posteriores e com boa cobertura muscular, optou-se pela inserção do diafragma remanescente na 8ª costela em detrimento da reconstrução do arcabouço costal com tela de polipropileno (BATISTA et al, 2014).…”

Facial rehabilitation with implant-retained nasal prosthesis of acrylic resin: a case report

“…The nose is the anatomical unit positioned in the central third of the face and is of fundamental importance, because, in addition to heating, humidifying and purifying the air, adapting it to reach the lungs, it defines the physiognomy, being responsible for the individual's phenotypic characterization. It consists of three layers (mucosa, osteocartilaginous framework and skin), its surface being full of anatomical curves and depressions [9]. The nose is an unique organ on the face, so it is difficult to conceal its loss, in addition to causing breaks in normality, harmony and facial balance [10].…”

Hypercalcemia with the development of chronic kidney disease, nephrolithiasis after intramuscular injection of oil solutions

“…Синтол -это масляный раствор, состоящий на 85% из среднецепочечных жирных кислот, бензилового спирта (7,5%) и лидокаина (7,5%). Среди бодибилдеров существует практика внутримышечного введения синтола в область бицепсов, квадрицепсов, ягодичных мышц с целью увеличения их объема [5][6][7][8][9][10][11][12]. Заполняя межфасциальные пространства и вызывая отек, синтол приводит к визуальному увеличению мышц, не влияя на силовые показатели.…”

“…В зависимости от суммарного количества, препарат вызывает острое или хроническое воспаление с формированием гранулем инородных тел, состоящих преимущественно из макрофагов и гигантских клеток инородных тел. В дальнейшем происходит деструкция и фиброз мягких тканей, чему способствует медленная деградация синтола и миграция по межфасциальным пространствам [9,10,[13][14][15].…”

“…В литературе описаны различные последствия внутримышечного применения синтола: тяжелая гиперкальциемия, не ассоциированная с гиперпаратиреозом, нефрокальциноз, снижение скорости клубочковой фильтрации, изъязвление и некроз кожи, местные гнойные осложнения [5,7,[8][9][10][11][12][16][17][18]. Данные исследования, проведенного в 2021 г. с участием 88 мужчин, подтвердило, что факторами риска развития гиперкальциемии являются суммарный объем препарата, инъекции нагретых растворов и высокий уровень антител к рецептору IL-2 в сыворотке крови [8].…”