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6.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(7): 590-599, sept. 2020. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-201801

RESUMO

INTRODUCCIÓN Y OBJETIVOS: Los defectos de la zona anterior del pabellón auricular (PA) son un desafío reconstructivo debido a la compleja topografía y el difícil acceso. Describimos nuestra experiencia con el uso del colgajo en isla en puerta giratoria (CIPG) para la reconstrucción de defectos auriculares y se presentan los resultados quirúrgicos. MATERIAL Y MÉTODOS: Estudio descriptivo retrospectivo de pacientes tratados mediante reconstrucción de oreja, de diversas localizaciones de la zona anterior, mediante el CIPG, tras la resección de tumores malignos. RESULTADOS: Entre 2011 y 2019 se operó a 17 pacientes: 7 carcinomas epidermoides y 10 basocelulares. El estudio histológico convencional mostró bordes quirúrgicos libres en todas las piezas de resección. El tiempo medio de seguimiento fue de 40 meses. Hubo una recidiva local en un carcinoma epidermoide, con buena respuesta a radioterapia, de forma que todos los pacientes estaban libres de enfermedad al completar el seguimiento. Solo 3 pacientes presentaron complicaciones menores (depresión de la superficie del colgajo en un caso y retracción del oído hacia la mastoides en 2 casos). Mediante escalas de valoración subjetiva, se determinó el resultado postoperatorio estético y funcional, tanto por parte del dermatólogo como del paciente. En todos los pacientes se conservó el contorno normal del PA reconstruido y ningún paciente requirió cirugía correctiva adicional. CONCLUSIONES: La reconstrucción auricular mediante CIPG permitió la reparación satisfactoria tras la resección completa de los tumores, preservando la estructura y funcionalidad. Está descrito que el CIPG es una muy buena opción reconstructiva de la concha auricular; es una técnica sencilla que permite reparar grandes defectos con mínimos riesgos de necrosis. En la serie presentada, el resultado cosmético fue excelente, con muy bajo índice de recurrencias. Los resultados son óptimos en la reparación de lesiones conchales pero también de otras zonas, como el antihélix y las fosas triangular y escafoidea


BACKGROUND AND OBJECTIVES: Defects of the anterior region of the pinna pose a reconstruction challenge owing to the complex topography and difficult access. We report our experience using the revolving door island flap (RDIF) to reconstruct pinna defects and present the surgical results. MATERIAL AND METHODS: Retrospective descriptive study of patients undergoing ear reconstruction using RDIF at different sites of the anterior region after resection of malignant tumors. RESULTS: Seventeen patients underwent surgery between 2011 and 2019 for squamous cell carcinoma (n = 7) and basal cell carcinoma (n = 10). Conventional histology showed disease-free surgical margins in all the resected tissue specimens. The mean follow-up period was 40 months. One local recurrence of squamous cell carcinoma was observed, which responded well to radiation therapy; all patients were free of disease at the end of follow-up. Only 3 patients presented minor complications (depression of the flap surface in 1 case and retraction of the ear toward the mastoid process in 2 cases). Subjective rating scales were used to evaluate cosmetic and functional outcomes as assessed by both the dermatologist and the patient. The normal contour of the pinna was conserved in all patients and no patients required additional corrective surgery. CONCLUSIONS: Reconstruction of the pinna using RDIF allowed for satisfactory repair following complete resection of the tumors, while conserving structure and functionality. RDIF has been reported to be a very good option for reconstruction of the pinna. It is a simple technique that makes it possible to repair large defects with minimal risk of necrosis. In our series, the cosmetic results were excellent and recurrence rates were very low. RDIF provided optimal results in repairing lesions in the concha and in other regions, such as the antihelix, triangular fossa, and scapha


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Procedimentos de Cirurgia Plástica , Neoplasias da Orelha/cirurgia , Cartilagem da Orelha/cirurgia , Pavilhão Auricular/cirurgia , Retalhos Cirúrgicos , Estudos Retrospectivos , Seguimentos
8.
Actas Dermosifiliogr (Engl Ed) ; 111(7): 590-599, 2020 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32576375

RESUMO

BACKGROUND AND OBJECTIVES: Defects of the anterior region of the pinna pose a reconstruction challenge owing to the complex topography and difficult access. We report our experience using the revolving door island flap (RDIF) to reconstruct pinna defects and present the surgical results. MATERIAL AND METHODS: Retrospective descriptive study of patients undergoing ear reconstruction using RDIF at different sites of the anterior region after resection of malignant tumors. RESULTS: Seventeen patients underwent surgery between 2011 and 2019 for squamous cell carcinoma (n=7) and basal cell carcinoma (n=10). Conventional histology showed disease-free surgical margins in all the resected tissue specimens. The mean follow-up period was 40 months. One local recurrence of squamous cell carcinoma was observed, which responded well to radiation therapy; all patients were free of disease at the end of follow-up. Only 3 patients presented minor complications (depression of the flap surface in 1 case and retraction of the ear toward the mastoid process in 2 cases). Subjective rating scales were used to evaluate cosmetic and functional outcomes as assessed by both the dermatologist and the patient. The normal contour of the pinna was conserved in all patients and no patients required additional corrective surgery. CONCLUSIONS: Reconstruction of the pinna using RDIF allowed for satisfactory repair following complete resection of the tumors, while conserving structure and functionality. RDIF has been reported to be a very good option for reconstruction of the pinna. It is a simple technique that makes it possible to repair large defects with minimal risk of necrosis. In our series, the cosmetic results were excellent and recurrence rates were very low. RDIF provided optimal results in repairing lesions in the concha and in other regions, such as the antihelix, triangular fossa, and scapha.


Assuntos
Recidiva Local de Neoplasia , Neoplasias Cutâneas , Humanos , Recidiva Local de Neoplasia/cirurgia , Estudos Retrospectivos , Neoplasias Cutâneas/cirurgia , Retalhos Cirúrgicos , Resultado do Tratamento
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