Candemir CERAN, Ersin AKŞAM, Düriye Deniz DEMİRSEREN, Berrak AKŞAM, Mustafa Erol DEMİRSEREN

Medial Kantal Bölge Cilt Defektlerinde Rekonstrüksiyon Alternatifleri

Giriş: Medial kantal bölge cilt kanserlerinin sık görüldüğü, estetik ve fonksiyonel açıdan önemli bir bölgedir. Bu bölge defektleri nadiren travma, enfeksiyon ve yanık nedeniyle ortaya çıksa da en sık tümör eksizyonu sonucu oluşmaktadır. Bu çalışma medial kantal bölge defektlerinde kullanılan rekonstrüksiyon yöntemlerini incelemek amacıyla yapılmıştır. Gereç ve Yöntem: Kliniğimizde son on yıl içerisinde tedavi edilen medial kantal bölge tümörü olguları yaş, cinsiyet, histopatolojik tanı ve rekonstrüksiyon yöntemleri açısından geriye dönük olarak incelendi. Bulgular: Ortalama yaşları 60.7 olan 61 hastada defektlerin ortalama boyutları 1.0 x 0.7 cm olarak ölçüldü. Defektlerin onarım yöntemleri geriye dönük olarak değerlendirildiğinde; 13 primer onarım, 15 tam kalınlıktaki deri grefti, 21 alın bölgesinden lokal flep, 14 yanak bölgesinden lokal flep ve bir hastanın burun bölgesinden planlanan flep ile onarıldığı tespit edildi. Sonuçlar: Medial kantal bölge defektlerinin rekonstrüksiyonunda estetik açıdan renk ve doku uyumu iyi olan, kılsız deri içeren ve doğal konkaviteyi bozmayacak bir yöntem seçilmelidir. Ayrıca fonksiyonel açıdan distorsiyona, ektropiyona ve epiforaya sebep olmayacak şekilde planlama yapılmalıdır. Primer onarılamayacak büyüklükte ve tam kalınlıkta deri grefti ile onarıma uygun olmayan defektlerde en iyi tercih lokal fleplerdir.

Anahtar Kelimeler:

medial kantal bölge, rekonstrüksiyon, tümör eksizyonu, glabellar flep, bilobe flep

Reconstruction Alternatives of Medial Canthal Region Skin Defects

Introduction: Medial canthal region is an important anatomical region both aesthetically and functionally and it is also a common location for skin malignancies. Medial canthal region skin defects most commonly occur after tumor excisions. This study was designed to evaluate reconstruction alternatives of medial canthal region skin defects. Material and Methods: Reconstruction methods of medial canthal region skin defects performed in our clinic in the last decade reviewed retrospectively. Age, sex, histopathological findings of the patients and reconstructive methods were evaluated. Results: Medial canthal region skin defects of 61 patients with a mean age of 60.7 was reconstructed in our clinic. Mean size of the defects were 1.0 x 0.7 cm. When the methods of reconstruction evaluated retrospectively; 13 defects were primarily closed, 15 defects were covered with full thickness skin grafts, 21 defects were reconstructed with local flaps from forehead region, 14 defects reconstructed with local flaps from cheek region and one defect was reconstructed with a flap from nasal region. Conclusions: The principles of the reconstruction is to ensure color and tissue match with a non hair bearing skin that prevents distortion, ectropion and epiphora while preserving the natural concavity of the medial canthal region. When the defects are not suitable for primary closure or full thickness skin grafting, local flaps are the best options.

Keywords:

medial canthal region, reconstruction, tumor excision, glabellar flap, bilobed flap,

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