[ bilobed flap in facial reconstruction]

The spinocellular carcinoma occurs mainly after 40 years old. The excision of these tumors in the cause of loss of substances that pose the problem of reconstruction, especially for tumors localized to the face. The bilobed flap is a useful technique to cover the losses of substances. We describe a 72 years old patient who presents an advanced tumor of the right cheek measuring 6 x 4 cm. we performed a resection of the tumor with a safety margin of 1cm. the reconstruction uses the bilobed flap. The postoperative result is very satisfying. More common for men than for women, this tumor is favored by excessive sun exposure, precancerous skin lesions, genetic diseases [xeroderma pigmentosum], chronic irritation [leukoplakia]. Any suspect lesion should be biopsed. The spinocellular carcinoma spreads quickly locally, spreading to some nearby lump nodes. The treatment of choice for this tumor is surgery. The bilobed flap is particularly suited to reconstract the losses of substances of medium or large size localized to the face. The bilobed flap is a very interesting technique to cover the defect left by excision of a spinocellular carcinoma

[Reconstruction of the upper lip by the radial chinese flap]

The defects of the face pose a problem of reconstruction, it must obey the imperatives of both functional and aesthetic, these requirements are even more pronounced with younger patients. The antibrachial radial flap of [Chinese] flap is an interesting technique for the reconstruction of such loss of substance. We describe the case of a young man of 26 years, victim of a work accident. The lesions involved the scalp, completely avulsed, forehead, right eye, right cheek, the left wing of the nose and upper lip. After replantation of the scalp and right eye enucleation, we used the Chinese flap to cover the defect of the upper lip. The flap was taken from the left forearm and connected to the superior thyroid artery. The postoperative course is simple. The aesthetic and functional results are very satisfactory. The antibrachial radial flap is called [chinese flap] because it was first described in China. It is a strip of low flow and vascular axial meso. Design of the skin paddle is longitudinal or oblique in the forearm, on the radial artery. The one-piece dissection of the radial artery and its septocutaneous branches is in the proximal-distal direction. The proximal dissection dates back to the origin of the radial artery. The donor area is covered by a thin skin graft immediately or secondarily. The Chinese free flap is characterized by a thin and flexible skin perfectly suited to the reconstruction of the face and its excellent vascularization. The disadvantages are unsightly scars on the donor area and the sacrifice of the radial artery. The Chinese flap that we used for the reconstruction of the upper lip has given a very good results on both functional and aesthetic points

[ Mustarde flap]

The main cause of substance loss of the face is a removal of skin tumors by surgical excision which remains an essential treatment of skin cancers. The coverage of these losses of substances must comply with functional and aesthetic requirements. We use in our work the Mustarde flap to cover the defect. We describe the case of a patient who suffers of a basocellular carcinoma. The loss of substance left by the excision is 3 x 4 cm. the flap design goes back horizontally 1 cm below the lower eyelid, extending to the temporal region and down to the front of the ear lobe. A large detachment followed by a rotation of the flap can easily cover the defect. The postoperative course are simple. The aesthetic and functional result is very satisfactory. As an incontestable social element, the face requires a functional and also aesthetic reconstruction to be the closest possible to "ad integrum" restitution as the socio-professional pressure is presently considerable. The Mustarde flap is a flap of skin, thick, with large area and inferior pedicle. The flap design goes above and beyond to outer canthus, swells around the temple area and down to the front of the ear lobe. A movement of medial rotation is printed an external cantholysis allows the possible mobilization of the lateral part when it is stored. To avoid ectropion, it should be securely moored at the temporal and orbital periosteum. The wide separation allowed by subcutaneous flap Mustarde can cover large medial, paranasal, losses of substance. The Mustarde flap is a very interesting technique in the treatment of loss of substance of the face

chondrosarcome mesenchymateux a localisation musculaire

This article deals with the extra skeletal mesenchymal chondrosarcoma especially the muscular localisation, through a report of one case and review of literature. It concerns a 38 years old female patient who developed a muscular tumor in her right calf, since 18 months. Treated by wide surgical resection without any adjuvant treatment. Follow up for 6 years showed a good general condition and no signs of local recurrence or distal metastasis. The extra skeletal mesenchymal chondrosarcoma exceptionally affects young patients. Treatment is essentially surgical. Radiotherapy and chemotherapy do not prove their efficiency. Local recurrence rate is about 52% in the subsequent 2 years, that is why a very rigorous surveillance should be done in this period. prognosis is bad wirh a 10 years survival rate of 32%