ABSTRACT
Introduction: An approach based on multiple anatomical structures and the use of different surgical strategies seems to achieve more lasting results in cervical rejuvenation surgery. Thus, extended cervicoplasty is an option with favorable results and low complication rates. However, little has been published regarding the durability of the results. This study aimed to objectively evaluate the long-term results obtained with extended cervicoplasty in difficult cases. Methods: Twenty patients, classified as having a "difficult neck," underwent extended cervicoplasty and were followed for 5 years. The results at 1- and 5-year post-operative follow-up were evaluated by eight plastic surgeons, using six objective criteria based on a theoretically ideal neck. The comparison of the results obtained at these time points was performed using a paired Student's t-test, with a level of significance of 5%. Results: There was no significant difference in five of the six items evaluated (p-value ranging from 0.137 to 1.000), in the comparison between the first and fifth postoperative years. Subhyoid depression displayed a significantly better mean score in the fifth evaluation year than that observed in the first year after surgery (p = 0.039): from 5.80 ± 0.25 points (mean ± standard error of the mean) in the first year, to 6.45 ± 0.30 points in the fifth postoperative year. Conclusion: Extended cervicoplasty is an important alternative in the treatment of the neck region, and even provides lasting results in difficult cases.
Introdução: A abordagem de múltiplas estruturas anatômicas e a utilização de diferentes estratégias cirúrgicas parece contribuir para a obtenção de resultados mais duradouros na cirurgia do rejuvenescimento cervical. Para isso, a cervicoplastia ampliada é uma opção com resultados agradáveis e baixos índices de complicações. A durabilidade dos resultados obtidos é, no entanto, pouco discutida na literatura. O objetivo desse estudo é avaliar objetivamente a manutenção dos resultados a longo prazo obtidos com a cervicoplastia ampliada aplicada em casos difíceis. Métodos: Vinte pacientes, classificadas como "pescoço difícil", foram submetidas à cervicoplastia ampliada e acompanhadas por 5 anos. Os resultados do pós-operatório de 1 e de 5 anos foram avaliados por oito cirurgiões plásticos, por meio de seis critérios objetivos vinculados a um teórico pescoço ideal. A comparação entre os resultados obtidos nestes momentos foi realizada por meio do teste t-student pareado, considerando um nível de significância de 5%. Resultados: Não houve diferença significativa em cinco dos seis itens avaliados (valor de p variando entre 0,137 a 1,000), na comparação entre o primeiro e o quinto ano de pós-operatório. A depressão subhioideia apresentou pontuação média na avaliação do quinto ano significativamente melhor do que aquela observada no primeiro ano após a cirurgia (p = 0,039), passando de 5,80 ± 0,25 pontos (média ± erro padrão da média) no primeiro ano, para 6,45 ± 0,30 pontos no quinto ano de pós-operatório. Conclusão: A cervicoplastia ampliada se valida como alternativa importante no tratamento da região cervical mesmo em casos difíceis, proporcionando a obtenção de resultados duradouros.
Subject(s)
Humans , Female , Adult , Middle Aged , History, 21st Century , Rejuvenation , Rhytidoplasty , Retrospective Studies , Plastic Surgery Procedures , Cervicoplasty , Head , Neck , Neck Muscles , Rejuvenation/psychology , Rhytidoplasty/methods , Plastic Surgery Procedures/methods , Cervicoplasty/methods , Head/anatomy & histology , Head/surgery , Neck/anatomy & histology , Neck/surgery , Neck Muscles/anatomy & histology , Neck Muscles/surgeryABSTRACT
Cervical tracheal reconstruction using platysma myocutaneous trap door flap strengthened with. auricular cartilage was studied in 16 dogs. Window defects involving 5 and 10 tracheal rings from the anterior tracheal wall were produced in different 2 groups of animals [group A and B]. The results were evaluated by clinical follow up to 3 months. In group A. six of the 8 animals completed the scheduled follow up while in. group B. five animals completed the follow up of 3 months without significant complications. Gross examination of the animals of both groups which completed the pre-established period of follow-up showed maintenance of the intraluminai diameter at the levels of the reconstructed segment. The mucosal cutaneous junction was healed with no apparent granulation tissue free edges of the resected tracheal rings were closely attached to the rotated flap. Hair was fully grown and covered with mucous. Histologically, the flap was covered by stratified squamous epithelium which was closely attached to the free margin or the trachea by fibrous tissue. The cartilage was seen intact with mature chondocytes. The use of platysma cutaneous door flap strengthened with auricular autologous gives relatively good anatomic and functional results in. reconstruction of tracheal defects. This may call for considering the clinical use of flap in selected cases of tracheal wall lesions in human