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Master Thesis

Le lipofilling cervico-facial appliqué à la réparation secondaire des cancers ORL irradiés : technique et indications, étude prospective sur 13 cas

Abstract : Introduction: The repair of head and neck cancers is a real functional and cosmetic challenge, that demands reconstruction ad integrum. Despite the progress of many repair processes such as pedicle flap or free flap and significant improvement in radiation techniques, unsightly trophic sequelae with facial and functional asymmetries - due to skin atrophy or adhesions - are common. Our goal is to improve the post-treatment outcome by treating the integumentary sequelae of radiotherapy and surgical volume losses using lipofilling techniques.
Material and method: In a prospective cohort of 13 patients treated for ENT cancers by surgery and radiotherapy, we evaluated, over a period of 24 months, the realization of fat cell transfer at the irradiated surface. The comparative evaluation of integumentary adipose tissue before and after injection was performed by skinfold measurement, the use of ultrasound and clinical analogue scales.
Results: We measured esthetic and functional improvement in all patients. Patients received two sessions of lipofilling, on average. The preferential areas to be injected for correction of a volumetric contribution were the latero-facial region, the chin and the basilar rim. The correction of facial asymmetries was particularly spectacular. The best functional results concerned the correction of labial and perioral atrophies and dystrophies. The trophic improvement of radiation sclerosis of operated neck was notable. When the patient’s site in question was prepared using preoperative physiotherapy, the results were notably improved. The only complications were cytosteatonecrosis cysts.
Conclusion: Cervico facial lipofilling is a safe, reliable and effective procedure for correcting trophic and cosmetic skin sequelae such as cervical radiosclerosis and cervicofacial asymmetries and improving quality of life. The knowledge of the anatomical risks of radiotherapy in remote facial procedures on patients who have been carcinologically controlled are essential conditions. For a stable and sustainable result in this timeframe, two to three procedures can be performed. Lipofilling is an additional way to improve the quality of life of patients.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02381577
Contributor : Bibliothèque Universitaire de Médecine Nice <>
Submitted on : Tuesday, November 26, 2019 - 4:44:30 PM
Last modification on : Sunday, October 25, 2020 - 7:05:28 AM

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  • HAL Id : dumas-02381577, version 1

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Alexandra Maertens. Le lipofilling cervico-facial appliqué à la réparation secondaire des cancers ORL irradiés : technique et indications, étude prospective sur 13 cas. Médecine humaine et pathologie. 2019. ⟨dumas-02381577⟩

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