Gyndych O. Surgical treatment of capillary malformation of head and neck.

The dissertation is based on the data of complex clinical investigation and surgical treatment of 37 patients with capillary malformation of head and neck. The reasons of unsatisfactory follow-up results in comparison group of patients were analyzed. After capillary malformation's incision, skin grafts, local and distant flaps were used to cover face defects, but these approaches often lead to an unsatisfactory facial appearance when principle of restore an aesthetic facial units were neglected. Complex individual approach by new reconstructive methods can allow us to create flaps with necessary characteristics and to improve results of tissue defects reconstruction after capillary malformation's resection. So, the tactics of treatment was worked out after careful evaluation of the type, location, depth, extent of lesion at present state. A diagnosis of simple, nodular or combined type was based on clinical symptoms, signs, Doppler examination and radiographic evaluations. All patients with simple and nodular capillary malformation were undergone excision or resection of the lesion and defects were closed by using local axial and randomized flaps transposition. Capillary - arteriovenous malformation required combined therapy with embolization, surgical incision and reconstruction. Embolization within 24 to 72 hours before excision to provide temporary occlusion of fistulas and facilitated the surgical procedure. Depended on localization we used transposition of axial flaps (paramedian forehead flap, submental flap, supraclavicular flap, superior thyroid artery perforator flap). If necessary we additionally we expanded the residual normal tissue on the face adjacent to the lesion. Basing on the analysis of results of compared and main groups of patient the advantages of axial flap transposition for defect covering was grounded. Offered tactics and operative treatment have allowed to increase good results rate from 29,4% to 45,0%.