![]() ![]() Extensive subcutaneous cysts that form on both sides of the neck, cause stretching of the neck skin in the initial period and then, as a result of their sclerosing, shrinking and scarring, even folds are formed on the lateral surfaces of the neck, extending from the mastoid processes of the temporal bone to the coracoid process of the shoulder blade (9). A webbed neck, occurring in approximately 15 per cent of patients with Turner’s syndrome, is probably a remnant of the backflow of subcutaneous lymphatic obstruction around the neck formed during fetal development. In Turner’s syndrome, the webbed neck is accompanied by a low hairline, which is an additional difficulty while planning a surgery (8). Such abnormality is also noticed in other congenital malformation syndromes (e.g. Of view of plastic surgery, one of the most important elements of the therapy is correction of the webbed neck deformity. ![]() Surgical correction of a webbed-neck deformity in Turner’s syndrome From the point Unauthenticated Download Date | 2/20/17 4:27 PM The latest scientific reports seem to confirm the positive effects of the use of a growth hormone in the early stages of treatment (7). A milestone in the treatment of this syndrome was the introduction of an estrogen replacement therapy in the first half of the last century by an American endocrinologist Henry Turner. Turner’s syndrome treatment methods are constantly developing (6). Turner’s syndrome is increasingly being diagnosed prenatally or in infancy or early childhood, which is crucial for the quick implementation of multidisciplinary (both pharmacological and surgical) treatment of the disease (5). 45,X/46,XX or 45,X/46,XY) are also fairly often, as well as structural abnormalities of chromosome X (4). A typical form of this syndrome is associated with a lack of one of the sex chromosomes (karyotype 45, X), but mosaics (e.g. This genetically determined pathology is characterised by a number of congenital disorders (short height, broad chest with widely placed nipples, gonadal dysgenesis, primary amenorrhea, aortic coarctation, bicuspid aortic valve, congenital kidney abnormality, facial cranium defects) (1, 2, 3). Turner’s syndrome occurs in approximately 1 out of every 2,000 to 2,500 live-born girls. Key words: web neck deformity, Turner’s syndrome, surgical correction Z-plasty enables an adequate extension of scars and improves the contour of the neck. The lateral approach with a shift of glabrous skin flap to the back, which we performed, allows for effective reduction of the webbed neck, excision of bands of the connective tissue and correction of the low hairline on the side of the neck. The lower line of the scalp in the central part of the neck has remained unchanged. The performed surgical procedures enabled correction of low hairline only in the lateral parts of the neck. In one case, the correction was insufficient. One patient was found to have unilateral moderate webbed neck recurrence after about 2 years of treatment. ![]() In the case of four operated patients, the folds were completely removed and a correct symmetrical outline of the neck was obtained. In the case of all patients, the aim was to distribute the neck skin folds by using Z-plasty in conjunction with a shift to the back of glabrous skin flaps mobilised from the anterolateral surface of the neck. The age of patients ranged from 9 to 17 years. In the years 2000–2012, six children with Turner’s syndrome were treated because of the webbed neck deformity. The aim of the study was to present the possibilities of surgical treatment of a webbed neck of patients with Turner’s syndrome and the evaluation of treatment results. From the point of view of plastic surgery, one of the most important elements of the therapy is correction of the webbed neck deformity. A typical form of this syndrome is associated with a lack of one of the sex chromosomes (karyotype 45, X). This genetically determined pathology is characterised by multiple congenital anomalies. Antoszewski Turner’s syndrome occurs in approximately 1 out of every 2,000 to 2,500 live-born girls. Surgical correction of a webbed-neck deformity in Turner’s syndrome Tomasz Zieliński, Katarzyna Lorenc-Podgórska, Bogusław Antoszewski Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University in Łódź Kierownik: prof. ![]()
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