KLEMPAVOST KOD DJECE DOVODI DO TRAUME: Korekcija se radi prije polaska djeteta u školu

Klempavost je više psihološki nego estetski problem i može dovesti do stvaranja kompleksa kod djeteta, kojeg se teško može osloboditi, osobito kada krene u vrtić ili školu.Da taj kompleks zaista postoji kod  nekih ljudi s deformacijom ušiju, govori činjenica da i mnoge odrasle osobe žele korigovati ovaj estetski nedostatak.Kako se nepravilnost uočava u ranom djetinjstvu, mnogi roditelji su u nedoumici kada operisati klempave uši kod djeteta.Čak više roditelji prave problem zbog klempavih ušiju nego djeca, jer se plaše(posebno ako su i oni imali /imaju isti problem )da njihova djeca ne budu ismijana od strane vršnjaka, insistirajući na operaciji vrlo rano.Stavovi hirurga su usaglašeni da se korekcija uradi prije polaska djeteta u školu, jer je do tada ušna hrskavica završila svoj razvoj sa 90-95%.

Gubitak samopouzdanja

Do treće godine života ušna školjka doseže 85 posto svoje veličine, a sa pet godina rast je skoro definitivan.Odstojeće uši predstavljaju  veliko psihičko opterećenje za dijete ili osobu  te može stvoriti kompleks kojeg se dijete teško može osloboditi. Djeca su izložena ruganju i podsmijehu vršnjaka. Djevojčice su osjetljivija kategorija, povlače se u sebe, ne žele da vežu kosu. To utiče na sampouzdanje i pravilno formiranje ličnosti. Zbog toga ne treba ovaj problem zanemariti, osobito ako to dijete opterećuje.Važno je da dijete uradi operativni zahvat prije polaska u školu zbog psihološkog aspekta razvoja djeteta. Treba  izbjeći psihološko maltretiranje od strane vršnjaka koji idu dotle da dijete nazovu Mini(mouse ) ili Micky(mouse),Klempo itd.Najmlađe dijete koje smo operirali u našoj poliklinici je bilo staro 5 g i 4 mjeseca.Ipak ,rekla bih, najviše operacija odstojećih radimo u 1.,7. i 8. mjesecu jer je tada raspust djece.Sto može da znači da su djeca, nažalost ,doživjela neprijatnost u školi.

Starija dob

Operativni zahvat se može izvesti i u starijoj dobi. Uho može biti klempavo obostrano, jednostrano, simetrično ili asimetrično.Ako je ugao između zadnje strane uha i glave veći od 30 stepeni, onda kažemo da je klempavo.Najstariju osobu koju smo operirali u poliklinici ,,Karabeg’’  imala je 62 godine.

 Jedinstvena hrskavica ušne školjke

Hrskavica ušne školjke je vrlo tanka, elastična, može da se savije i ima određen reljef. Ako se takva hrskavica  operativno deformiše  ili  na neki način hirurškim putem uništi, ne može više da se dobije takav kvalitet modeliranja .Mogu da se dobiju oblik i reljef, ali takva hrskavica je tanka i kruta, nije elastična kao prirodna hrskavica ušne školjke.Napraviti istu, nikom još nije uspjelo. Zbog toga je važan odabir iskusnog i kvalitetnog ljekara.Minimalna trauma

Ovu vrstu operacija ubrajamo u red minimalnih operacija i sa najmanjom traumom, a uz to dobijemo impresivnu i snažnu promjenu izgleda.Korekcijom klempavih ušiju uške se priljubljuju uz glavu ili se smanjuje njihova veličina.Postoje različite hirurške tehnike kojima se uške priljubljuju uz glavu, smanjujući na taj način preveliki ugao između zadnje strane uha i glave.(Mustard, Converse, Becker i dr). Na našoj poliklinici radimo sopstvenu metodu oblikovanja hrskavice kojom se dobije prirodni oblik uha.Izuzetno rijetko se ovom metodom uho vrati u nepovoljan položaj.

Mali ožiljak

Oporavak je jednostavan.Dijete nosi zavoj oko glave  3-5 dana koji omogućava da proces zarastanja novoformirane uške teče nesmetano i da u ranom postoperativnom periodu ne bi došlo do povrede ili presavijanja uški, što bi moglo dovesti do recidiva( ponovnog vraćanja) deformiteta. Narednih  do mjesec dana nosi  se  elastična trakica da bi se spriječilo savijanje uški.Ožiljak nije uočljiv jer se nalazi na stražnjoj strani uški.

Prednost dajemo lokalnoj anesteziji

Na našoj poliklinici većinu operativnih zahvata izvodimo u analgosedaciji. Tako je i kod korekcije odstojećih ušiju.Ova vrsta anestezije obezbjeđuje komfor djetetu ali i hirurgu koji obavlja operativni zahvat. Dijete nema boli,, nema straha,, opušteno je ili spava i ne sjeća se samog izvođenja procedure.Ova vrsta anestezije nije opšta anestezija( gdje je dijete potpuno uspavano).Naravno, sve ovo se ne bi moglo postići bez iskusnog anesteziologa koji čitavo vrijeme prati vitalne funkcije( rad srca i disanje) i ne dozvoljava bilo kakav negativan efekat primjenjenih lijekova.

Rezultati

Rezultati su beskrajno zadovoljavajući za pacijenta.Samo u 1-2 % slučajeva se u našoj poliklinici rade manje dodatne korekcije mada se literaturno nalazi procent od 5-8-12 % zavisno od tehnike i hirurga.

Najvažnije je da se odabere najkompetentniji hirurg ,koji ima povjerenje pacijenta ili roditelja,dovoljno iskustvo ,znanje.Zbog ranijeg navedenog ,najbolja je uvijek prva operativna šansa.Novi zahvat je sa više rizika i mogućih(izuzetno rijetkih) komplikacija.

Polikilnika Karabeg

Tel 033 556 556,033 556 555

www.karabeg.com

Dr. Danijela Crnogorac 

član Udruženja plastično rekonstruktivnih i estetskih hirurga  u BIH

Član BAPRAS-a

Član ESPRAS-a

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