-
[show abstract]
[hide abstract]
ABSTRACT: Abstract In otoplasty surgery the antihelical fold is frequently created using Mustarde sutures. When using the Mustarde suture technique it is important to insert the needle through the cartilage at right angles. This technical objective is easily achieved with an external Mustarde suture technique. A review of 82 patients who underwent otoplasty between 2005 and 2011 was conducted. All patients underwent external Mustarde suture otoplasty without conchal cartilage resection. The cartilage had been softened by rasping and conchomastoidal sutures had been used to correct conchal excess if necessary. In one patient, a secondary revision was performed for inadequate superior pole correction. In three patients sutures were visible after 1 year postoperatively and the sutures were removed under local anaesthesia without any recurrence. In one patient blister formation occurred due to inaccurate packing, but healed without any problem in a few days. No other complications, such as bowstringing of the internal sutures, haematoma, or infection, were observed. The patients expressed a high degree of satisfaction with their results. The risk of technical error is minimal. It is easy to perform and not time-consuming. Due to these advantages, this method is a reliable technique in otoplasty.
Journal of plastic surgery and hand surgery. 04/2013;
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Although many studies have shown that breast reduction surgery is effective in reducing neck, back, and lumbar pain, most of these studies are subjective evaluations that usually provide data through pain scales. This study was undertaken to objectively evaluate the radiologic effects of breast reduction on the vertebral column. METHODS: Thirty patients who underwent breast reduction surgery were included in the study. A lateral thoracolumbar radiograph was taken before and 3 months after surgery for each patient. The thoracic kyphosis, lumbar lordosis, and sacral inclination angles were measured for each radiograph. The impact of breast reduction surgery on posture was evaluated according to the comparison of these angles before and after surgery. The effect of age, body mass index, and the total amount of removed tissue was also taken into account, and the relationship between these parameters and their effects on the change in preoperative and postoperative angle measurements were evaluated. RESULTS: There was a significant decrease in all 3 angles after breast reduction surgery. A significant correlation was determined between body mass index and the total amount of removed tissue on the change in angle measurements, whereas a definite relationship was not observed between the angles and the patient's age. CONCLUSIONS: This study has shown the objective impact that breast reduction surgery has on the vertebral column. Although the symptomatic relief of breast reduction surgery on the musculoskeletal system is widely accepted, the objective assessment of this relief will be beneficial in persuading health insurance companies and those who think of this surgery as a purely aesthetic procedure.
Annals of plastic surgery 11/2012; · 1.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Xeroderma pigmentosum is an autosomal recessive disease, characterized by vulnerability of the skin to solar radiation. Increase in sunlight-induced cancer is a direct consequence of an increase in mutated cells of the skin of patients with xeroderma pigmentosum. There is no specific technique for facial resurfacing in patients with xeroderma pigmentosum. In this article, a patient with xeroderma pigmentosum with multiple malignant melanomas on her face and radical excision of total facial skin followed by facial resurfacing with monoblock full-thickness skin graft from the abdomen is presented.
The Journal of craniofacial surgery 09/2012; 23(5):1542-3. · 0.81 Impact Factor
-
The Journal of craniofacial surgery 05/2012; 23(3):949. · 0.81 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: There are many synthetic materials for the treatment of bone defects, which have their own advantages and disadvantages. We aimed to compare the efficacy of ostrich eggshell, which is cheap and easily available, and demineralized bone matrix in healing of cranial bone defects.
A full-thickness circular bone defect was created in the frontal bone of 40 Wistar rats. Group 1 was the operative control group. In group 2, demineralized bone matrix applied into the defects; in group 3, Struthio camelus (ostrich) eggshell implants (OSIs) were applied into the defects; and in group 4, ostrich eggshell powders were applied into the defects. Computed tomographic analysis was performed to evaluate the healing of bone defects, the bone density, the OSI area measurements, and the OSI volume and density. At the end of the 24th week, all rats were killed. New bone formation, infection, resorption, and tissue reactions were evaluated.
Ostrich eggshell implants were slightly resorbed, integrated with bone, stable, and supplied good cranial completeness. Ostrich eggshell powders were totally resorbed at the sixth month. There were no significant differences between control and ostrich eggshell groups in new bone formation.
Ostrich eggshell did not seem to be an osteoproductive material, but it has some important advantages as an implant. Ostrich eggshell has a strong structure, is cheap, is shaped easily, and does not cause tissue reaction or infection. Ostrich eggshell could be a good alternative graft material for craniomaxillofacial procedures. Further studies are required to find out the potential use of the ostrich eggshell in craniomaxillofacial reconstructions.
The Journal of craniofacial surgery 09/2011; 22(5):1843-6. · 0.81 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Demineralized bone matrix (DBM) could be a good alternative for craniomaxillofacial contour restoration, especially in perialar, malar, temporal, and frontal regions. In this study, the histologic behavior of DBM was investigated in different tissue planes to determine its proper application plane for restoration of craniomaxillofacial contour deformities and defects.Forty Wistar rats were divided into 6 groups: (1) 0.3 mL of 0.9% saline was injected into the subperiosteal plane of the cranium, (2) 0.3 mL of DBM was implanted into the subperiosteal plane of the cranium, (3) 0.3 mL of 0.9% saline was injected into the subdermal plane on the left inguinal region, (4) 0.3 mL of DBM was implanted into the subdermal plane on the right inguinal region, (5) 0.3 mL of 0.9% saline was injected between the left external and internal oblique muscles, and (6) 0.3 mL of DBM was implanted between the right external and internal oblique muscles. At the 8th week half of the rats and at 16th week the remaining rats were killed in each group, and tissue samples were harvested. Histological and immunohistochemical evaluation revealed new bone tissue and bone marrow formation in all planes that DBM was given.Demineralized bone matrix can provide satisfactory results in craniomaxillofacial contour deformities including forehead, temporal, and malar augmentations, as well as mental and perialar augmentations and saddle nose corrections, with supraperiosteal or deep subcutaneous applications. However, superficial applications must be avoided because of the possibility of palpation, because it induces hard bone tissue formation in all tissue planes.
The Journal of craniofacial surgery 09/2011; 22(5):1888-92. · 0.81 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Temporalis muscle metastasis of a tumor is a rare condition. Basaloid squamous cell carcinoma is an uncommon variant of squamous cell carcinoma, which often occurs in the aerodigestive tract. To the best of our knowledge, there have been no previous reports dealing with temporalis muscle metastasis from esophageal carcinoma in the literature.
The Journal of craniofacial surgery 03/2011; 22(2):736-7. · 0.81 Impact Factor
-
Plastic & Reconstructive Surgery 09/2010; 126:131. · 3.38 Impact Factor
-
Plastic and reconstructive surgery 04/2010; 125(4):159e-160e. · 2.74 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Congenital anatomic deformities or acquired weakness of the lateral crura of the lower lateral cartilages after rhinoplasty could cause alar rim deformities. As lower lateral cartilages are the structural cornerstone of the ala and tip support, deformities and weakness of the alar cartilages might lead to both functional and esthetic problems. In this article, we are introducing sliding alar cartilage flap as a new technique to reshape and support nasal tip. One hundred sixty consecutive patients between 18 and 55 years of age (mean age: 27.51) were included in the study between January 2007 and May 2008. Of the total number of patients 60 were male and 100 of them were female. None of the patients had rhinoplasty procedure including lower lateral cartilage excision previously. Sliding alar cartilage technique was used in an open rhinoplasty approach to shape the nasal tip in all patients. This technique necessitates about 2 to 3 minutes for suturing and undermining the alar cartilages. The follow-up period was between 4 and 18 months. In no patients any revision related to the sliding alar cartilage technique was required. Revision was applied in 3 patients due to thick nasal tip skin and in one patient due to unpleasant columellar scar. In this article, we are presenting the "sliding alar cartilage flap" as a new technique for creating natural looking nasal tip. This technique shapes and supports nasal tip by spontaneous sliding of the cephalic portion of the lower lateral cartilage beneath the caudal alar cartilage, with minimal manipulation, without any cartilage resection, or cartilage grafting.
Annals of plastic surgery 10/2009; 63(5):480-5. · 1.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: While certain parameters such as blood loss and serum lidocaine levels following liposuction have been well studied, fluid shifts between the intravascular and extravascular space have not. With the advent of large volume liposuction, prudent fluid management has become obligatory. Hence, the reason for our study.To test the impact of large volume infiltration on intercompartmental fluid shifts, we measured urine output and hemodynamic changes in 10 anesthetized female Yorkshire pigs weighing between 50 and 85 kg. Eight pigs were infused with 5 to 10 L of tumescent fluid. Two pigs were anesthetized, received no wetting solution, and served as controls. Hemodynamic variables were recorded before infusion and hourly for 48 hours. Animals were extubated after 4 hours of anesthesia. Plasma volume was measured using Evan's Blue Dye, and intravascular fluid shifts were calculated using Foldager's method.Total fluid shift into the intravascular space ranged between 511 and 1036 mL per animal with a mean of 767 mL in the first 3 hours. Higher volumes of fluid infiltration did not lead to fluid overload in the experimental group. Hemodynamic changes were characterized by significant increases in central venous pressure, cardiac output, pulmonary artery pressure, and heart rate consistent with the increase in intravascular volume. Hemodynamic parameters returned to baseline 20 hours following tumescent fluid infiltration.In this porcine model, animals were able to tolerate large fluid challenges delivered by clysis with statistically significant but only modest increases in hemodynamic parameters which gradually returned to baseline within 20 hours.
Annals of plastic surgery 10/2009; 64(1):83-8. · 1.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Lymphedema typically occurs on the extremities and affects millions of people throughout the world. Although currently there is no single treatment proven effective for lymphedema in every patient, suction-assisted lipectomy has been shown to be effective in some patients. Suction-assisted lipectomy offers patients with lower-extremity lymphedema a less invasive, less morbid surgical option compared with traditional excisional techniques. In this article we present a case of lymphedema reduction with suction-assisted lipectomy in a patient with bilateral lower-extremity lymphedema.
Aesthetic Plastic Surgery 06/2009; 33(4):671-3. · 1.41 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Odontogenic keratocyst is an epithelial developmental odontogenic cyst most commonly occurring in the jaws. It comprises approximately 11% of all cysts of the jaws. It has an aggressive behavior including high rates of recurrence, rapid growth, and extension into adjacent tissues. Odontogenic keratocyst is commonly found in the mandible with a predilection for angle and ascending ramus of the mandible. We document a case of odontogenic keratocyst that is unusually originated from the temporomandibular joint and we review the existing literature concerning odontogenic keratocyst. As far we know this is the first case of the odontogenic keratocyst originating from the temporomandibular joint.
Annals of plastic surgery 03/2009; 62(2):210-2. · 1.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Selection of the material for the reconstruction of orbital floor defects is controversial. There are both autogenous and alloplastic materials, each having its own benefits and disadvantages. Resorbable mesh plate is one of the alloplastic implants. Although it has many advantages, the considerable complication related to the mesh is local inflammatory reaction along the infraorbital rim.We present a patient treated using resorbable mesh plate for the orbital floor fracture, in whom gaze restriction in the eye movements was detected because of some fibrotic bands passing through holes of the resorbable mesh.
The Journal of craniofacial surgery 02/2009; 20(1):71-2. · 0.81 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Dorsal hump reduction almost always breaks the internal nasal valve and nasal obstruction is likely to occur postoperatively, unless reconstructed. One hundred eighty patients were operated using both open and closed rhinoplasty approaches. Upper lateral cartilages were meticulously separated from their junction with septum. Following bony and septal cartilaginous hump removal, upper lateral cartilages were folded inward. Either transcartilaginous horizontal mattress/simple sutures or perichondrial sutures were used depending of the desired width of the middle vault and the necessity for a splay-graft effect. In 7 patients unilateral, and in 1 patient bilateral, nasal synechia occurred and they were all treated under local anesthesia. All patients but 9 stated significantly improved nasal breathing. There was no inverted-V deformity or middle-vault narrowing observed. This technique is simple and physiologic, might be applicable for almost all primary rhinoplasty patients. Although it is possible with closed rhinoplasty approaches, it is easier with an open approach.
Annals of plastic surgery 12/2008; 61(5):527-32. · 1.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Prominent ear deformity is a common congenital ear deformity. Prominent ear deformity includes components such as valgus of concha, failure of scaphal folding, conchal hypertrophy, and prominent lobule. The deformity and the elastic properties of the ear cartilage determine the method of surgical correction in each case. Concha-mastoid suture, conchal excision, and posterior auricular muscle excision are different treatment options for mild to severe cases of conchal hypertrophy and valgus deformity. In this article we present a method of conchal excision, combined with a posterior auricular muscle flap, to repair severe conchal hypertrophy or valgus deformity. Six patients (11 ears) were operated on using this method. The results obtained were satisfactory. Postoperative results at 6 months were satisfactory in all patients. The smoothness and the natural appearance of the conchal bowls were notable in all patients. In contrast to the early methods of utilizing the posterior auricular muscle by transposing to the scapha or excising, its usage as a muscle flap for conchal hypertrophy and valgus deformity may be a promising option for the future.
Aesthetic Plastic Surgery 11/2008; 33(4):527-32. · 1.41 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We aimed to evaluate the impact of gradual blood reperfusion on ischaemia-reperfusion injury and to explain the pathophysiology of reperfusion injury in a rat cremaster muscle microcirculation model.
Twenty-four Sprague-Dawley rats weighing 150-200 g were evaluated in three groups. Cremaster muscles were prepared for microcirculatory observations. Group I (n=8, control): no ischemia was induced. Group II (n=8, acute reperfusion): microclamps were applied to the right external iliac vessels for 150 min, then venous and arterial clamps were released at once. Group III (n=8, gradual reperfusion): microclamps were applied to the right external iliac vessels for 150 min, and then the first venous clamp was released; the arterial clamp was opened gradually by a specially designed microclamp holder (Sheey ossicle holding clamp). In all groups, following a wait of 150 min blood flow velocity was measured for 15 min and then the animals were reperfused freely for 1h. Next, red blood cell velocity, vessel diameters, functional capillary perfusion and endothelial oedema index were analysed, and rolling, migrating and adhesing leukocytes and lymphocytes were counted. All observations were videotaped for slow-motion replay. Muscle damage was evaluated histologically.
In the acute clamp release group, blood velocities increased up to 600% of their pre-ischaemic values during the post-ischaemia-reperfusion period. The numbers of rolling, adhering and transmigrating leukocytes were significantly higher and histological evaluation revealed more tissue damage in the acute reperfusion group.
Depending on histological and microcirculatory findings, gradual reperfusion was confirmed to reduce the intensity of reperfusion injury.
Journal of Plastic Reconstructive & Aesthetic Surgery 08/2007; 61(8):939-48. · 1.49 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Various materials such as autogenous bone, cartilage and alloplastic implants have been used to reconstruct orbital floor fractures. A new material is needed because of disadvantages of nonresorbable alloplastic materials and difficulties in harvesting autogenous tissues. In this study safety and value of the use of resorbable mesh plate in the treatment of orbital floor fractures are discussed. Between 2002 and 2004 a total of 17 maxillofacial trauma patients complicated with orbital floor fractures were treated with resorbable mesh plate through subciliary or transconjunctival incisions. Pure blow-out fractures were determined in 6 patients and 11 patients had accompanying maxillofacial fractures. Resorbable plate was easily shaped to fit to the orbital floor by cutting with scissors. Patients were evaluated clinically and with computed tomography scans preoperatively and at 3-, 6- and 12-month intervals postoperatively. Twelve patients had preoperative enophthalmos. Two patients had diplopia that was corrected postoperatively. In all 17 cases there was no evidence of infection, diplopia and gaze restriction postoperatively. Scleral show appeared in three patients by the second postoperative week but resolved totally within 3 to 6 weeks except one patient. In this patient anterior displacement of mesh was evident which caused ectropion and enophthalmos and required re-operation. No any other mesh related problems were seen at 15 months mean follow-up time. The advantage of the resorbable mesh system in orbital floor fracture is the maintenance of orbital contents against herniation forces during the initial phase of healing and then complete resorption through natural processes after its support is no longer needed. Our experience represents that resorbable mesh is a safe and effective material for reconstruction of the selected, non-extensive orbital floor fractures.
Journal of Craniofacial Surgery 06/2007; 18(3):598-605. · 0.82 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This study aimed to evaluate the results of maxillary advancement by using internal Le Fort 1 distractors on six patients with unilateral cleft lip and palate who had maxillary hypoplasia. The retrognathic maxilla of five patients were protracted with distractor bilaterally, and asymmetric advancement was performed in one patients. A removable intraoral acrylic appliance was used as an anchorage appliance in two patients, and Ragno fan-type expander appliance was used in the others to prevent maxillary collapse during the distraction period. The maxilla of one patient was not distracted successfully due to the maxillary collapse in result of breaking the removable anchorage appliance away. Lateral cephalograms were evaluated before 3 and 12 months after distraction.A desired level of advancement was attained in five patients. In one patient distraction was not performed due to the maxillary collapse. In one of the five patients with a wide oronasal fistula, the size of the fistula was decreased with asymmetric advancement of right and left maxillary segments. Following the retention period of 12 months, the results were stable. It was concluded that effective and easy distraction is possible with internal Le Fort 1 distractors in cleft lip and palate patients who requires maxillary advancement.
Journal of Craniofacial Surgery 02/2007; 18(1):177-85. · 0.82 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: In this study, we evaluated the role of host thymus in tolerance induction in composite tissue allografts (CTA) across major histocompatibility complex (MHC) barrier during a 7-day alphabeta- T-cell receptor (TCR)/ cyclosporine A (CsA) protocol.
A total of 62 limb allograft transplants were studied. Euthymic (group A) and thymectomized (group B) Lewis recipients (LEW, RT1(1)) received vascularized hind-limb allografts from hybrid Lewis x Brown-Norway (F1), (LBN, RT1(1+n)) donors. Mixed lymphocyte reaction (MLR) and skin grafting assessed donor-specific tolerance in vitro and in vivo, respectively. Flow cytometry determined the efficacy of immunosuppressive protocols and the presence of donor-specific chimerism. Immunocytochemistry revealed the presence of donor-specific cells in the lymphoid organs of recipients.
Isograft transplants survived indefinitely. For thymectomized rats, the median survival time (MST) of limb allograft in non-treated recipients was 7 days; monotherapy with alphabeta-TCR extended MST to 16 days, and CsA therapy extended it to 30 days. Using the alphabeta-TCR/CsA protocol, the MST of allografts was 51 days. For euthymic rats, the MST of limb allograft in non-treated recipients was 7 days; monotherapy with alphabeta-TCR or CsA extended MST to 13 or 22 days, respectively. Treatment with alphabeta-TCR/CsA resulted in indefinite allografts survival (MST=370 days). MLR and skin grafting confirmed donor-specific tolerance in euthymic recipients. Flow cytometry showed stable chimerism in the euthymic rats and transient chimerism in thymectomized limb recipients. Immunoperoxidase staining revealed the persistence of donor-derived cells in the lymphoid tissues of euthymic recipients.
We found that the presence of thymus was imperative for the induction of donor-specific tolerance in rat hind-limb composite tissue allografts using a alphabeta-TCR/CsA protocol.
Transplantation 07/2006; 81(11):1568-76. · 4.00 Impact Factor
