Cemal Alper Kemaloğlu

The Alar Rim Flap: A Novel Technique to Manage Malpositioned Lateral Crura

BACKGROUND Alar cartilage malposition is a common anatomic variation in which the axis of the lateral crus lies cephalically and may be parallel to the cephalic septum. Malposition of the lateral crura may produce inward collapse of the alae that is observable on deep inspiration. OBJECTIVES The authors performed the alar rim flap technique to treat patients with alar malposition and assessed functional and aesthetic outcomes. METHODS Twelve patients who underwent primary open rhinoplasty with the alar rim flap technique were evaluated in a prospective study. A 2- or 3-mm caudal portion of the lateral crus was elevated from the underlying mucosa, pulled caudally, and extended with a cartilage graft. This extension of the alar rim flap was placed through the pyriform aperture for additional support. Patients completed pre- and postoperative questionnaires addressing nasal obstruction and underwent paranasal computed tomography. Patients received follow-up for an average of 16 months (range, 8-27 months). RESULTS Patients with alar cartilage malposition and external valve insufficiency experienced aesthetic and functional improvements after rhinoplasty with the alar rim flap technique. No patients developed alar rim collapse or flap displacement. CONCLUSIONS The alar rim flap technique is effective for the correction of malpositioned lateral crura and external valve insufficiency. Because this technique does not damage the scroll area, disruption of the internal valve area is avoided. LEVEL OF EVIDENCE 4 Therapeutic.

An unpredicted side effect of prophylactic antibiotic use

Abstract Introduction and Objective: We investigated the effects of cefazolin sodium (CS), on wound healing in rats. Material and Method: Forty rats in which an incisional wound model was created by removing two skin strips (4×1 cm), and suturing the wound edges, were included. Four groups were formed in a randomized way with each having 10 rats. The Control group (Group 1) received 1 cc 0·9% NaCl twice daily, whereas Group 2 received single-dose preoperative 30 mg/kg CS, Group 3 received single-dose preoperative 30 mg/kg CS followed by the same dose for three postoperative days, and Group 4 received single-dose preoperative 30 mg/kg CS followed by the same dose for seven postoperative days (via i.p. route). On the first day of the study, as the wound was created, a skin strip of 1×1 cm area was collected for bacteriologic examination. On the third day, specimens were acquired from the incision for histopathologic examination. The rats were sacrificed on the seventh day and more specimens were gained for histopathologic, tensiometric, and bacteriologic tests. Result: Group 4 demonstrated disrupted normal skin flora; reduced inflammatory cell density, fibroblastic activity, and collagen density; and decreased wound tensile strength. The histopathologic findings with Groups 2 and 3 were as same as with Group 4 and wound tensile strength showed no significant difference compared with the Control group. Group 2 revealed no significant difference compared with the Control group with regard to all parameters. Discussion: Seven-day CS therapy had a negative effect on wound healing and changed the normal skin flora.

The effect of sildenafil on fascia‐wrapped diced cartilage grafts

Diced cartilage grafts are frequently used, especially in rhinoplasty. The effect of sildenafil on the viability of diced cartilage grafts was investigated in this study.

The effect of sildenafil on fascia-wrapped diced cartilage grafts: Sildenafil's Effect on Diced Cartilage Grafts

Diced cartilage grafts are frequently used, especially in rhinoplasty. The effect of sildenafil on the viability of diced cartilage grafts was investigated in this study.

Reconstruction of a subtotally amputated auricle with a very narrow inferior pedicle

Abstract In our case study, the left ear of a 57-year-old male patient was subtotally amputated due to an iron-plate cutting accident. Only a 5-mm inferior skin pedicle connected the amputated ear to the lobule. The ear was reattached with primary suture without microsurgery. The reattached ear healed uneventfully.