Metin Görgü

Multiple Occurrence of Pilomatrixoma

Multiple occurrences of pilomatrixoma are rare. Although it has been known as a benign lesion, there are reports of some tumors that have histopathologic features of malignancy. A case of a 68-year-old Caucasian women with multiple pilomatrixoma is presented. She was operated on to remove three other pilomatrixomas on the arms 3 years after the initial excision from the face. Two years after excision of the lesions on the arms, no recurrences were evident.

Late and long-standing capsular hematoma after aesthetic breast augmentation with a saline-filled silicone prosthesis: A case report.

Abstract. Late capsular hematoma is an extremely rare complication after the implantation of silicone breast prostheses for aesthetic or reconstructive objectives. We present a unique case of late capsular hematoma in an aesthetic breast augmentation with a saline-filled, textured silicone implant, which remained for a year after formation.

Bilaterally involved Tessier No. 4 cleft: case report.

Craniofacial clefts are rare among facial anomalies, with an incidence of 1.5 to 5 per 100,000 births, and 1 per 100 cases of cleft lip and palate. The Tessier No. 4 oro-ocular cleft is one of the rarest, with 33 unilateral and bilateral clefts reported in the literature. Among the bilateral clefts only 3 of 9 involved Tessier No. 4 cleft bilaterally. We report a case of bilateral Tessier No. 4 craniofacial cleft and our approach to surgical correction.

Maximizing Breast Projection with Combined Free Nipple Graft Reduction Mammaplasty and Back-folded Dermaglandular Inferior Pedicle

Abstract:  Standard technique for free nipple reduction mammoplasty was described by Thorek in 1922 ( 1 ). In contrast to its effectiveness, late postoperative results included insufficient projection of the breast and the nipple–areola region. We describe a modification of this well recognized technique in order to increase central mound projection and improve nipple–areola projection by suturing the dermaglandular flap to the pectoralis major muscle by back‐folding the pedicle. Twenty macromastia patients were subjected to free‐nipple‐graft reduction mammoplasty in combination with inferior pedicled dermaglandular reduction mammaplasty of a total of 40 breasts with this technique between years 2000 and 2004. Preoperative planning for inferior pedicled dermaglandular flap was made using the “Wise” pattern for large breasts. The variation of the technique comes from using the back‐folded deepithelialized inferior pedicled dermaglandular flap for increasing the breast mound projection by fixating the demaglandular flap with absorbable sutures to the underlying pectoralis major muscle fascia and the costal cartilage pericondrium. By applying this technique, increased projection during the early preoperative and late postoperative periods are achieved, compared with patients who only underwent free‐nipple‐ graft reduction mammoplasty.

Three-dimensional computed tomography in evaluation of ankylosis of the temporomandibular joint.

Ankylosis is an uncommon disease of the temporomandibular joint (TMJ), the effective treatment of which requires detailed preoperative evaluation of the type and extent of the deformity. As well as lateral radiographs and computed tomography (CT), three-dimensional CT has been introduced to improve the preoperative evaluation. We present six patients with ankylosis of the TMJ who were evaluated by three-dimensional CT before and after condylectomy. Preoperative findings were compared with operative findings. Three-dimensional CT provides a detailed three-dimensional image of the TMJ non-invasively and we suggest that it is a valuable tool for evaluation of ankylosis in the TMJ.Ankylosis is an uncommon disease of the temporomandibular joint (TMJ), the effective treatment of which requires detailed preoperative evaluation of the type and extent of the deformity. As well as lateral radiographs and computed tomography (CT), three-dimensional CT has been introduced to improve the preoperative evaluation. We present six patients with ankylosis of the TMJ who were evaluated by three-dimensional CT before and after condylectomy. Preoperative findings were compared with operative findings. Three-dimensional CT provides a detailed three-dimensional image of the TMJ non-invasively and we suggest that it is a valuable tool for evaluation of ankylosis in the TMJ.

Application of external fixators in major foot contractures

Extremity contractures are one of the most common deformities faced by the reconstructive surgeon. Major deformities with ankylosis of the related joint have to be managed by both soft tissue and bone operations. Contractures existing for a long period of time cannot be brought into anatomic position easily because of shortened tendons, nerves, and vessels or ankylosed joints. Although tendons can be lengthened in one operation, this is not the case for neural and vascular structures. The authors use external fixators associated with soft tissue procedures to gradually correct major foot dorsiflexion contractures.

Congenital lateral cleft palate : a new anomaly ?

A case of atypical cleft palate abnormality that had not been identified before in a 9-year-old girl is presented. The cleft was localized laterally and in an oblique position at the soft palate. The patient had cleft palate repair. Finally, she had acceptable soft palate movements and speech.

Interactıon of Botulınum Toxın Type A wıth Local Anesthetıc Agents: An Experımental Study with Rabbıts

Injection of botulinum toxin is a painful procedure, limiting the number of patients treated. This study was designed to establish whether infiltration of local anesthetics plays a role in the effectiveness of botulinum toxin. For the study, 24 New Zealand white rabbits were divided into three groups. In all three groups, local anesthetics (prilocaine, lidocaine, lidocaine, and epinephrine) were injected into the right anterior auricular muscle before a 2.5-U injection of botox A. The contralateral anterior auricular muscle of all the rabbits was injected with the same dose of the toxin to serve as a control. Photographic documentation was recorded; electromyographic study was performed; and results were statistically analyzed. The results show that local anesthetics do not play a role in the efficacy of botulinum toxin. Thus, the use of infiltrative local anesthetics before botulinum toxin injection is a safe method for achieving a less painful procedure for the patient.

Nonsurgical delay of cutaneous flaps using the flashlamp pumped pulsed dye laser

&NA; The surgical delay procedure is an effective method for improving skin flap survival. However, it has many disadvantages, such as bleeding, infection, and pain. It also requires an additional operation and a long time for wound management. Nonsurgical delay has a great importance, but pharmacological efforts for delay phenomena have never found clinical application. In this study, the authors attempted to reproduce the delay phenomena via the flashlamp pumped dye laser. Forty Sprague‐Dawley rats were studied in four groups of 10 rats each. The experimental and control flaps were on the same rat. Flaps were planned on the ventral skin of the rats, and were symmetrical, three sided, based caudally, and were 2 cm in width, extended to the measured midpoint between the xiphoid and the sternal notch. The laser was applied to the different areas of the experimental flaps 15 days before flap elevation. A week later flap survival was determined by overlaying millimeter‐grid acetate paper. Full‐surface and perimeter “lased” experimental flaps showed a marked increase in surviving areas when compared with the control flaps. This kind of flap delay has a great potential in clinic application. Aslan G, Karaçal N, Görgü M, Erdoğan B. Nonsurgical delay of cutaneous flaps using the flashlamp pumped pulsed dye laser. Ann Plast Surg 2000;44:277‐281

Various applications of chondrocutaneous composite grafts in secondary cleft lip nose patients.

Composite chondrocutaneous grafts were applied to 12 patients in various forms to repair the columellar deficit, to form the nasal tubercle and nostril sill in cleft lip nose patients. Cleft lip-nose deformity patients with alar cartilage hypoplasia, obtuse angulation of the medial and lateral crura and the resulting plica vestibularis, internal nasal valve problems associated with the weakness of upper lateral cartilages are included in this study and composite conchal cartilage grafts are utilized to achieve a symmetrical and functional result.