Mustafa Şengezer

Measurement of orbital volume by a 3-dimensional software program: an experimental study.

PURPOSE This study reports a simple method with high accuracy for determining orbital volume from computed tomography (CT) scans. MATERIALS AND METHODS The volume of 20 orbits was evaluated in 20 dry skulls by use of a 3-dimensional software program in General Electric High-Speed Advantage CT/I (Milwaukee, WI), and compared with the volume obtained by direct measurement using the water displacement method. Accuracy of volume measurement by this software program was assessed statistically by paired samples t-test. RESULTS The mean volume was found to be 28.37 mL +/- 2.15 by direct impression and 28.41 mL +/- 2.09 by the software program. Volume difference between the 2 methods averaged 0.93 +/- 1.08 mL for each orbit (P < .01). The correlation between the techniques was found to be high (r = 0.887, P < .01). There was no significant volume discrepancy between the 2 methods. CONCLUSION Measurement by the technique described is an easy and accurate method of assessing the volume of the orbit.

Treatment modalities for post-burn axillary contractures and the versatility of the scapular flap

Inappropriate treatment of axillary burns frequently results in adduction contractures. In this clinical study we have reviewed 32 patients with different types of axillary post-burn adduction contractures. We have used a variety of surgical treatments for reconstruction of axillary contracture releasing defects such as simple grafting, Z-plasties and locally pedicled flaps. Among these alternatives, we preferred to use scapular island flap most frequently. In addition to conventional harvest of this flap, extension of its pedicle up to the subscapular ramification by passing it through the triangular space allowed its transfer even to the anterior axillary line defects in a vertical orientation without pedicle kinking. In conclusion, the island scapular flap is a good choice for reconstruction of all types of axillary contracture, releasing defects with satisfactory results in terms of function and cosmesis.

Treatment of temporomandibular joint ankylosis and facial asymmetry with bidirectional transport distraction osteogenesis technique.

Transport distraction technique is a good treatment modality for unilateral temporomandibular joint ankylosis. However, with a unidirectional distraction, it is not possible to correct facial asymmetry that results from mandibular hypoplasia associated with early-onset unilateral temporomandibular joint ankylosis. For this purpose, gap arthroplasty and simultaneous bidirectional transport distraction was used to correct these deformities. Although vertical distraction corrects vertical deficiency of the ramus and creates a neocondyle, the simultaneous anteroposterior distraction of the transport segment corrects facial asymmetry resulting from horizontal shortness of mandible. Three patients, whose mean mouth opening was 8.6 mm, were successfully treated with this technique. Mean advancements in vertical and anteroposterior direction were 14.7 and 7.7 mm, respectively. Mean maximal mouth opening was 29.7 mm postoperatively. The average follow-up period was 13 months (range, 12-15 mo). During this period, reankylosis was not observed, and the interincisal distance did not decrease. Gap arthroplasty and bidirectional transport distraction of the mandibular ramus is a good and effective therapeutic option in treatment.

Reconstruction of the microtic external ear in adults using porous polyethylene implant

Autogenous rib cartilage and many other materials have been used for external ear reconstruction. Although the most commonly used material is the former, harvesting, carving and shaping are problems. Recently, porous polyethylene implants have proved to be useful for ear reconstruction. Ten ear reconstructions were performed in adults using porous polyethylene implants over the last two years. The patients were treated in two stages. First, the material was implanted and at the second stage the ear was elevated and the lobule was transposed. Both stages were performed under local anesthesia. There were three exposures which were managed without implant removal. One infected implant was salvaged by irrigation with antibiotics. All reconstructions were accepted as pleasing by the patients.

Electrical burn caused by contact of radio receiver antenna with overhead cables

Two soldiers suffering from electrical burns due to contact of radio receiver antenna with overhead cables are presented. The necessary preventive measures for such injuries are discussed.

Cataract formation after a major burn due to explosion: a case report

Cataract is a very rare complication of burn injuries in which the eye is not directly marked. A unilateral cataract presented some 85 days after a burn injury to a 21-year-old soldier. The cataract was treated surgically with excellent return of vision.

Evaluation of Childhood Burns Between 0-15 Ages

Çocukluk ça¤›nda en s›k görülen yan›klar, s›cak bir obje veya s›cak s›v› ile temas sonucu meydana gelmektedir. Çocukluk ça¤› yan›k olgular›nda etiyoloji genellikle kaza olup, ihmale ba¤l› yan›k olgular› %6-20 oran›nda görülmektedir. ‹hmale ba¤l› yan›klar›n en s›k nedeni hafllanma yan›klar›d›r. Hafllanma yan›klar› vücudun s›cak s›v›ya dalmas› veya s›cak s›v›n›n vücuda s›çramas› ile oluflmaktad›r. Bu çal›flmada, Gülhane Askeri T›p Akademisi Yan›k Merkezinde, 2002-2006 y›llar› aras›nda yat›r›larak tedavi edilen, 0-15 yafl aras›, 82 olgunun hasta dosyalar› retrospektif olarak incelendi. Olgular›n yafl, cinsiyet, yan›k nedeni, yan›k derecesi, yan›k yüzdesi, hastanede yat›fl süresi, mortalite ve morbidite özellikleri de¤erlendirildi. Olgular›n, %72’sinin hafllanma yan›¤›, %19’unun alev ve aleve ba¤l› inhalasyon yan›¤›, %5’inin elektrik yan›¤› ve %4’ünün temas yan›¤› oldu¤u saptand›. Olgular›n vücut yan›k yüzde oran›n›n %20.71, mortalite oran›n›n ise %17.1 oldu¤u tespit edildi. Sözlü olarak ifade etme becerileri tam geliflmemifl, küçük yafltaki çocuklarda ihmalin saptanmas› zordur ve bu olgular kolayl›kla kaza fleklinde yorumlanabilmektedir. Yan›¤›n lokalizasyonu, biçimi, yaralanman›n olufl flekli ile yan›¤›n karakteristi¤i aras›ndaki iliflki de¤erlendirilerek, yaralanman›n kaza veya ihmal sonucu meydana gelip gelmedi¤i saptanabilir. Çocuk ihmaline ait kan›tlar›n fark edilmesi ile sa¤l›k personelinin sorumlulu¤u artmakta ve olgular›n adli makamlara bildiriminin yap›lmas› gerekmektedir. Anahtar kelimeler: Çocuk, yan›k, ihmal The most common burn causes of childhood are due to contact to a hot subject and scalding. The injury generally results from an incident but in 6-20% of the cases there may be neglect. Burns due to neglect are generally scalding injuries. Between 2002-2006, 82 patients whose ages were between 015 years old were treated in Gulhane Military Medical Academy Department of Plastic and Reconstructive Surgery and Burn Center. In this study, the patient charts of these 82 patients were retrospectively evaluated. Age, sex, etiology of burn injury, severity of burn injury, hospitalization time mortality and morbidity of the patients were evaluated. Of the patients, 72% had scalding injury, 19% had flame injury with inhalation injury, 5% had electrical injury and 4% had contact injuries. The average total body surface area of burn (TBSA) of the patients was 20.71% and the mortality rate was 17.1%. During childhood period, the detection of the neclegt of the child-sitter or the family is quite difficult. As the patient is not fully able to explain himself, the event is easily misdiagnosed as an accident. The localization and the characteristics of the burn injury will help us to differentiate accident from neglect as an etiology. When an evidence of neglection of children is determined, the judicial responsibility of the health care personnel increases. In such cases the judicial procedures must be started.