Osman Akdag

Extracorporeal Septoplasty Combined With Valve Surgery in Rhinoplasty Patients.

AbstractExternal nasal deviation is caused primarily by severely a deformed septum. The nose functions as a whole composed of the septum, valve systems, and mucosal structures. Patients with severely deviated septums also have deformed nasal valve systems. Extracorporeal septoplasty is advocated for an extremely deviated nasal septum. Nasal valve dysfunctions can be resolved successfully with spreader grafts. Application of extracorporeal septoplasty in combination with spreader grafts in patients with nasal valve dysfunction not only enables nasal respiration but also supports aesthetic appearance. The 19 patients in our study had undergone aesthetic rhinoplasty and presented with breathing problems and septal deviations. The patients were treated with extracorporeal septoplasty and spreader grafts. The patients were followed with clinical measures and computed tomographic scanning. No complications such as relapse, perforation, or saddling were encountered during follow-up. Aesthetically and functionally satisfactory results were obtained.

Camouflaging Cleft Lip Scar Using Follicular Unit Extraction Hair Transplantation Combined with Autologous Fat Grafting.

Background: The scar that occurs after cleft lip surgery poses a serious cosmetic problem. One of the methods used to solve this problem in adult male patients is hair transplantation. However, satisfactory results with this method cannot always be achieved because of possible graft loss. The corrective feature of fat grafting has been reported in many studies. The authors’ aim with this report is to share their results with hair transplantation combined with fat grafting in patients with cleft lip. Methods: This study included 20 patients who had both a scar and alopecia in the cleft lip area. The patients underwent fat grafting from the periumbilical region by means of miniature liposuction harvesting cannulas. Three months after fat injection, hair transplantation was performed with hair from the submental area and scalp using the folliculate unit extraction technique. Patients were followed for 12 months. Survival rate of transplanted hair and patient satisfaction were analyzed after the procedures. Results: After this camouflaging technique with fat grafting and hair transplantation, the scar was hidden quite well. The graft survival rate was also better compared with results from similar studies. Patient and observer satisfaction results with the scar tissue were significantly improved, which was confirmed statistically. Conclusions: This study demonstrates that this combined camouflaging technique is a very effective treatment in male patients with cleft lip who have serious secondary upper lip scars. The authors present a series of patients treated with this technique, which resulted in a high level of patient satisfaction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Palmar epidermoid inclusion cyst mimicking Dupuytren's contracture

Epidermoid inclusion cyst in palmar localization is very rare. We present an unusual case of palmar epidermoid inclusion cyst which causes Dupuytren-like contracture in hand. A 32-year-old male patient was complaining of the traction feeling of the mass. The mass was excised surgically, it was a hairy nodule like structure and reported as epidermoid inclusion cyst. Cystic lesions are very common masses. However epidermoid inclusion cysts in the palmar region are important because they may arise from the eccrine ducts and may be relevant with HPV infections. Thus, HPV screening should also be done in such a case.

Simultaneous Reconstruction of Both Facial Paralysis and Temporomandibular Joint Ankylosis With a Composite Flap From Dorsum of Foot

Abstract Free extensor digitorum brevis muscle flap in facial paralysis, and the second metatarsophalangeal joint flap is used at the temporomandibular joint reconstruction for a long time. Anatomically, these flaps can be harvested through even the same pedicle flap even on the same regions. Literature is available of their usage along with the use of hand and upper extremity reconstruction. Unlike this example, the authors have used these flaps in maxillofacial region where facial paralysis and temporomandibular joint reconstruction will be performed together. In this study, clinical report and surgical details of this flap have been shared.

An Overview of the Technical Details and Seven Cases of Lagophthalmos Treatment with Gold Implant

Üst gözkapağına altın ağırlık yerleştirilmesi, lagoftalmi tedavisinin genel kabul görmüş bir yöntemidir.2 Üst gözkapağına ağırlık yerleştirilmesi; ilk olarak 1950 yılında tanımlanmıştır.1 İngilizce literatürde “custom-made” olarak kullanımı bulunan, hastaya özel yapılan implantlar hem pahalı hem de ulaşımı güç olduğundan sıklıkla kullanılanlar ticari olarak üretilmiş hazır sentetik implantlar veya kuyumculardan yaptırılan implantlardır. Ne var ki, kuyumcu aracılığı ile elde edilen altın implantın standardize edilememesi çeşitli 207

Multiple Primary Tumors: Evaluation Accompanied by a Rare Case

Multipl primer tumorler, ayni hastada es ya da farkli zamanda birbirinden farkli gelisen tumorlerdir. Bu yazida cok nadir rastlanan bazal hucreli karsinom, skuamoz hucreli karsinom ve akciger adenokarsinomu birlikteligi sunulmustur. 70 yasinda, erkek, sigara icicisi hastanin frontal cilt bolgesindeki tumoru eksize edilmis bazal hucreli karsinom olarak raporlanmistir. Fizik muayenesinde nefes darligi saptanan ve ileri tetkikler neticesinde akciger adenokarsinomu nedeni ile opere olan hastada eszamanli olarak temporal ciltte orbitaya invaze bazal hucreli karsinom saptanmis, goze ekzantarasyon ve anterolateral uyluk flebi ile rekonstruksiyon yapilmistir. Bu cerrahiden yaklasik 1 ay sonra mandibula uzerindeki ciltteki skuamoz hucreli karsinom nedeni ile hasta yeniden opere edilmistir. Bizim olgumuzdaki gibi akciger ve cildin primer kanserlerinin birlikteligi cok nadirdir. Kanserli bir hastada ikincil primer tumor olasiliginin yuksek oldugu her zaman goz onunde tutulmali, hastaliga degil hastaya yaklasim saglanmalidir.

Repair of a thrombosed pseudoaneurysm that developed after puncture for an arterial blood gas using a vein graf

Pseudoaneurysms involving the leakage of blood between the arterial wall and the peripheral parenchyma can occur as a result of an artery’s perforation. In this case report, we present a repair, using a vein graft, of a thrombosed pseudoa- neurysm that developed in a radial artery after a single puncture to obtain a sample for the determination of arterial blood gases. A 56-year-old female patient was admitted with a mass in her left wrist on the radial side. Upon examination, a sen- sitive and mobile mass was detected by palpation. The patient had no fever or any other symptoms of inflammation. Her detailed anamnesis revealed that the mass had developed after a puncture to obtain a blood sample for an arterial blood gas measurement. By using magnetic resonance imaging the mass was determined to be a thrombosed pseudoaneurysm. The mass was excised and the gap that had developed in the radial artery was repaired with a vein graft obtained from the forearm. Magnetic resonance angiography imaging after 1 month confirmed the vein graft’s patency. Cannulations for blood monitoring, blood gas analysis and interventional radiological procedures are indispensable processes used in medicine; however, they are not risk-free. Following these procedures, thromboses and pseudoaneurysms can develop. A number of treatment options exist, including bandaging, percutaneous thrombin injections, and surgical treatment for complicated cases. For pseudoaneurysms that create a mass effect, as in our case, surgery is needed. Such complications after interventional procedures involving the radial artery should be kept in mind.