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Biomedical subjects

Reha Yavuzer

Publications and source records attributed to Reha Yavuzer.

At least 37 records · Page 2Linked to original sources
PubMed2004

Reconstruction of orbital floor fracture using solvent-preserved bone graft.

The orbital floor is one of the most frequently damaged parts of the maxillofacial skeleton during facial trauma. Unfavorable aesthetic and functional outcomes are frequent when it is treated inadequately. The treatment consists of spanning the floor defect with a material that can provide structural support and restore the orbital volume. This material should also be biocompatible with the surrounding tissues and easily reshaped to fit the orbital floor. Although various autografts or synthetic materials have been used, there is still no consensus on the ideal reconstruction method of orbital floor defects. This study evaluated the applicability of solvent-preserved cadaveric cranial bone graft and its preliminary results in the reconstruction of the orbital floor fractures. Twenty-five orbital floor fractures of 21 patients who underwent surgical repair with cadaveric bone graft during a 2-year period were included in this study. Pure blowout fractures were determined in nine patients, whereas 12 patients had other accompanying maxillofacial fractures. Of the 21 patients, 14 had clinically evident diplopia (66.7 percent), 12 of them had enophthalmos (57.1 percent), and two of them had gaze restriction preoperatively. Reconstruction of the floor of the orbit was performed following either the subciliary or the transconjunctival approach. A cranial allograft was placed over the defect after sufficient exposure. The mean follow-up period was 9 months. Postoperative diplopia, enophthalmos, eye motility, cosmetic appearance, and complications were documented. None of the patients had any evidence of diplopia, limited eye movement, inflammatory reactions in soft tissues, infection, or graft extrusion in the postoperative period. Providing sufficient orbital volume, no graft resorption was detected in computed tomography scan controls. None of the implants required removal for any reason. Enophthalmos was seen in one patient, and temporary scleral show lasting up to 3 to 6 weeks was detected in another three patients. Satisfactory cosmetic results were obtained in all patients. This study showed that solvent-preserved bone, which is a nonsynthetic, human-originated, processed bioimplant, can be safely used in orbital floor repair and can be considered as another reliable treatment alternative.

Adolescent↗
PubMed2003

Chondroid syringoma: a diagnosis more frequent than expected.

BACKGROUND: Chondroid syringoma or mixed tumor of the skin is a rare subcutaneous tumor that may be confused with various skin lesions. OBJECTIVE: To elucidate the incidence of condroid syringomas among skin lesions that were excised under local anesthesia. METHODS: The histopathologic diagnosis of 16,200 skin lesions that had been operated between 1986 and 2002 were retrospectively evaluated. The cases with condroid syringoma were histopathologically re-examined, and confirmed cases were further analyzed for preoperative diagnosis, age, gender, and lesion location. RESULTS: Sixteen patients were found to have histopathologic diagnosis of chondroid syringoma constituting 0.098% of the excised skin lesions in this series. All of these 16 cases were misdiagnosed preoperatively. The typical presentation was a solitary skin lesion located in the head and neck region in a middle-aged male patient. CONCLUSION: In the evaluation of a middle-aged male patient with a small subcutaneous nodule in the head and neck region, chondroid syringoma should be also taken into consideration for differential diagnosis. For such a lesion, excisional biopsy without destroying aesthetic and functional structures is the preferred diagnostic approach.

Adenoma, Pleomorphic↗
PubMed2003

Recurrent auricular pseudocyst: a new treatment recommendation with curettage and fibrin glue.

BACKGROUND: Pseudocyst of the auricle is a rarely seen fluctuant swelling of the ear. Although various hypotheses on the etiology have been suggested, the exact cause still remains unclear. Chronic minor trauma, which is believed to create intracartilaginous cavity, is accepted to be the most probable cause. Several treatment methods have been used for this benign lesion, but higher recurrence rates can be seen if not properly treated. OBJECTIVE: To discuss a new treatment modality for this rare disorder. METHOD: A 44-year-old man presented with a large pseudocyst of the auricle that had been treated several times previously with unsuccessful outcomes. For its treatment, we performed curettage and then used fibrin glue as a sealer between the two leaves of the cartilage. RESULTS: At postoperative 6-months follow-up, there was no evidence of recurrence. The cosmetic outcome was excellent. CONCLUSION: The use of fibrin glue both to obliterate the pseudocyst space and to make the two leaves of the cartilage adhere to each other should be kept in mind in this rare disorder in order to avoid recurrences.

Adult↗
PubMed2003

Early bone grafting in Tessier number 4 cleft: a case report.

Rare craniofacial clefts have an incidence of at least 1 per 100,000 live births. A Tessier number 4 cleft is one of the most rare craniofacial clefts, with less than 50 cases being reported in the literature. Both soft and bony tissue abnormalities take place in the cleft morphology, so not only clinical examination of the maxillofacial region but a detailed radiological workup is needed to assess clearly the nature of the clefts. A patient with a Tessier number 4 cleft is presented, whose bony defect was obliterated with autogenous iliac bone graft chips and soft tissue reconstruction was performed with multiple Z-plasty flaps. Postoperative clinical and radiological results demonstrate fine healing and good cosmesis. Although controversy still exists about the treatment of facial clefts with early bone grafts, advantages of performing both bony and soft tissue reconstructions in a single session make this treatment a good alternative with satisfactory clinical and radiological results.

Alveolar Process↗
PubMed2003

Hard tissue augmentation of the mandibular region with hydroxyapatite granules.

Interventions in the maxillofacial region for either reconstructive or esthetic reasons may sometimes necessitate the augmentation of hard tissues. Although autogenous bone grafts are the first choice, donor site morbidity and difficulties in shaping make alloplastic implants another reliable alternative. Among the alloplastic implants, hydroxyapatite granules, with their high biocompatibility, are a good choice. In a total of 11 patients presenting with mandibular deformities between 1998 and 2002, contour enhancement was performed with the use of hydroxyapatite granules, with a porous structure of 200 microm obtained in prefabricated syringes of 0.8 ml. Follow-up ranging from 3 to 46 months has revealed that the desired contours were established without any significant volume loss. No complications regarding the use of hydroxyapatite granules were encountered. Hydroxyapatite granules heal by allowing fibrovascular tissue ingrowth, do not cause foreign body reactions, and offer ease in use and shaping. These advantages make them a comfortable and reliable choice in maxillofacial hard tissue augmentation procedures in general and in mandibular deformity corrections in particular.

Adult↗
PubMed2003

Augmentation of the craniomaxillofacial region using porous hydroxyapatite granules.

Augmentation of the craniomaxillofacial region is required for many aesthetic and reconstructive procedures. A variety of different materials and techniques have been used. Coralline hydroxyapatite has proved to have biocompatible properties as a bone graft substitute. This study further analyzes the use of porous coral-derived hydroxyapatite granules in craniomaxillofacial augmentation for cosmetic and reconstructive purposes and evaluates the long-term clinical result. This retrospective study reviewed the use of porous coral-derived hydroxyapatite granules over a 20-year period, between 1981 and 2001, in 180 patients, in whom 393 procedures were performed. The surgical technique is described and discussed. Statistical significance was evaluated by descriptive statistics and the correlation bivariate Spearman's test (p > 0.05). For 61.6 percent of the procedures, the surgical indication was reconstructive and in 38.4 percent, cosmetic. The maxilla was the most common site of surgery (44.3 percent), followed by the mandible (21.6 percent) and zygoma (15.4 percent). The complication rate was 5.6 percent (n = 22 of 393), with contour irregularities being responsible for 59 percent (n = 13 of 22). Both infection and granule extrusion were responsible for 1.3 percent of the complications. Good results were achieved in 96.4 percent of the procedures. Porous coral-derived hydroxyapatite granules have shown considerable efficacy and versatility in craniofacial contour refinement and augmentation. They are stable, biocompatible, and safe. A sterile technique is advised, with care taken not to tear the periosteum in the pocket design and with subperiosteal placement of the granules, compaction of the granules at the site, overcorrection of 15 percent of the required total volume, watertight closure, and postoperative taping to prevent mobilization. The correct surgical indications and adherence to the principles stated above will result in a very satisfactory long-term outcome.

Adolescent↗
PubMed2002

Microcystic adnexal carcinoma of the breast: a very rare breast skin tumor.

BACKGROUND: Microcystic adnexal carcinoma is a rare, slowly progressing, malignant tumor of sweat gland origin. OBJECTIVE: A case of microcystic adnexal carcinoma of the breast with a history of 20 years is presented. METHODS: On initial examination, the ulcerative cutaneous mass was fixed to the underlying breast tissue and chest wall. Both the macroscopic appearance of the tumor and its location suggested a glandular breast carcinoma. However, an incisional biopsy revealed the nature of the tumor as microcystic adnexal carcinoma of the breast skin. Following the diagnosis, a wide excision of the tumor was carried out for the final treatment. RESULTS: To our knowledge this is the first case of microcystic adnexal carcinoma arising in the breast skin presented in the literature. CONCLUSION: This case demonstrates that microcystic adnexal carcinoma can occur on the breast skin and should be treated with wide excision due to its locally aggressive behavior.

Aged↗
PubMed2002

Dirofilaria repens presenting as a premasseteric nodule.

Dirofilariasis is a rare zoonosis that is mainly seen with subcutaneous or pulmonary involvement. Natural hosts are dogs, cats, jackals, and raccoons; however, humans can rarely become an accidental host for the parasite. In the reported case, infection manifested as a subcutaneous nodule, representing a significant diagnostic challenge for both the surgeon and the pathologist. A case of a 62-year-old man with a premasseteric soft tissue mass caused by Dirofilaria repens is presented with histopathologic confirmation.

Adipose Tissue↗
PubMed2002

Turnover epineural sheath tube in primary repair of peripheral nerves.

The epineural repair technique, which is the gold standard of peripheral nerve injuries, is still far from being ideal. The purpose of this study was to investigate the effects of the turnover epineural sheath tube (TEST) when used over the primary nerve repair site to improve nerve regeneration. Twenty-five Wistar rats were divided into three groups and were operated. In the sham control group, the sciatic nerve was dissected from the sciatic notch to its bifurcation and was left intact. In the primary epineural repair group an incision was made on the nerve and it was repaired using six epineural sutures. In the TEST group, after the incision was made the nerve ends were approximated with two epineural sutures. A proximal circular epineural incision was then made to enable the epineurium to be turned and slid over the repair site. Functional recovery was evaluated by walking tract analysis, and the sciatic functional index was calculated. Histomorphometric studies of the sciatic nerves and gastrocnemius muscles were also performed 3 months postoperatively. Three months postoperatively, functional analysis and nerve and muscle histomorphometric studies revealed similar results in the primary repair and TEST groups. There was no significant difference (p > 0.05) between the results of the TEST and the primary nerve repair groups. However, during the microscopic examination, a decrease in both foreign material reaction and an inflammatory response with less fibrosis were observed in the TEST group. The TEST has a nerve-healing property similar to primary epineural repair, with the advantage of a reduced number of sutures, which decreases the fibrosis around the repair site. The TEST is an alternative treatment modality among other techniques, especially for polyfascicular peripheral nerves.

Animals↗