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Öğe Comment on 'reconstruction of orbital floor and maxilla with divided vascularised calvarial bone flap in one session'(Elsevier Sci Ltd, 2008) Bilen, Bilge Turk; Kilinc, Hidir; Aslan, Serkan; Tenekeci, Goektekin[Abstract Not Available]Öğe Correction of True Hanging Columella Using Medial Crural Tuck-Up Technique(Springer, 2013) Bilen, Bilge Turk; Aytekin, Ahmet Hamdi; Erbatur, Serkan; Geyik, YilmazThe nasal tip and columella are the two main key components that affect the results of a successful and aesthetically satisfactory rhinoplasty. A true hanging columella is a deformity in which the caudal border of the columella has a downward bowing appearance due to disproportion between the ala nasi and the columella, which is usually congenital. In the management of this challenging deformity, a thorough understanding and consideration of tip dynamics and the anatomical causes address the proper technique to be used. In this study we present our clinical experience with the medial crural tuck-up technique used on 53 consecutive patients with a true hanging columella. A total of 1,421 patients underwent rhinoplasty between January 2005 and September 2011; 53 of those patients (age range = 20-37 years; mean = 27.3 years), who underwent this technique, were involved in the study. Thirty-eight patients were followed up for more than 1 year. The results were evaluated by comparing postoperative photos with preoperative photographic documentation. The appearance of the nasal tip and columella remained fine and stable over the 1 year of follow-up. Despite its limitation of applicability in secondary cases, the advantages of this technique are that it does not require conchal or costal cartilage and the desired tip rotation and projection can be done with ease.Öğe The effect of addition of ketamine to lidocaine on postoperative pain in rhinoplasties(Tubıtak scıentıfıc & technıcal research councıl turkey, ataturk bulvarı no 221, kavaklıdere, ankara, 00000, turkey, 2016) Sanli, Mukadder; Gulhas, Nurin; Bilen, Bilge Turk; Erdogan Kayhan, Gulay; Ucar, Muharrem; Aytekin, Ahmet Hamdi; Yologlu, SaimBackground/aim: The objective of this study was to examine the effect of addition of subanesthetic doses of ketamine to an epinephrine-lidocaine solution on postoperative pain, analgesic use, and patient comfort during rhinoplasties. Materials and methods: Ninety patients were randomly divided into three groups: Group L, lidocaine with epinephrine; Group K, lidocaine with epinephrine plus ketamine; and Group S (control group), physiological saline solution with epinephrine. The local anesthetic solution was injected as preincisionally with intranasal submucosal infiltration following induction of general anesthesia. We evaluated visual pain score, analgesic demand, Wilson sedation score, and antiemetic demand at 5, 15, and 30 min and 1, 2, 4, 6, 8, 16, and 24 h after the operation. The patient satisfaction score was checked 24 h after the operation. Results: Visual pain score was significantly reduced in Group K in comparison with the other groups and this group did not need any rescue analgesics (P < 0.05). The postoperative patient satisfaction scores were highest in Group K compared with the other groups (P < 0.05). Conclusion: Addition of ketamine solution to lidocaine for infiltration block during rhinoplasty was successful in decreasing pain during postoperative periods and reducing analgesic consumption during the first 24 h after the operation.Öğe The Effect of Selenium on Ischemia-Reperfusion Injury: An Experimental Study on a Transverse Rectus Abdominis Musculocutaneous Flap Model(Lippincott Williams & Wilkins, 2016) Tenekeci, Goktekin; Bilen, Bilge Turk; Turkoz, Yusuf; Sahin, Nurhan; Bulam, Nazire; Erdemli, Mehmet ErmanBackground:The aim of this study is to investigate effects of selenium and enlighten the possible mechanism of action in a rat transverse musculocutaneous flap model following ischemia-reperfusion injury.Materials and Methods:In this study, an experimental model, which mimicked free tissue transfer, was applied. Twenty-four male Wistar Albino rats were divided into a control group (N=12), and a selenium treated group (N=12). A superiorly based transverse rectus abdominis musculocutaneous (TRAM) flap was elevated and an ischemic insult for 4 hours was given. In selenium treated group (Group 2), sodium selenite (0.625mg/kg) was injected intraperitoneally (i.p), 2 hours before the induction of ischemia. Six rats from each group were sacrificed at 24 hours after the operation and malonyldialdehyde (MDA), nitric oxide (NO), and glutathione (GSH) levels were measured biochemically, whereas the intensity of neutrophil infiltration was evaluated. For the rest of the rats in Group 2, sodium selenite was injected at the same dose everyday to the postoperative 10th day, in which the remaining 6 rats from each group were sacrificed. On postoperative 10th day, flap viability was assessed along with the evaluation of intensity of neovascularization.Results:In Group 1, MDA levels were higher significantly (P<0.05) when compared with Group 2. No statistical difference, however, was found for NO (P>0.05), and GSH (P>0.05) levels among Group 1 and 2. Neutrophil infiltration was more intense in Group 1, when compared with Group 2 whereas neovascularization was more abundant in samples of Group 2. Group 2 shows higher average flap surface areas when compared with Group 1 (P<0.05).Discussion:The results of this study demonstrated the preventive effect of selenium against ischemia-reperfusion injury by reducing tissue necrosis in muscle flaps possibly by decreasing MDA, increasing neovascularization, and decreasing neutrophil infiltration, thus suppressing inflammation.Öğe Effects of Verapamil, Nifedipine, and Daflon on the Viability of Reverse-Flow Island Flaps in Rats(Lippincott Williams & Wilkins, 2013) Kilinc, Hidir; Aslan, Suleyman Serkan; Bilen, Bilge Turk; Eren, Ahmet Tuna; Karadag, Nese; Karabulut, Aysun BayReverse-flow flaps are preferable in reconstructive surgery due to their several advantages. However, they may have venous insufficiency and poor blood flow. In this study, effects of various pharmacological agents on the viability of reverse-flow flaps were investigated. Forty Sprague-Dawley rats were used. Superficial epigastric artery- and superficial epigastric vein-based reverse-flow island flaps were preferred. The rats were divided into 4 groups. Group 1 was considered as the control group. Group 2 was given verapamil 0.3 mg/kg per day, group 3 nifedipine 0.5 mg/kg per day, and group 4 Daflon 80 mg/kg per day for 7 days. On day 7, viable flap areas were measured, angiography was performed, serum nitric oxide levels were evaluated, and histopathological examination was done. The mean flap viability rate was 67.59%(+/- 13.12259) in group 1, 77.38% (+/- 4.12506) in group 2, 74.57% (+/- 3.44780) in group 3, and 85.39% (+/- 4.36125) in group 4 (P = 0.001). The mean nitric oxide level was 31.66 mu mol/dL (+/- 2.42212) in group 1, 51.00 mu mol/dL (+/- 2.96648) in group 2, 34.00 mu mol/dL (+/- 2.96648) in group 3, and 47.66 mu mol/dL (+/- 2.80476) in group 4 (P=0.001). On angiography, there were vessel dilations and convolutions in group 2; capillaries became noticeable, and anastomotic vessels extended toward the more distal part of the flaps in group 4. Histological examinations showed severe inflammation in group 3 and minimal inflammation and venous vasodilatation in group 2. Verapamil and Daflon in therapeutic doses significantly increased the viability of reverse-flow island flaps. However, nifedipine did not make a significant contribution to the flap viability. The results of this study will contribute to the literature about the hemodynamics of reverse-flow island flaps and guide further studies on the issue.Öğe Nasal Dorsum Management Using Fragmented Cartilage Grafts(Lippincott Williams & Wilkins, 2016) Bilen, Bilge Turk; Tenekeci, GoktekinThinness of nasal dorsum skin and subcutaneous tissue underlying nasal dorsal skin are the major factors related to the visibility of small irregularities. Here, the authors discuss the use of bare fragmented cartilage grafts in managing nasal dorsum and the results obtained.Eight hundred fifty-six patients were operated for rhinoplasty between September 2009 and September 2014. Fragmented cartilage grafting over the nasal dorsum was performed in 781 of 856 patients. In total, 214 patients who were followed up regularly were evaluated. Nasal dorsum management of 182 out of 214 patients was performed as is described here and is included in this study. The authors fragmented the cartilage grafts with Kocher clamp until the fragmented cartilages do not exhibit resistance, which are then placed over the nasal dorsum and can be shaped easily by external manouevers.Follow-up period ranged from 6 to 36 months. There was no seroma formation, infection, or abscess formation during the postoperative follow-up period. Four patients required a secondary operation for nasal dorsum management. The irregularity was corrected by simple rasping. The rest of the patients were satisfied with their nasal dorsum appearance. Nasal dorsum management with fragmented crushed cartilages showed durable results during the follow-up period.The authors use fragmented cartilage grafts in nasal dorsum management and do not wrap them into endogenous or exogenous sleeve material thus preventing the delay for vascularization of cartilage grafts, which is directly related to obtain durable results. By this way, durable results and smooth nasal dorsum can be maintained.Öğe Radiological and Histopathological Evaluation in Reduction Mammoplasty(İnönü Üniversitesi, Tıp Fakültesi, Plastik Rekonstrüktif ve Estetik Cerrahi Anabilim Dalı, Malatya, Türkiye, 2013) Kilinc, Hidir; Elmas, Omer; Bilen, Bilge TurkRadiological and Histopathological Evaluation in Reduction Mammoplasty Öz: Amaç: Mammografi ve Ultrasonografi (USG), redüksiyon mammoplasti öncesinde asemptomatik lezyonların tespit edilmesinde yardımcı tanı yöntemleridir. Ancak preoperatif radyolojik değerlendirme her zaman kesin sonuçlar vermemektedir. Bu nedenle premalign lezyonların veya sessiz kanser odaklarının tanısı amacıyla, preoperatif radyolojik inceleme ve postoperatif histopatolojik değerlendirme birlikte kullanıldı. Gereç ve Yöntemler: Kliniğimizde, 2007-2011 yılları arasında 135 hastada radüksiyon mammoplasti ameliyatı yapıldı. Hastaların yaşları 18 ile 67 arasında değişmekteydi (ortalama 44,6 yıl). Operasyondan önce tüm hastalarda USG ve 40 yaş üstündeki hastalarda ek olarak mammografi yapıldı. Çıkarılan tüm doku örnekleri histopatolojik olarak incelendi. Bulgular: Preoperatif olarak yapılan radyolojik incelemede; 96 hastada (%71,1) USG sonuçları normal olarak değerlendirildi. %8,1 Fibrokistik değişiklik, %0,7 lipoma, %4,4 fibroadenoma, %2,9 benign lenf nodu olduğu tespit edildi. Histopatolojik olarak yapılan incelemede; %7 hafif-orta epitelyal hiperplazi, %4,8 ağır epitelyal hiperplazi, %25,9 fibrokistik değişiklik, %16,2 fibrozis, %9,6 yağdan zengin meme dokusu, %7,7 apokrin metaplazi, %4,4 duktal ektazi, %3,7 fokal adenozis, %4,4 hafif-orta dereceli duktal hiperplazi, %3,7 fibroadenoma ve %12,2 normal meme dokusu olarak değerlendirildi. Sonuç: Bu çalışmada, meme dokusu örneklerinde %87,6 oranında non-proliferatif benign değişiklikler olduğu görüldü. Premalign veya malign lezyona rastlanmadı. Bu sonuçlar, preoperatif radyolojik değerlendirme ve postoperatif histopatolojik incelemenin, memenin benign, premalign veya sessiz malign lezyonlarının tanısındaki önemini göstermesi açısından anlamlı bulundu.Öğe Radiological and Histopathological Evaluation in Reduction Mammoplasty(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2013) Kilinc, Hidir; Elmas, Omer; Bilen, Bilge TurkAim: Mammography and ultrasonography are helpful diagnostic methods for the detection of asymptomatic lesions prior to reduction mammoplasty operations. Preoperative radiological evaluation does not give accurate results all time. Consequently, preoperative radilological and postoperative histopathologic evaluation were used together in order to diagnose the premalignant and silent cancer foci. Material and Methods: In our clinic, 135 patients underwent reduction mammoplasty operation between 2007 and 2011. The age of the patients ranged from 18 to 67 (mean 44.6). Ultrasonography was performed for all the patients and mammography was performed additionally for the ones older than 40 years of age. The excised tissue samples were sent for histopathologic evaluation. Results: Preoperative radiologic evaluation, USG results were assessed as normal in 96 patients (71,1%) and, of the patients, % 8,1 had fibrocystic changes, 0,7% had lipoma, 4.4% had fibroadenoma and 2,9% had benign lymph node. In the histopathologic evaluation, 7% had mild epithelial hyperplasia, 4,8% had severe epithelial hyperplasia, 25,9% had fibrocystic changes, 16.2% had fibrosis, 9,6% had fatty breast tissue, 7,7% had apocrine metaplasia, 4,4% had ductal ectasia, 3,7% had focal adenosis, 4,4% had mild ductal hyperplasia, 3,7% had fibroadenoma and 12,2% had normal breast tissue. Conclusion: In this study, non-proliferative benign changes were seen in the 87,6% of the breast tissue samples. No premalignant or malignant lesions were detected. These results revealed that preoperative radiologic evaluation and postoperative histopathologic analysis were significant in terms of diagnosis of benign, premalignant or silent malignant lesions of the breast.Öğe Reconstruction of orbital floor and maxilla with divided vascularised calvarial bone flap in one session(Elsevier Sci Ltd, 2008) Bilen, Bilge Turk; Kilinc, Hidir; Aslan, Serkan; Tenekeci, Goektekin[Abstract Not Available]
