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Öğe Can Displaced Whole Zygomatic Bone as Bone Graft Be Reused for Zygomatic Bone Defect in a Neglected Tetrapod Fracture?(Lippincott Williams & Wilkins, 2011) Coban, Yusuf Kenan; Tenekeci, Goktekin; Elmas, Omer[Abstract Not Available]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 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 Nasal Tip Contouring Using Lower Lateral Cartilages(Lippincott Williams & Wilkins, 2011) Bilen, Bilgetuerk; Kilinc, Hidir; Tenekeci, GoktekinNasal tip management is the most important and challenging part of rhinoplasty surgery. For nasal tip management, optimal nasal tip projection and rotation must be maintained. For this reason, several methods have been developed to obtain optimal results. In this article, we share with the rhinoplasty surgeons how we use cartilage grafts for nasal tip projection, nasal tip shaping, and maintaining natural and symmetric appearance and avoid visible cartilage problem by using a simple and easily applicable method. After performing standard open rhinoplasty techniques, we used the cephalic portion of the lower lateral cartilages to overgraft the already placed numerous layers of shield or onlay grafts. All the cartilage grafts are sutured in their place to prevent malpositions or undesired angularities. We operated on 1480 patients between September of 2002 and September of 2009 for rhinoplasty. Ages of the patients range from 18 to 58 years with nasal tip ptosis. We performed 1235 primary rhinoplasties and 245 secondary rhinoplasties. Of 365 patients, who were followed up regularly, 330 (approximately 90%) were operated on according to this technique and were included in the study. By using such an overgrafting technique for nasal tip, we obtained satisfactory results both by the patients and by the surgeons. Satisfactory results and being a facilitating method for shaping of nasal tip are the advantages of this technique.
