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Biomedical subjects

Bülent Erdoğan

Publications and source records attributed to Bülent Erdoğan.

14 recordsLinked to original sources

The correction of velopharyngeal insufficiency by Furlow palatoplasty in patients older than 3 years undergoing Veau-Wardill-Kilner palatoplasty: a prospective clinical study.

BACKGROUND: Velopharyngeal insufficiency may persist after primary repair of the palate. This insufficiency causes a speech deficit. Although there are many treatment alternatives, the most effective treatment of velopharyngeal insufficiency remains controversial. METHODS: The authors performed Furlow palatoplasty in patients older than 3 years who had undergone primary palatoplasty with the Veau-Wardill-Kilner technique. Speech was assessed by a speech therapist before and after the operation. Velopharyngeal closure and velum motion were recorded using a video nasendoscope before and also 12 months after the operation. Any increase in velum length was measured. RESULTS: After Furlow palatoplasty, 10 of 27 patients (37 percent) made complete recovery and 12 (44 percent) made substantial recovery from hypernasal resonance, but five (18.5 percent) showed no improvement. Regarding nasal emission, 16 of 27 patients (59.3 percent) made complete and eight (29.6 percent) made substantial recovery, but there was no change in three (11 percent). Five of 27 patients (18.5 percent) achieved complete intelligibility and 18 of 27 (66.7 percent) improved intelligibility, but four (14.8 percent) did not show any improvement in intelligibility. Articulation improved considerably in 17 of 27 (63 percent). The overall rate of surgical success and near misses who benefited from the surgery was 18 of 27 (67 percent), and a positive correlation between surgical success and articulation and intelligibility was noticed. Video nasendoscopy showed complete velopharyngeal closure in 15 of 27 patients (56 percent). The mean velar length increased by 44 percent. After secondary Furlow palatoplasty, patients with small gaps benefited more. CONCLUSIONS: The results suggest that Furlow palatoplasty performed in later years improves not only speech but also velopharyngeal closure by reorienting the levator veli palatini muscle and augmenting the velum.

Adolescent↗

Prospective comparative study of the range of movement of temporomandibular joints after mandibular fractures: rigid or non-rigid fixation.

Temporomandibular joints (TMJ) are negatively affected by trauma and disuse. In this prospective study, 103 patients with mandibular fractures were evaluated for the influence of trauma and maxillomandibular fixation on the TMJ. A total of 54 patients were treated by maxillomandibular fixation and 49 by titanium miniplate fixation. Those patients with condylar fractures and multiple mandibular fractures and malocclusion at presentation were not included in the study. The control group consisted of 44 randomly-selected healthy people with no past history of mandibular fracture or symptoms referable to the TMJ. Trauma was a major factor leading to TMJ dysfunction and maxillomandibular fixation increased the incidence and severity of TMJ dysfunction.

Adult↗

Reconstruction of the upper extremity with a compound rib-latissimus dorsi osteomusculocutaneous flap.

The reliability and versatility of the pedicled latissimus dorsi muscle or osteomusculocutaneous flap make it our first choice in the management of upper arm injuries and we have treated three such patients in this way. They had severe skeletonising, crushing injuries of an upper extremity with humeral defects that were treated with latissimus dorsi musculocutaneous flaps and segments taken from the ribs. All the flaps survived completely with no injury of the pleura at the donor site. The reconstructed humerus was strong enough for the patients to participate in all activities of daily living. We think that this technique is suitable for the upper arm defects with humeral loss because of its simplicity and minimal morbidity.

Adolescent↗

Osteogaleal flaps in pediatric cranioplasty.

Reconstruction of cranial defects larger than 2 to 3 cm in diameter and frontal defects of any size is indicated for mechanical protection and cosmetic reasons. The authors used osteogaleal flaps for cranioplasty in 2 pediatric patients with the aim of decreasing infection risk and maximizing bone healing. In the first patient, bone was harvested from the diploë. Children's cranial bones are thin, and in the second patient the authors used full-thickness grafts of adjacent bone, splitting this into three pieces to cover the recipient and donor sites. The postoperative period was uneventful for both children. Scintigraphic studies performed the first week after surgery revealed uptake in the flaps. Computed tomography demonstrated rapid bone healing with good contouring. The scintigraphic findings and rapid bone healing suggest that the bone component of the osteogaleal flap nourishes the graft site with blood from the galea and the periosteum. These flaps are an ideal choice for reconstruction of cranial defects because of their membranous origin, ease of harvest, applicability to any part of the calvarium, and reliable vascularity.

Adolescent↗

Cartilage shaping with the Er:YAG laser: an in vivo experimental study.

Reshaping and preserving the new shape of cartilage grafts is important for reconstruction of congenital or acquired deformities. In this in vivo study the authors investigated the effect of the Er:YAG laser on cartilage reshaping in comparison with scalpel stripping. The study consisted of two groups (N = 9). After measuring the angle between two margins of the ear, the cartilage in the right ear in rabbits was reshaped using the Er:YAG laser in group I, and scalpel incisions were used to reshape the left-ear cartilage in group II rabbits. Changes in the shape of the ears were evaluated at 10 days, and 1 and 6 months. The laser-reshaped ears were flattened and preserved the new flattened shape at the end of 6 months. The ultrastructural changes in the cartilage were evaluated based on the results from histopathological examination and electron microscopy. The authors conclude that cartilage can be reshaped using the Er:YAG laser. The mechanical effect of laser ablation and the thermal effect of laser radiation caused ultrastructural changes in the cartilage tissue, resulting in permanent changes in cartilage shape.

Animals↗

Giant hamartoma.

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Buttocks↗

Postauricular cartilage storage in rhinoplasty.

In the past decade, the number of patients demanding rhinoplasty has increased, and this has increased the use of grafts. Although different materials are used as grafts, cartilage is the most popular one. In secondary rhinoplasties the need for cartilage is very frequent. The most suitable cartilage grafts are the ones extracted during primary rhinoplasty. These grafts are disposed of after the operation and in a secondary operation, grafts are obtained from a new donor site. In our department, the surplus cartilages obtained during primary rhinoplasties of the patients who are thought to be probable secondary rhinoplasty candidates are stored in a postauricular pocket after their volumes are measured and marked down. In the secondary operations the volume of the grafts are measured again and the grafts are used. We have found out that there is no significant difference between the initial and secondary volumes of lower lateral cartilages (3.6% of initial volume is lost), but the difference between the initial and secondary volumes of septal cartilages is significant (6.9% of initial volume is lost), and the stored cartilages are sufficient qualitatively and quantitatively for the secondary rhinoplasties.

Cartilage↗