PubMed Health⌕ Search

Biomedical subjects

Kenan Atabay

Publications and source records attributed to Kenan Atabay.

18 recordsLinked to original sources
PubMed2006

Fixation of the split calvarial graft in nasal reconstruction.

Reconstruction of nasal contour where skeletal support is deficient or absent has usually been achieved using autogenous bone. Membranous bone taken from the cranium is clearly superior to rib or iliac crest when used as autografting material to the craniofacial skeleton. Conventionally, the bone graft is rigidly fixated to the recipient nasal bone with either metal plate-screw systems or Kirschner wires. Reported here are the results of a single biodegradable screw fixation of the split calvarial graft that is used for nasal reconstruction. Ten patients with moderate to severe saddle nose deformity underwent reconstruction using the open rhinoplasty approach. The graft was harvested from the outer cortex of the parietal bone, shaped, and secured in place with a single bioresorbable screw. No significant resorption has been observed in the grafts and a favorable aesthetic result was achieved in all of the cases. Described modification in fixation of the bone graft in nasal reconstruction avoids some of the disadvantages of permanent materials while preserving the advantages of rigid fixation.

Absorbable Implants↗
PubMed2005

Homodigital reverse flow island flap for reconstruction of neuropathic great toe ulcers in diabetic patients.

Diabetic ulcers located in the plantar surface of the great toe resist conservative treatment modalities including skin grafts and usually require flap coverage for a stable reconstruction. Free tissue transfer is not feasible in these patients, because these defects are closely associated with peripheral vascular disease and local flap alternatives are extremely limited in this region. Reported here is the use of homodigital reverse flow island flap for reconstruction of neuropathic great toe ulcers in diabetic patients with encouraging results.

Aged↗
PubMed2005

Hemodynamic effects of perioperative stressor events during rhinoplasty.

The hemodynamic effects of perioperative stressors, including preoperative patient anxiety, intraoperative local anesthetic/adrenaline infiltrations, and some painful interventions, have not been fully elucidated in plastic surgery procedures. The present study was designed to determine the hemodynamic effects of perioperative stressor events in American Society of Anesthesiologists class I patients undergoing rhinoplasty procedures under general anesthesia. The study included 50 healthy patients, 18 to 51 years of age (mean age, 27 +/- 7 years), who underwent a rhinoplasty procedure in the authors' department. All patients were connected to a digital ambulatory Holter recorder for 24 hours starting on the day before the operation and continuing throughout the procedure. All of the patients received 10 ml of 2% lidocaine with 1:80,000 adrenaline 15 minutes after intubation. Observations consisted of heart rate, noninvasive blood pressure, and power spectral heart rate variability analyses, the latter of which is indicative of the sympathovagal balance of the patients. The majority of patients developed a persistent, moderate sinus tachycardia before the induction of anesthesia. After the infiltration of lidocaine/adrenaline, a mild to moderate and short-lasting tachycardia was detected. A similar increase in pulse rate was also noticed during lateral osteotomies. No significant blood pressure changes attributable to perioperative stressors (with the exclusion of general anesthesia induction, intubation, and extubation) were observed. Sympathetic activity was found to be responsible from marked tachycardia before the induction, which was attributable to preoperative anxiety. The authors' study has demonstrated that there are three hemodynamically unstable periods causing tachycardia for rhinoplasty patients that directly concern the plastic surgeon: immediate preoperative anxiety, local anesthetic/adrenaline injection, and lateral osteotomies. The authors conclude that these patients would benefit from routine use of premedications and that a lidocaine/adrenaline combination is a safe adjunct to general anesthesia in young rhinoplasty patients. In addition, a deeper anesthesia during local infiltration and osteotomies would be appropriate.

Adult↗
PubMed2004

Plastic surgeon's life: marvelous for mind, exhausting for body.

Surgery is accepted as one of the most demanding professions that create both physical and mental strain on the performers. Therefore, the authors aimed to elucidate the mental burden of surgeons, which is dedicated to operative stress. They also tested the hypotheses that participating in surgery creates mental stress on surgeons that leads to cardiovascular changes, and that this stress is more pronounced for actual operators than for first assistants. The method chosen for this purpose was an analysis of heart rate variability. Twelve surgeons (five plastic surgery staff and seven plastic surgery residents) were monitored by a digital ambulatory Holter recorder on at least two occasions. Half of the recordings were carried out on operating days and the other half on office days. Heart rate variability indices (low frequency, high frequency, high frequency/low frequency ratio, and heart rate) were analyzed from those recordings using computerized research tool software. The heart rate variability indices of the operators showed statistically significant differences between operating days and office hours in favor of an increased sympathetic and decreased parasympathetic activity for the former. For first assistants, three of the parameters, with the exception of heart rate, changed in favor of a sympathetic predominance over parasympathetic activity; these changes were also statistically significant. These results showed a sympathetic hyperactivity for both operators and first assistants during the operations. When the sympathovagal balance of the actual operators was compared with that of assistants, the former group showed a more pronounced sympathetic arousal. This difference is accepted as a proof for the mental stress of the surgery being the main factor responsible for the sympathetic hyperactivity that we detected during the operations. Surgeons continuously face a unique mental strain that other professions rarely bring forth, and these psychological stressors are associated with alterations in cardiac autonomic control that may contribute to the development of cardiac disease. Prolonged sympathetic hyperactivity could anticipate cardiac discomfort in more experienced surgeons with marginal cardiac reserve. Such cardiac diseases would be reconsidered as occupation-related illnesses, which might be reimbursed to the physician. In addition, the legal responsibility of surgeons concerning their unfavorable results might be assessed with more understanding with a realization of their undue working conditions.

Adult↗
PubMed2004

Impact of epineurial excision of the distal recipient nerve in terminolateral neurorrhaphy.

Different surgical modifications were studied to improve success in terminolateral neurorrhaphy. The authors evaluated the efficacy of distal epineurial excision of the recipient nerve stump. Forty male Wistar rats were evaluated in four groups. The right hind limbs of the animals were used as experimental limbs and the left hind limbs as control limbs. The peroneal nerve was transected at a level 1 cm above the bifurcation of the tibial nerve. The proximal stump of the peroneal nerve was covered with gluteus maximus muscle fibers in all groups. In Group 1, the distal peroneal nerve was not processed and was left in the operative field. In Group 2, the distal peroneal nerve stump was sutured to an epineurial window on the tibial nerve by epineurial neurorrhaphy. In Group 3, the distal stump of the peroneal nerve was buried in the tibial nerve without epineurial resection, and in Group 4 with a 1-mm epineurial excision. Walking track analyses, electromyographic studies, and histomorphometric analyses were performed after a 3-month follow-up period. Statistical analysis was done with ANOVA and Tukey tests. No important donor-nerve injury was detected. Axonal regeneration and functional results were better in Group 4 compared to Groups 2 and 3. An increased donor and recipient nerve contact surface area with the excision of the epineurium from the distal peroneal nerve stump (Group 4) might provide superior results with longer follow-up periods.

Animals↗
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↗
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↗
PubMed2002

Nonhealing ulcerative mass of the elbow: do not forget tuberculosis.

Skeletal tuberculosis is a rare condition and is seen in only 1 to 2% of all cases of tuberculosis. The authors present a 69-year-old white woman with tuberculosis of the left elbow joint whose disease was suspicious for synovial sarcoma. Skeletal tuberculosis usually conflicts with neoplastic or inflammatory diseases. One should remember the possibility of bone-joint tuberculosis and send biopsy specimens for culture to determine the presence of acid-fast bacilli. However, neither culture nor polymerase chain reaction nor histological examination may be capable of showing the bacilli. Only a suspicion may be enough. The treatment protocol is usually a combination of surgical debridement and multidrug antituberculous chemotherapy.

Aged↗
PubMedDate not supplied

The employment of bone wax as a template in the reconstruction of nasal dorsum defects.

Choosing materials of the most appropriate form and quantity is an important factor in the success of the surgical repair of nasal dorsum defects. In our study, bone wax, a hemostatic agent, was employed as a template in the correction of nasal dorsum defects. This inexpensive, pliable material is an effective template that helps to model the three-dimensional form of a defect and thus to plan and carry out the most suitable reconstruction.

Drug Combinations↗
PubMedDate not supplied

Histologic profiles of breast reduction specimens.

Reduction mammaplasty is one of the most common procedures performed by plastic surgeons all around the world. This procedure is performed for aesthetic or reconstructive purposes, but also offers the opportunity to examine all resected breast tissue histopathologically. The purpose of this study was to evaluate the histologic diagnoses of the reduction mammaplasty specimens retrospectively and to determine the incidence of breast lesions in otherwise asymptomatic and healthy women. Therefore, 149 patients who had undergone reduction mammaplasty were reviewed with regard to their histologic diagnoses. We found that 61% of these women have pathologic alterations in at least one of their breasts, so each patient who requests a breast reduction surgery should be evaluated carefully and the specimens should be handled with particular care.

Adolescent↗
PubMedDate not supplied

Sociological aspects of rhinoplasty.

Although the psychological aspect of the rhinoplasty operation has been a subject of interest for a long time, with the exception of a few studies, sociological factors have been almost totally ignored. In this prospective study the personality characteristics and socioeconomic backgrounds of 216 rhinoplasty patients were evaluated. Between 1994 and 2000, a questionnaire and the Minnesota Multiphasic Personality Inventory (MMPI) were given preoperatively to 157 females and 59 males. The MMPI was also given to age-matched people as a control. Six months after surgery, patients were called on the telephone and asked to rate their satisfaction. According to questionnaire, a great majority of the rhinoplasty patients were young, unmarried women with high education levels. In the rhinoplasty group, one or more scales of the inventory were not in the normal ranges in 45% of the patients, whereas this proportion in the control group was 28% (p < 0.01). When MMPI results are considered, female patients of this study could be described as egocentric, childish, highly active, impulsive, competitive, reactive, perfectionistic about themselves, talkative, and emotionally superficial. Male patients could be described as rigid, stubborn, over-sensitive, suspicious, perfectionistic, pessimistic, over-reactive, and having somatizations. Tension and anxiety with feelings of inferiority were found to be characteristics of the male patients. The satisfaction rate after six months was reported as 72%. There was no significant correlation between MMPI results and demographic variables, nor satisfaction rate. In conclusion, the rhinoplasty patients in our study are young people at the very beginning of their careers. It could be that their personalities and socioeconomic backgrounds combine to make aesthetic surgery rewarding enough, both socially and personally, to encourage them to follow through.

Adolescent↗