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Biomedical subjects

M Akyürek

Publications and source records attributed to M Akyürek.

16 recordsLinked to original sources
PubMed1999

A new flap model in the rat: the pectoral skin flap.

The purpose of this study was to describe a new axial-pattern experimental flap model in the rat. Wistar rats weighing 200 to 250 g were used in the experiment. In 15 rats, the superficial anatomy of the ventral thoracic region was studied by anatomic dissection, dye injection, and microangiography, using 5 rats in each group. The anatomic studies revealed that the ventral thoracic skin derives its principal blood supply from the long thoracic artery--a branch of the common thoracic artery. Based on these anatomic studies, the pectoral skin flap model, pedicled on the long thoracic vessels, was created in the rat. The flap is bounded medially by the midsternal line, laterally by the anterior axillary line, and superiorly and inferiorly by transverse lines passing at the level of the suprasternal notch and the xyphoid process respectively. In 5 animals, bilateral flaps (N = 10) were raised and replaced in situ. In 15 animals, oversized flaps were created by extending the flap for both a greater width (N = 10) and length (N = 10). Although all the flaps limited to the cutaneous territory as described were found to survive totally, oversized flaps underwent partial necrosis distally. The authors conclude that the pectoral flap is a simple and reliable skin flap model for future biological and pharmacological study because it is very easy to raise, has a consistent vascular pedicle, and has well-defined borders with consistent landmarks.

Animals↗
PubMed1999

Endoscopically assisted removal of unilateral coronoid process hyperplasia.

Coronoid process hyperplasia (CPH) is an uncommon disorder characterized by an enlarged coronoid process impinging against the posterior aspect of the zygomatic arch. Young male adults are usually affected, presenting with limited mouth opening, which is typically painless and progressive in nature. The diagnosis of true CPH is established by the findings of (1) uniform coronoid enlargement on radiographic examination and (2) normal bone structure on histopathological examination (i.e., the specimen should be free of any neoplastic growth, such as the previously reported cases of coronoid osteomas, osteochondromas, or exostoses). The treatment is mainly surgical, by means of a coronoidectomy. An intraoral approach is mostly preferred for this procedure to avoid an external scar. However, to avoid the drawbacks of this approach, such as limited exposure and the risk of hematoma and subsequent fibrosis, an extraoral approach may be indicated. This report describes a case of true unilateral CPH in a 17-year-old boy who presented with progressive limited mouth opening in the absence of any pain. Computed tomography (CT) demonstrated a uniformly enlarged right coronoid process. A coronoidectomy was performed with the aid of endoscopic systems, approaching via two short incisions in the temporal scalp. Histopathological examination of the specimen demonstrated essentially a normal bony structure with no evidence of a neoplasm. The authors present the endoscopically assisted technique of coronoid process excision as an alternative method of surgical treatment of CPH and any mass of the coronoid process in general. With this method, the incision is much shorter than a conventional coronal incision and thus morbidity is diminished considerably.

Adolescent↗
PubMed1998

A new experimental flap model in the rabbit: scapular osteomyocutaneous flap.

Despite the use of various types of osteomyocutaneous flaps in clinical practice, there are many unanswered questions regarding their basic physiology. Simple and reliable flap models are needed to investigate these problems. However, very few of these flap models have been described in small animals to date. The purpose of this study was to develop a new osteomyocutaneous flap model in the rabbit. Twenty adult New Zealand white rabbits, weighing 2.5 to 3.0 kg, were used in the reported experiment. In seven rabbits, the anatomy of the axillary vessels was studied by anatomic dissection and selective angiography. Based on this anatomic study, a new osteomyocutaneous flap, namely, the scapular osteomyocutaneous flap, is described in the rabbit model. The flap is composed of a skin island (16 x 8 cm) in the scapular region, the latissimus dorsi and intrinsic shoulder muscles, and the whole scapula as the bony component The flap is based on the axillary vessels, while the skin island and the latissimus dorsi muscle are independently supplied by branches of the thoracodorsal vessels. The flap could thus also be considered as a combined flap model. As an island flap, the flap was replaced in situ in eight rabbits, and transferred to the anterior chest in two rabbits. In the remaining three animals, the flap was transferred to the groin as a free flap. The viability of each component of the flap was demonstrated by direct observation, microangiography, bone scintigraphy, India ink injection study, and histologic examination. The authors concluded that the flap is a simple and reliable osteomyocutaneous flap model, since its dissection is easy; there is a long vascular pedicle with large vessel diameters; and large amounts of skin, muscle, and bone are included.

Animals↗
PubMed1998

Head and neck reconstruction with the latissimus dorsi musculocutaneous pedicled flap: functional preservation of the muscle by staged transfer.

The reconstruction of soft-tissue defects in the head and neck region with the latissimus dorsi musculocutaneous pedicled flap is traditionally carried out with dissection of a transaxillary subcutaneous tunnel, which may result in compression of the vascular pedicle in the tunnel, a contour deformity of the neck, or morbidity to the tissues in the axilla and the neck (such as hematoma and seroma). Furthermore, the flaps are often bulky and require secondary defatting. Loss of the muscle causes contour deformity in the back, and its functional loss may be a concern for the patient. To overcome such drawbacks of the traditional use of the flap, we devised a technique of regional transfer of the latissimus dorsi musculocutaneous pedicled island flap to the head and neck region over a pectoral skin bridge rather than utilizing a transaxillary subcutaneous tunnel. This is a two-stage procedure. During the first stage the musculocutaneous flap is transposed in an extracutaneous route to the recipient site. Following a 3-week neovascularization period, the second stage is performed, during which the muscle is detached from its overlying skin island and replaced in situ. This technique was utilized successfully in 5 patients for reconstruction of various head and neck defects with no complications. We conclude that this staged technique of latissimus dorsi musculocutaneous flap transfer to the head and neck region enables functional preservation of the muscle and overcomes many of the complications of the traditional method of utilizing a transaxillary subcutaneous tunnel.

Cicatrix↗
PubMed1998

Arterialized venous dorsal digital island flap for fingertip reconstruction.

Fingertip resurfacing is a challenging reconstructive problem; despite the existence of many different surgical methods, enthusiasm on developing versatile flap techniques has been continuing. In this report, we describe an arterialized venous dorsal digital island flap for fingertip reconstruction. The vascularity of the reverse dorsal digital island flap is augmented by performing an arteriovenous anastomosis between a dorsal vein in the flap and one of the proper digital arteries at the fingertip. Eight flaps were used in eight patients for the reconstruction of their fingertip defects. The ages of the patients ranged from 19 to 41 years, with an average of 28.4 years. In two cases, the flap was used as a neurosensorial flap by coapting the dorsal digital radial nerve to the digital nerve. The mean follow-up was 11 months, and all but one flap totally survived. The operative technique is easy except for the necessity of performing standard microvascular surgery. The flap may be a good alternative for repairing fingertip defects in selected cases.

Adult↗
PubMed1997

Metastatic malignant blue nevus: a case report.

This report presents a 63-year-old Caucasian woman with a malignant blue nevus, which is an extremely rare form of melanoma originating from or associated with a preexisting blue nevus. The background blue nevus on the left upper arm, which had been present for 5 to 6 years, increased in size and darkened in color for 3 months prior to histological diagnosis of malignant blue nevus. Although the tumor looked much like a nodular melanoma clinically, the diagnosis of malignant blue nevus was established histologically. The patient had a poor outcome due to metastatic spread of the tumor to the visceral organs 1 year following the initial excision of the tumor. To distinguish this rare tumor from other melanocytic lesions, strict histological criteria are needed to make the diagnosis of malignant blue nevus. Differential diagnosis includes cellular blue nevus, atypical cellular blue nevus, primary malignant melanoma, and metastatic melanoma to the dermis. Malignant blue nevus is most commonly seen on the scalp. The tumor has an aggressive behavior and metastasizes in the majority of patients. This paper describes the second reported case of malignant blue nevus involving the upper arm. Clinical and histological features of this uncommon tumor are presented, along with a review of the literature.

Arm↗
PubMed1997

Use of bone wax as a template for intraoperative evaluation of facial defects and shaping of polyethylene implants.

With the advent of polymer chemistry, an increasing number of alloplastic materials are now available for use as onlay implants for reconstruction of facial bony and soft-tissue deformities. An optimal clinical result of a facial contour deformity surgery will depend not only on the choice of implant, but also on the method of giving exact shape to the implant to be used. The latter is particularly important to fit the implant into the complex configuration of a specific defect of bone and soft tissue. A template greatly enhances the accuracy of implant design. In this paper we describe a new method of fabricating polyethylene implants by using bone wax as an intraoperative template. We used this technique in four patients aged 8 to 35 years (average, 18 years) with posttraumatic and congenital facial defects without any complications. We present this method as a simple, inexpensive, and accurate alternative to the more sophisticated, but expensive and time-consuming, computer-assisted implant generation.

Adolescent↗