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Meltem Ayhan

Publications and source records attributed to Meltem Ayhan.

At least 19 recordsLinked to original sources

Periocular metatypical cell carcinoma: clinicopathologic correlation, management, and follow-up in 35 patients.

BACKGROUND: To present the clinical characteristics and treatment outcomes in a relatively large series of patients with periocular metatypical cell carcinoma. METHODS: This is a retrospective study of 35 patients with periocular metatypical cell carcinoma, who were seen between January 2000 and December 2004 in Izmir Ataturk Research and Training Hospital, Turkey. The patients were histologically confirmed metatypical cell carcinoma with radiologic evidence of periocular region. The main outcome measures were patients' demographics, duration of tumour, clinical presentation, tumour site, treatment modalities, recurrence rate and tumour-related exenteration. Statistical comparisons between the nonrecurring group and recurring group were completed using the Cox regression analysis and the log rank test. Significance was determined for all statistical tests as pé 0.05. RESULTS: The median age of patients at time of diagnosis was 61 years. The most common site for metatypical cell carcinoma was medial canthus and lower eyelid region. The median follow-up for all patients was 18 months. The average length of time until recurrence was 13 months. Five of the 35 patients received adjuvant therapy to the primary tumour site after excision. Signs suggestive of orbital involvement included bone fixation of the mass, limitation of ocular motility and globe displacement. The early lack of diagnostic criteria for metatypical cell carcinoma created considerable debate and confusion regarding its diagnosis. We believe that once this diagnosis is made, the treatment modality should be individualized and chosen with consideration of the extent of orbital involvement, visual function, and the patient's general health.

Adult↗

An alternative treatment for postburn microstomia treatment: composite auricular lobule graft for oral comissure reconstruction.

Microstomia is one of the most distressing results of burn. In this article, two cases presenting with microstomia following burn injury were revealed. In these patients, perioral and commisure defects due to burn were severe. The commissuroplasties were performed with a composite graft harvested and reshaped from the ear lobule. The oral aperture was evaluated before and after the operation and the patients were followed-up for two years. As a result, the opening was nearly normal without the help of a splint. Functional recovery were satisfactory as the incidence of drooling disappeared. Both patients were satisfied with the end results since their quality of life increased significantly.

Burns↗

Various applications of chondrocutaneous composite grafts in secondary cleft lip nose patients.

Composite chondrocutaneous grafts were applied to 12 patients in various forms to repair the columellar deficit, to form the nasal tubercle and nostril sill in cleft lip nose patients. Cleft lip-nose deformity patients with alar cartilage hypoplasia, obtuse angulation of the medial and lateral crura and the resulting plica vestibularis, internal nasal valve problems associated with the weakness of upper lateral cartilages are included in this study and composite conchal cartilage grafts are utilized to achieve a symmetrical and functional result.

Adolescent↗

Narrowband ultraviolet B phototherapy to clear and maintain clearance in patients with mycosis fungoides.

BACKGROUND AND PURPOSE: Narrowband ultraviolet B (UVB) phototherapy for early-stage mycosis fungoides (MF) has been found to be beneficial in some reports. Although rapid recurrences after discontinuation of therapy appear to interfere with its efficacy, optimal maintenance schedules for prolonged relapse-free intervals are not discussed in the literature. The purpose of this study was to review our experience with narrowband UVB in patients with MF. PATIENTS AND METHODS: All available data that belong to 14 patients (10 male, 4 female; age range, 28-74 years) with histologically proven MF, at disease stages IA-IB (n = 10) and IIA (n = 4) who received narrowband UVB were retrospectively evaluated. RESULTS: Complete response (CR) was achieved in 11 of 14 cases (78%) after a mean of 25 treatments. Ten of 11 patients were followed up for a median of 22 months (range, 7-43 months) after CR; one patient was lost to follow-up immediately after CR. Eight patients completed the recommended maintenance narrowband UVB therapy protocol. The median duration of maintenance was 18 months (range, 12-30 months). No patient had relapse during maintenance. Mean relapse-free duration was 26.0 +/- 9.9 months. LIMITATIONS: The number of patients in the study group was relatively few. CONCLUSION: This study provides evidence that narrowband UVB might be an efficient treatment option for MF patients at stages IA and IB, as well as at stage IIA. Results suggest that using maintenance phototherapy after CR is a logical approach, which may prolong the duration of remission in MF.

Adult↗

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↗

Prefabricated nasolabial flap for reconstruction of full-thickness distal nasal defects.

BACKGROUND: The reconstruction of full-thickness nasal tip and alar defects is challenging owing to the distal nose's triple-layer structure: skin, cartilage, and mucosa. OBJECTIVE: In the reconstruction of wounds of the distal half of the nose involving the rim, the most important issue to be considered is to provide a good functional and an acceptable esthetic result. Various local and distant flaps have been described for this purpose. The nasolabial flap is one of the most frequently used flaps in reconstruction of small- to moderate-size distal nasal defects. Its reliable blood supply, minimal donor site morbidity, and excellent texture and color match are some of the advantages of this local flap. METHODS: In this study, superiorly based subcutaneous pedicled nasolabial flaps have been prefabricated with cartilage and skin grafts. This method has been used in 10 cases. RESULTS: One patient had partial flap necrosis, and two patients experienced hyperpigmentation on the suture line. Scar revision was performed in one patient for hypertrophic scar tissue at the flap margins. No other complications were seen in the remaining patients. None of the patients experienced a skin graft loss or cartilage exposure. CONCLUSION: The prefabricated nasolabial flap offers a superior esthetic and functional result and may be an appropriate reconstructive option in reconstruction of small- to moderate-size distal nasal defects.

Adolescent↗

[In vitro activity of ketoconazole, itraconazole and terbinafine against Malassezia strains isolated from neonates].

Malassezia, a yeast-like fungus found in normal skin flora is known to be associated with various skin diseases and systemic infections. There is yet no standardized in vitro susceptibility testing method and minimum inhibitory concentration (MIC) breakpoints for Malassezia species. In this study, we investigated the in vitro activity of ketoconazole, itraconazole and terbinafine against 30 Malassezia strains (22 Malassezia furfur/dermatis, 8 M. japonica) isolated from cheek and/or scalp swabs and/or cephalic pustules of 21 neonates. The isolates were identified to species level on the basis of growth on Sabouraud dextrose agar, assimilation of Tween compounds and catalase reaction. The antifungal susceptibility tests were performed by agar dilution method using modified Dixon agar (MDA) and the agar dilution plates were incubated at 32 degrees C. For the isolates which exhibited sufficient growth, MICs were read at 48 hours, for the remaining slow-growing isolates, MIC readings were done on 7th day. For all drugs tested, the lowest concentration that provided complete inhibition of growth visually was interpreted as the MIC (microg/ml) value. Itraconazole was the most active drug in vitro against Malassezia species, followed by ketoconazole and terbinafine in rank order. In vitro activity of terbinafine was poor for half of the Malassezia strains tested. Variations in activity against individual Malassezia strains were detected for ketoconazole and terbinafine, while in vitro activity of itraconazole was similar for all strains tested. In order to validate the clinical significance of these results, further in vitro and in vivo correlation studies are needed.

Antifungal Agents↗

Augmentation rhinoplasty with dermal graft and review of the literature.

Nasal augmentation required following a trauma or a rhinoplasty operation poses a challenging problem to many plastic surgeons. Currently, allografts and autologous tissues are used for nasal augmentation; however, an ideal technique has not yet been described. Although preferred for augmentation of different parts of the body, pure dermal graft use has not been described for nasal augmentation. The authors performed nasal augmentation using a dermal graft in 90 patients in their hospital between 1994 and 2000, and they followed up the patients for 6 months to 8 years. In this article, the early and late results of dermal grafts for nasal augmentation are presented, and their advantages and disadvantages are discussed with a review of the literature. It was concluded that the easily obtained dermal graft could be an appropriate alternative in nasal augmentation, though it has not been used widely for this purpose.

Adolescent↗

Treatment of anogenital warts by pulsed dye laser.

BACKGROUND: Treatment of anogenital warts is difficult in that the disease spectrum is wide. Moreover, varying degrees of improvement are obtained. OBJECTIVE: To study the treatment of persistent anogenital warts by pulsed dye laser. METHODS: Pulsed dye laser was used with the following settings: spot size 7 mm, pulse duration 1500 microsec, and fluence 7.5 J/cm2. Two different wavelengths were used: 585 and 595 nm. RESULTS: Lesions healed completely using both wavelengths after one treatment. CONCLUSION: Pulsed dye laser has been found to be safe, effective, satisfactory, and less traumatic compared to other options for treatment of perianal warts in children.

Anus Diseases↗

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.

Explore the source record for details and available documents.

Buttocks↗

Importance of pedicle length in inferior pedicle technique and long-term outcome of areola-to-fold distance.

Various techniques are being used to perform reduction mammaplasty. One of the most widely used techniques is the inferior pedicle technique. To our knowledge, there are not many studies on long-term changes in areola-to-fold distance, distribution of pedicle length, and its importance. Therefore, in this study, breast volume, suprasternal notch-to-nipple distance, and nipple-to-inframammary fold distance were analyzed and the movement range of the nipple-areola complex was determined. In addition, the degree of benefit derived from the technique and the degree of long-term ptosis were investigated. The desired transposition of the nipple can be achieved by the inferior pedicle technique. The most serious complication of reduction mammaplasty is impairment of the blood supply to the nipple. However, the inferior pedicle technique has a slight possibility of causing the above complications. The most important criterion in deciding whether to perform free nipple technique or inferior pedicle technique is the pedicle length. This is a detailed study on the pedicle length and its statistical analysis.

Adolescent↗

Contribution of vitamin C administration for increasing lipolysis.

This experiment was designed to investigate whether addition of vitamin C to the solution used in tumescent technique of liposuction might increase lipolysis and whether increased fibrosis might improve skin retraction where liposuction did not work properly and the skin had poor retraction ability. Eighteen Sprague-Dawley rats were used in two groups. Both inguinal fat pads of rats with their vascular structures were elevated and the right inguinal fat pad was injected with 1 cc tumescent solution as a control and the left fat pad with a 1 cc vitamin C-tumescent solution. Histopathological examination showed that all fat pads injected with tumescent solution had normal adipocytes. Those injected with vitamin C-tumescent were shown to have extreme fibrosis and occasional adipocytes.

Adipose Tissue↗

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↗

Umbrella graft of columella tip: 20 years' experience.

We present our experience with nasal grafts over 20 years. The nose, located centrally, always plays a key role in facial aesthetics. Public recognition of this makes rhinoplasty the most popular operation. From the traditional aesthetic point of view, propogated by the media, the nose must be narrow and straight and have correct nasolabial and forehead angles. It is the desire of every surgeon to obtain permanent and satisfactory cosmetic results. However, it is not always possible to obtain good cosmetic appearance using conventional methods when the nose is small or large, when the columella is short, or when the skin is thick. Mostly, nasal tip projection cannot be achieved. In the present article, we report our experiences in primary asthetic rhinoplasty using cartilaginous grafts obtained from septum, costa, and ear as umbrella grafts of columella type.

Cartilage↗