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Biomedical subjects

Mustafa Sengezer

Publications and source records attributed to Mustafa Sengezer.

At least 37 records · Page 2Linked to original sources
PubMed2005

The correction of auricular and mandibular deformities in auriculo-condylar syndrome.

Auriculo-condylar syndrome is a rare genetic syndrome. The characteristic features of the syndrome are auricular deformity and mandibular hypoplasia. The special auricular deformity is called a question mark ear because of the appearance of the auricle. A 21-year-old male patient with auriculo-condylar syndrome is presented. The auricular deformities are treated by local flaps and anterior scoring. The mandibular contour deformity is corrected by porous polyethylene implant. Both reconstructions were successful, and patient satisfaction was good.

Adult↗
PubMed2005

A custom-made distraction device for experimental mandibular distraction osteogenesis.

Distraction osteogenesis has recently become popular in craniofacial reconstruction, after it was first described for long bones. Despite the widespread clinical use of this technique, currently, lack of an ideal experimental model for small animals hampers investigations focused on its molecular basis, which warrants further elucidation. The authors developed a new device for distraction of the rat mandible and, to asses its effectiveness, practiced on 30 animals assigned to either an acute 3-mm distraction group (n = 7) or a gradual distraction group (0.25 mm twice a day for 6 days; n = 23). The authors applied the devices to a localization that allowed them to perform the ostomies posterior to the molar teeth. Because of a U-shaped plate that the authors used for posterior pin fixation, their device maintained its stability until the end of the study, despite the delicate anatomy of the bone at the posterior part of the mandible. Additionally, the authors described a practical and easy method of transient mandibular stabilization method that facilitates the manipulations while the mouth is open for safer airway control during surgery. This new nutrition technique with enteral feeding solution solved the problem of progressive weight loss after surgery. Application of the device was easy and practical, without demanding complex manipulations. The authors did not observe any device dislodgement or a high rate of accidental fractures during the manipulations. They demonstrated that the device works properly and is able to create ossified regenerate bones that fill the entire distraction gap, which can be used for various investigations during distraction osteogenesis.

Animals↗
PubMed2005

Long-term outcomes of ultra-thin porous polyethylene implants used for reconstruction of orbital floor defects.

PURPOSE: The objective of this article is to present the long-term outcomes of ultra-thin polyethylene implants used for orbital floor reconstruction in facial trauma patients. MATERIALS AND METHODS: From 1998 to 2004, 38 patients underwent orbital floor reconstruction with porous polyethylene implants with a mean follow-up of 4 years. A subciliary incision and preexisting facial wounds or scars were used. The boundaries of the maxillofacial injury and the orbital volumes of both orbits were assessed by computed tomography images obtained pre- and postoperatively. In all patients, ultra-thin porous polyethylene implants in various sizes were used to reconstruct the orbital floor defect. RESULTS: None of the patients needed removal of the implants during the follow-up. The volume increase of the traumatized orbits ranged from 0.04 to 6.18 (average 3.12 +/- 1.48) mL compared with the intact orbit (P < 0.01). This difference was not significant postoperatively (P > 0.01). Postoperative ectropion in three cases was corrected under local anesthesia. Persistence of complications were as follows: enophthalmos, 3 in 28; diplopia, 1 in 16; dystopia, 1 in 4; and infraorbital nerve hypoesthesia, 3 in 31. One patient underwent late enucleation of the globe because of initial penetrating trauma. CONCLUSIONS: We recommend the use of ultra-thin porous polyethylene implants in the reconstruction of the orbital floor defects in facial trauma patients. The implants are durable in the long-term and mimic the anatomy of the thin orbital floor and avoid the morbidity of autogenous bone grafts.

Adult↗
PubMed2004

Comparison of membranous bone healing characteristics in fetal and postnatal periods: an experimental study.

In this experimental study, the postnatal and fetal membranous bone healing were investigated radiologically, histologically and levels of growth factors. Sixteen sheep fetuses and 16 sheep were included in this study. In the fetal group, 5 mm diameter ostectomy, and a 10 mm osteotomy were created in 90th gestational day. In the postnatal group, similar ostectomy and osteotomies were created. In the early period, radiologically similar radiolucencies in the ostectomy areas were seen in both groups. Histologically, fetal bone healing was decreased in the early postoperative period. However, it was accelerated in further time points. Histomorphometric analyses revealed accelerated fetal bone healing. TGF-beta1 levels were higher and then lower in early and late postoperative periods respectively in the fetal group. In the postnatal group, the levels of TGF-beta1 were lower and the differences between two groups were statistically significant in all time points (p < 0.05). The FGF and PDGF levels in both areas were higher in early postoperative period whereas lower in the late period in both groups. However, the fetal FGF levels were higher compared to the postnatal group (p < 0.05). The fetal PDGF levels were lower compared to the postnatal ones (p < 0.05). In conclusion, the calvarial bone gap model at the end of the second trimester of gestation in the fetal sheep model proved useful in examining the membranous bone healing. Histologically, the process of fetal bone healing seems similar to that of postnatal healing, albeit at an accelerated rate. Histomorphometric evaluation is a valuable tool in the evaluation of bone formation and gives more objective information about the ratio of bone formation.

Animals↗
PubMed2004

Situs inversus totalis with accompanying craniodiaphysial dysplasia: a new syndrome?

A 20-year-old man with craniofacial anomalies of craniodiaphysial dysplasia (CDD), facial paralysis, mental retardation, and situs inversus totalis is described. Similar features except situs inversus totalis are also present in two of his sisters. The authors believe this to be the first reported case of CDD with accompanying situs inversus totalis.

Adolescent↗
PubMed2004

Long-term follow-up of total penile reconstruction with sensate osteocutaneous free fibula flap in 18 biological male patients.

Surgical reconstruction of the penis is challenging because of the many cosmetic and functional (e.g., sexual intercourse and voiding) requirements that must be addressed. Since the free sensate osteocutaneous fibula flap was first described for total penile reconstruction in 1993 it has been widely accepted, with its advantages and minimal shortcomings. In this article, the authors present the longest follow-up of biologically male patients with free fibular phalloplasties. Since 1994, 18 biologically male patients with total penile losses for various reasons were treated with free sensate osteocutaneous fibula flaps. All patients were included in the study. The ages of the patients ranged between 20 and 26 years (mean, 22.2 years). The average follow-up period was 5.4 years (range, 1 to 9 years). Patient satisfaction was evaluated by a questionnaire regarding both quality of orgasm and daily activities. Conventional radiographic imaging, magnetic resonance imaging, and bone mineral densitometry were performed to evaluate the fate of the bony component of the flap. Also, sensibility was evaluated by bulbocavernous reflex and penile somatosensory evoked potentials testing in nine patients. Six patients married, and five of them had six children. Most patients and their partners reported pleasurable sexual intercourse and orgasm. Conventional radiographs of the fibular bone in neophalluses showed robust, calcified bone structure without any evidence of bone resorption or fracture. The magnetic resonance images showed the cortical substance and spongiosum of the bone marrow, which are characteristic signs of bone viability. After intravenous injection of gadolinium, the neophallus bone showed uptake of contrast medium. Viability of neophallus bone was shown even at 9-year follow-up (the longest follow-up in the literature). Dual energy x-ray absorptiometry measurements of the penile bone grafts showed that fibular components in the penis had bone mineral density values that were close to but lower than those of intact fibula in the same subjects. These results were considered as evidence of viability of bone grafts. Neural integrity was found between the nerves of the neophallus and the residual penile bodies by both bulbocavernous reflex and penile somatosensory evoked potentials tests. In conclusion, free sensate fibula flap phalloplasty provides the cosmetic and functional requirements that an ideal penis should have. All results put an end to the discussion that the fibular component of the neophallus could resorb. Constitution of neural integrity is important in terms of pleasurable sexual intercourse. The authors believe the free sensate osteocutaneous fibula flap should be considered as the standard in penile reconstruction.

Adult↗
PubMed2004

Split sternocleidomastoid muscle repositioning for correction of depressed post-tracheostomy scar and tracheal tug.

One important complication of tracheostomy procedure is the depressed scar left after the airway is removed. The problem is more challenging for the surgeon if tracheal tug accompanies. Six male patients with unaesthetic, depressed tracheostomy scars due to late removal of tracheostomy tubes after maxillofacial high-velocity gunshot injuries were treated. The patients' age ranged from 20 to 23 years, with an average age of 21 years. The mean tracheostomy tube removal time was 18 days (range, 9 to 34 days) postoperatively. The mean scar dimension was 13.4 mm x 14.4 mm x 4 mm (width, length, and depth, respectively). All patients showed tracheal tug and complained of swallowing discomfort. Under local anesthesia, split sternocleidomastoid muscle flaps were used bilaterally following excision of the skin scars and covered by adjacent skin flaps. The mean follow-up was 18 months. Cosmetic and functional results were satisfactory for all patients. Dysphagia disappeared in all patients following surgery. This technique is useful and easy to perform for reconstruction of complex post-tracheostomy scars.

Adult↗
PubMed2003

Proliferative "crescentic" glomerulonephritis in a burned patient.

Acute renal failure is one of the major complications of burn and it is accompanied by a high mortality rate. However, acute glomerulonephritis due to major burn have not been reported in burn literature. We report a case of crescentic glomerulonephritis which began at 27 days postburn. In this case glomerulonephritis may be due to infection probably pseudomonas or enterococus sepsis. We also felt that imipenem may be contributed the formation of glomerulonephritis.

Acute Kidney Injury↗
PubMed2003

Reconstruction of the middle and lower face with three simultaneous free flaps: combined use of bilateral fibular flaps for maxillomandibular reconstruction.

A 23-year-old man sustained massive maxillofacial destruction from a close-range, high-velocity gunshot injury. The devastating nature of the injury led to extensive soft-tissue and bone loss involving nearly the total middle and lower portions of his face, including the deeper anatomic structures. Reconstruction of this extraordinarily extensive and three-dimensional defect was accomplished by simultaneous transfer of three free flaps during one session. A specially designed radial forearm flap replaced the internal lining and external cover of the nose, a large fibular osteocutaneous flap restored the lower face, and a second fibular osteocutaneous flap harvested from the other leg restored the midface. The second fibular flap was revascularized by combining it with the first one in a flow-through manner, and its pedicle vessels were anastomosed to the distal ends of the vessels of the first flap. Dorsal nasal reconstruction with an expanded paramedian forehead flap, commissurotomy, and intraoral flap debulking were additional procedures performed to improve cosmetic and functional outcome during the following 1-year period. Along with a radial forearm flap, combined use of bilateral osteocutaneous fibular flaps provided simultaneous, single-stage reconstruction of a huge facial defect involving both the lower and middle face with an acceptable result.

Adult↗
PubMed2002

Replantation of a crush amputation of distal tibia followed by lengthening with Ilizarov circular external fixator: two-year follow-up.

A 20-year-old male sustained a severe crush injury to his left leg, resulting in amputation of the foot at the level of the distal tibia. Despite 12-h warm ischemia, replantation was attempted after radical debridement, bone shortening, and proximal fasciotomies. The replanted part survived totally. Four months later, a 13-cm shortness of the extremity was managed by 10-cm lengthening with distraction osteogenesis, using Ilizarov's circular external fixator and by means of a special shoe. Two-year follow-up of the patient revealed acceptable functional and sensorial recovery. Success of replantation despite the excessive warm-ischemia time was attributed to the sparse muscle content of the distal tibia and foot. Fasciotomies performed on the proximal segment of the leg ensured the patency of anastomoses by maintaining adequate blood flow distally despite increasing edema after the crush injury. Debridement and bone shortening at the proximal stump eliminated the vein and nerve grafts to bridge the gap. In conclusion, considering the functional outcome of our case, replantation of distal parts of a lower extremity should be attempted first, even if the nature of the injury is unfavorable and the ischemia time is longer than the documented ischemia-tolerance.

Adult↗
PubMed2002

Treatment modalities for post-burn axillary contractures and the versatility of the scapular flap.

Inappropriate treatment of axillary burns frequently results in adduction contractures. In this clinical study we have reviewed 32 patients with different types of axillary post-burn adduction contractures. We have used a variety of surgical treatments for reconstruction of axillary contracture releasing defects such as simple grafting, Z-plasties and locally pedicled flaps. Among these alternatives, we preferred to use scapular island flap most frequently. In addition to conventional harvest of this flap, extension of its pedicle up to the subscapular ramification by passing it through the triangular space allowed its transfer even to the anterior axillary line defects in a vertical orientation without pedicle kinking. In conclusion, the island scapular flap is a good choice for reconstruction of all types of axillary contracture, releasing defects with satisfactory results in terms of function and cosmesis.

Adult↗
PubMed2002

Nuclear imaging of the brain in electrical burn patients.

Patients surviving high-voltage electrical injury may have early or delayed sequelae. Technetium-99m (Tc-99m) hexamethylpropyleneamine oxime (HMPAO) is a lipid soluble brain perfusion agent rapidly retained in the brain tissue in proportion to regional cerebral blood flow without any redistribution. The aim of this study is to point out the importance of nuclear imaging of the brain and estimate the possible sequelae due to high-voltage electric injured patients. Brain perfusion analyses may help the early detection of cerebral blood disturbances and to inform both patient and surgeons about the possible neurological complications in electric burn patients.

Adolescent↗
PubMed2002

Accurate method for determining functional penile length in Turkish young men.

There are only a few reports that investigate the measurement of functional penile length and compare the methods used for this purpose. The aim of this study was to determine the correlation between the measurement techniques and to determine an appropriate method that correlates the erect state most closely. Measurements of penile length in 200 healthy men were made during three different states--flaccid, erect, and stretched--of the penis. The results were evaluated using descriptive statistics, paired t-test, correlation coefficients, and regression equations. The correlation between the flaccid and the erect lengths was 71.2%, and it was 80.2% between the stretched and the erect lengths (p < 0.01). Using regression equations, the degree of accuracy in estimating the erect length by using the stretched length was 65.3% (R2 = determination coefficient; p < 0.01) and was 50.8% by using the flaccid length (p < 0.01). When both the flaccid and the stretched lengths were considered together, the predictability of erect length was R2 = 65.5%. The results obtained using different statistical methods showed that the most accurate results can be obtained by considering stretched penile length, whereas flaccid length had little importance in determining erect penile length. In conclusion, the stretched penile length measurement technique is highly recommended for the accurate prediction of the erect penile length.

Adult↗