PubMed Health⌕ Search

Biomedical subjects

O K Coşkunfirat

Publications and source records attributed to O K Coşkunfirat.

15 recordsLinked to original sources
PubMed2001

Preserved costal cartilage homograft application for the treatment of temporomandibular joint ankylosis.

Ankylosis of the temporomandibular joint has been a daunting problem in oral and maxillofacial surgery. Condylectomy with gap arthroplasty is the basic technique for treatment of the fully grown patient. In the past, reconstruction has primarily been accomplished with alloplastic materials or with autogenous tissue harvested from the patient. Joints reconstructed with alloplastic materials have been subject to complications such as acute infection and chronic inflammatory problems as a result of foreign-body reaction with the immune system. Biologic reconstruction with autogenous materials does expose the patient to the risk of complications at the donor site. In the last 4 years, we have treated seven patients between the ages of 20 and 42 years who had complete temporomandibular joint ankylosis. In each patient, the affected joint was exposed through an extended preauricular incision. The ankylosed mandibular condyle with the surrounding abnormal bone, together with the coronoid process, was resected and removed. The ankylosed area was resected until an improvement of at least 15 mm in the interincisal opening distance was obtained. A solvent-preserved homologous cartilage graft was sculpted according to the size and shape of the gap and was then placed in it as interpositional material. Physical therapy, including active and passive mouth-opening exercises, began on the second postoperative day and continued for 6 months. Patients were observed for 6 months to 4 years. During this period, no major complications were noted, and satisfactory results were obtained. The initial mean interincisal opening distance was 15.2 mm after surgery, and the final mean interincisal opening distance was 32 mm after completion of physiotherapy. No recurrence was seen during the 4 years of follow-up. This technique seems to be an effective, time-saving, and simple alternative to other methods of joint reconstruction in adults who have fairly extensive ankylosis of the temporomandibular joint. In this article, a description of the surgical technique, a review of all cases, and recommendations for the use of this type of graft material are discussed. Our clinical experience over the past 4 years with the use of preserved homologous costal cartilage grafts as interpositional material has been encouraging.

Adult↗
PubMed2001

Perforator-based flap in rats: a new experimental model.

A new type of flap, the perforator-based flap, has been described in the last decade. It has been used successfully as a pedicle or free flap by many plastic surgeons. There is no animal model for research, although these flaps have gained popularity in clinical use. We created a perforator-based flap model in the rat (a perforator-based flap group and two control groups; 10 rats in each group) and evaluated the survival characteristics of the new flap. The abdominal skin flap was elevated based on the second perforator of the right superior deep epigastric artery and then sutured to its original bed. In the first control group, the same flap was elevated with a subcutaneous pedicle without any perforator; in the second control group, a right-sided, random-pattern pedicle abdominal skin flap with the same dimensions and location was elevated and sutured to its original bed. Flap survival was studied, and microangiography and histologic studies were performed. The amount of viable skin in the three groups was compared 1 week later. The area of surviving skin paddles in the experimental group ranged from 74 to 83 percent; in the first control group, it was 0 percent; and in the second control group, it ranged from 29 to 44 percent (p < 0.001 and p < 0.001, respectively). There was a predictable and constant area of necrosis in the model. The results of this study demonstrate that most of the abdominal skin of the rat can survive on the basis of a single musculocutaneous perforator vessel. This flap can be easily elevated, and it can be used as a reliable model for flap research.

Abdomen↗
PubMed2000

Reverse radial forearm flap as a source of soft tissue and blood supply for thumb reconstruction.

Soft-tissue deficiency is sometimes a major problem in thumb reconstructive cases with toe-to-thumb transfer. In the patient presented, a reverse radial forearm flap was used to provide a vascular pedicle for anastomosis with the second toe vessels. The flap also provided soft-tissue coverage for the metatarsal bone of the transferred toe. The radial artery and concomitant vein were used for the dorsalis pedis artery and vein anastomosis. The skin island of the forearm flap was wrapped around the transferred metatarsal bone. Using this technique, two limiting problems in toe-to-hand transfers were solved at the same time. In the crushed hand, sometimes it is not possible to find enough soft tissue and a good vascular pedicle for a new thumb, and this option seems to be a reasonable choice.

Adult↗
PubMed2000

Effect of the delay phenomenon in the rat single-perforator-based abdominal skin flap model.

During the last decade, innovations in reconstructive surgery have presented a new type of flap called the "perforator-based flap." Perforator-based flaps became useful alternatives for solving difficult problems. In the authors' previous study, they created a single musculocutaneous perforator-based abdominal skin flap. In their current study they evaluate the effect of various surgical delay procedures on this model. They divided 32 Sprague-Dawley rats equally into four groups (one control group and three delay groups). Three different delay procedures were employed in the delay groups. In one group, only the flap boundaries were incised (delay group 1). In the other delay groups, flap boundaries were incised and the contralateral (opposite side of the pedicle, delay group 2) or ipsilateral (pedicle side, pedicle left intact; delay group 3) musculocutaneous perforators were ligated. The period of delay was 1 week in all groups. After 1 week, a single-perforator-based abdominal skin flap was elevated as in the control group. One week after the final procedure, surviving skin areas were calculated and microangiograms were acquired. The mean surviving skin area was 75% +/- 3% (standard deviation) in the control group, 97% +/- 3% in delay group 1, 81% +/- 6% in delay group 2, and 96% +/- 3% in delay group 3. Delay group 2 showed substantial necrosis 1 week after the delay procedure and was thus excluded from the study. Results were analyzed using one-way analysis of variance, and post hoc analyses were performed using Tukey's multiple comparison test. The authors observed the advantages of the delay phenomenon in the two delay groups (p < 0.05). Microangiograms were examined grossly, and a marked difference between the two delay groups and the control group was observed. Many dilated choke vessels were seen in delay groups 1 and 3. Incising the flap boundaries with or without ligating the ipsilateral perforators (keeping the pedicle intact) 1 week before harvesting single-perforator-based abdominal skin flaps in the rat results in a delay effect. Conversely, incising the flap boundaries and ligating the contralateral perforators have no delay effect in this model.

Abdomen↗
PubMed1999

An unusual case of hypoglossia-hypodactyly syndrome.

Hypoglossia-hypodactyly syndrome is seen very rarely and its appearance is sporadic. Different degrees of tongue hypoplasia and transverse deficiencies in the upper extremities are seen. In the patient presented there was a sulcuslike deformity at the midline of the lower lip, and the continuity of the orbicularis oris muscle was disturbed at this location, in addition to the classic findings of hypoglossia-hypodactyly syndrome. A description of this variant and its treatment are described.

Abnormalities, Multiple↗
PubMed1999

Reverse neurofasciocutaneous flaps for soft-tissue coverage of the lower leg.

The evolution of neurocutaneous flaps has created a new concept in reconstructive surgery. These flaps, based on the arterial network around the superficial sensory nerves, are gaining popularity in soft-tissue coverage. Various flaps can be planned based on the neurocutaneous perforators. These kinds of flaps are available for extremity reconstruction. In the lower leg, reverse neurocutaneous flaps have been used successfully. Although these flaps in the lower leg are called neurocutaneous, they have been elevated with the underlying fascia like fasciocutaneous flaps, and thus the authors call these flaps neurofasciocutaneous flaps. They have used 11 reverse neurofasciocutaneous flaps (6 saphenous and 5 sural) since 1995. All flaps survived completely, and stable coverage of soft-tissue defects of the lower leg was achieved in all patients.

Adult↗
PubMed1999

Reversed neurofasciocutaneous flaps based on the superficial branches of the radial nerve.

Soft-tissue reconstruction of the hand needs to cover the vital structures with flaps. It is usually difficult to maintain function and form with minimal morbidity. Local tissue is preferable but it is also very valuable. Especially in the distal part of the upper extremity, flap coverage is a challenging problem because of limited reconstructive alternatives. On the dorsum of the hand, flaps can be designed based on the paraneural vascular network of the cutaneous sensory nerves. These paraneural vascular networks send branches to the surrounding tissues. The branches to the skin are known as neurocutaneous perforators. The authors used eight reversed neurofasciocutaneous flaps based on the superficial branches of the radial nerve. Six flaps were based on the branch to the index finger and two flaps were based on the branch to the thumb. All flaps survived completely, and successful flap coverage was achieved in all patients with minimal morbidity.

Adult↗
PubMed1997

The surgical management of incomplete testicular feminization syndrome in three sisters.

Three sisters with incomplete testicular feminization syndrome are presented. Most of the patients with this syndrome are females and surgery is an important part of their multidisciplinary treatment. Two of the sisters had gonadectomies, herniorrhaphies, vaginoplasty with neurovascular pudendal thigh flaps, reduction clitoroplasty and labia minora reconstruction. The third sister had sufficient vaginal depth and had release of an introitus skin web, clitoroplasty and labia minora reconstruction. All patients had a good result. The reconstructed vaginas are stable and sensate.

Adolescent↗
PubMed1997

Uncommon Klinefelter's variant (49,XXXXY) with cleft palate.

The karyotype 49,XXXXY is a rare form of Klinefelter's syndrome. Various anomalies can be found in this variant--more than other variants of Klinefelter's syndrome. Cleft palate is rarely seen among these anomalies. A cleft palate deformity can be diagnosed early and easily. This deformity should cause one to suspect an uncommon variant of Klinefelter's syndrome. Here we present a patient with an uncommon variant of Klinefelter's syndrome who was diagnosed with the help of the presence of an incomplete cleft palate deformity.

Child, Preschool↗
PubMed1996

H-plasty: a new modification for correction of nasal stenosis.

Unilateral complete nasal stenosis is a rare condition and is usually acquired. The alar wing and nasal vestibule may be disturbed because of stenosis. We operated on 2 patients with complete nasal stenosis by using the H-flap technique described in this paper. Anterior nares are formed by this technique and, in one case, we used a cartilage graft for creating symmetry of the alar wings. Functional and aesthetic anterior nares are obtained by this technique.

Cartilage↗