Congenital double lip deformity: presentation of eight cases

Dogumsal çift dudak nadir rapor edilen, ancak sık görülen bir anomalidir. Bu klinik durum sıklıkla izole bir deformite olarak görülse de, bir sendromun parçası da olabilir. Sıklıkla erkeklerde görülen ve patogenezi embriyolojik gelisimdeki defektlerle açıklanmaya çalısılan bu deformite ile ilgili olarak literatürde yirmiden az sayıda yayınlanmıs çalısma vardır. Bizim çalısmamızda, kadın erkek sayısı esit olup olguların hepsi estetik yakınmalarından dolayı doktora basvurmuslardır. Olguların hepsine lokal anestezi altında eliptik eksizyon yapılmıstır. Alınan cerrahi örneklerin patolojik incelemeleri normal dudak mukozası olarak rapor edilmistir. Olguların hiçbirinde post-operatif erken yada geç komplikasyon görülmeyip istenilen kozmetik sonuç elde edilmistir. Bir olguda parsiyel çift dudak deformitesi saptanmıs olup, bilgilerimize göre literatürde parsiyel çift dudak deformitesine ait bir yayın yoktur. Sonuç olarak bu çalısmada, dogumsal çift dudaga sahip toplam 8 olgu sunulmus ve bu deformitenin etyolojisi, görülme sıklıgı ve tedavi yöntemleri literatürdeki bulgular esliginde tartısılmıstır.Although congenital double lip deformity is not an uncommon condition, this deformity was presented rarely in the literature. Congenital double lip deformity may be present either as an isolated anomaly or a component of a syndrome. However less than twenty reports were presented in the literature, males were affected predominantly and pathogenesis of this deformity was explained by the embryological defects. In our study male to female ratio was equal and all patients were operated since the aesthetical reason. Elliptical excision was performed under the local anesthesia in all patients. All specimens were evaluated pathological and reported as “normal lip mucosa”. There were no early or late post-operative complication and aesthetical results were achieved in all patients. One case of our patients had partial congenital lip deformity, best of our knowledge; there was no data about the partial congenital lip deformity. Finally, in this study we present eight cases with congenital double lip and discuss the etiology, incidence and treatment modalities according to the data presented in the literature

Reconstruction of cervical esophagus defectswith three different techniques

Servikal özafagus defektlerinin onarımı, rekonstrüktif cerrahinin en zor konularından biridir. Bu defektler hipofarinks tümörleri ve primer servikal özafagus tümörleri sonucu gelisir. Ideal rekonstrüksiyon yönteminin, onkolojik cerrahi ile aynı seansta yapılabilir, erken fonksiyon saglayabilir ve düsük morbidite oranına sahip bir teknik olması gereklidir. Bu çalısmada üç farklı teknikle servikal özafagus onarımları, literatür bilgileriyle birlikte ayrıntılı olarak sunulmustur. Olguların biri pektoralis major kas deri flebi, digeri deltopektoral fleple ve en son olgu da servikohumeral flep ve deri grefti ile rekonstrükte edilmistir. Olguların tümünde oral alımı erken dönemde saglanmıstır.Yutma fonksiyonun en erken zamanda saglanmasının, yöntem seçiminde temel belirleyici oldugunu düsünmekteyiz. Sonuç olarak bu çalısmada her ne kadar üç farklı yöntem, farklı cerrahların seçimi olarak sunulmus ise de, bu yöntemler kendi avantaj ve dezavantajlarına sahiptir. Deltopektoral flepde parsiyel nekroz gelismesi, servikohumeral flebin ise geciktirme islemine ihtiyaç duyması nedeniyle, sunulan yöntemler içinde pektoralis major kas deri flebi ile onarımdaha basarılı bunmustur.Reconstruction of defects of the cervical esophagus is one of the most difficult tasks in reconstructive surgery. These defects are generally seen after tumors of hypopharynx and cervical esophagus. The method of reconstruction, which will be selected, therefore, must be reliable, a one-stage procedure with minimal morbidity and one that restores function in the shortest time possible. In this article, we present our experience with three different techniques: the pectoralis major musculocutaneous flap, the deltopectoral flap and a combination of cervicohumeral flap and skin grafting. Oral feeding was established early in all cases.We are of the opinion that the time for swallowing ability after operation is the one of the most important factors in determining the technique chosen for reconstruction of defects of the cervical esophagus. In conclusion, although three different techniques were presented in this study according to the surgeons choice, each technique has its own advantages and disadvantages. Since the partial necrosis in deltopectoral flap and necessity of the delay process in cervicohumeral flap were complications of the techniques, pectoralis major myo-cutaneous flap may be accepted as a more suitable reconstruction technique

İs the vertical scarmammaplasty a safe procedure for reduction of heavy sized breasts?

Aim: The vertical scar mammaplasty is one of the most frequently performed operations among reduction mammoplasties. The technique has now been adopted by many surgeons for mastopexies and small reductions, but it has not been commonly used for large reductions because of the frequency of healing problems of the vertical scar. The best candidate for surgery is a patient with elastic skin, moderate hypertrophy (up to 800 g removed per breast), and a breast which is a mixture of fat and glandular tissue. Method: In this study, we present our late term results with vertical scar reduction mammaplasty in heavy sized breast with resection of 1000g or more per breast in eleven patients. Eleven patients with heavy sized 22 breasts in which more than 1000g of tissue was resected are evaluated. Results: Median age of the patients was 32 years (20-46 years) and the average amount of resected specimen was 1322g (1000-1780g) per breast. All patients were operated by the same team and senior surgeon. During the follow up period 2 major complications in the early period were observed: partial nipple-areola necrosis and hematoma. Secondary healing of a partial nipple areola necrosis in a heavy smoker patient resulted in periareolar hypertrophic scar. There were no late term complications. Conclusion: We think that the vertical mammaplasty technique can safely be applied to heavy breasts and large reductions over 1000 gr of tissue.Amaç: Dikey izli (vertikal skar) meme küçültme tekniği mevcut ameliyat teknikleri içinde sıklıkla kullanılan yöntemlerden biridir. Bu teknik, özellikle meme düzeltme ve çok büyük olmayan memelerin küçültülmesinde pekçok cerrah tarafından başarı ile uygulanmaktadır.Ancak aşırı büyük memelerde özellikle dikey izin iyileşme problemleri ile ilgili olarak kullanımı tartışmalıdır. Bu tekniğe en iyi aday hasta elastik derisi olan, orta derecede hipertrofik(800gr.danaz) veyağ vebez karışımından oluşan memelerdir. Yöntem: Bu çalışmada, 1000gr.danfazla miktarda doku rezeksiyonu yaptığımız toplam 11 hastadaki aşırı büyük memelerde uyguladığımız dikeyizli tekniğin erken ve geç dönem sonuçları sunulmuştur. Bulgular: Hastaların yaşları 20 ile 46 arasında değişmekte olup ortancası 32idi. Eksize edilen doku miktarı 1000 ile 1780 gr. arasında olup ortalaması 1322 gr. idi. Tüm hastalar aynı cerrahi ekip tarafından ameliyat edildiler. İzlem süresince olgularda erken dönemde iki komplikasyon gözlendi: parsiyel meme başı - areola nekrozu ve hematom. Aşırı sigara içimi öyküsü olan nekrozlu hasta hipertrofik skar ile iyileşti. Uzun dönem sonuçlarında hastalarda herhangi bir komplikasyon gözlenmedi. Sonuç: Sonuç olarak dikey izli meme küçültme yönteminin, 1000 gr. dan fazla rezeksiyon yapılacak aşırı büyük memelerde güvenli bir şekilde uygulanabileceği görüşündeyiz

Retrospective analysis of 63 mandible cases who have been operated three years

PURPOSE: Maxillofacial fractures, especially fractures of the mandible, are common among the trauma patients admitted to the emergency department. MATERIALS and METHODS: Sixty- three patients admitting to our emergency department or outpatient clinic between January 2008 and December 2011 with a diagnosis of mandible fracture who have been surgically treated have been included in our study. Records of these patients have been retrospectively analyzed regarding gender, age, etiology, and anatomic location of the fracture. RESULTS: A total of 74 fractures (1.17 fractures per patient) were detected in 63 patients. Female/male ratio was approximately 1/4. The mean age of the patients was 28.4. Etiology of the trauma was traffic accidents in 51% and interpersonal violence in 28%. Most commonly fractured anatomic sites were symphyseal (56%) and corpus regions (22%). CONCLUSION: Maxillofacial fractures are common among patients with maxillofacial or generalized body trauma in the emergency settings. Due to the tendency towards interpersonal violence and to longer time spent in traffic, most of these patients are male at the third decade of life. Traffic accidents and violence are the most common etiological factors for these fractures; however, number of the trauma patients due to traffic accidents is clearly declining due to more frequent controls in traffic regulations