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Öğe Dermabrasion and staged excision of facial lesions in a neurofibromatosis case for improvement of facial appearance(B C Decker Inc, 2013) Karabekmez, Furkan Erol; Duymaz, Ahmet; Karaçor, ZeynepBackground: Neurofibromatosis may present with different skin lesions. Disfiguring lesions on the face might be challenging for the surgeon or clinician to correct and may have adverse effects on patients' social lives, especially in young women. Objective: To present the dermabrasion technique combined with serial excisions of a deeper accompanying lesion to treat superficial facial lesions in a young neurofibromatosis patient. Methods: Dermabrasion was applied to superficial lesions on the face, and staged excision was applied to the deeper lesion located on the forehead. Results: We obtained high patient satisfaction with the result. The deep lesion was excised totally, and superficial lesions were decreased with dermabrasion. Conclusion: Dermabrasion may become a good alternative in cases of neurofibromatosis with superficial facial lesions.Öğe Early and late term microsurgical free flap reconstruction and risks in high voltage electrical injury(Carbone Editore, 2013) Karabekmez, Furkan Erol; Duymaz, Ahmet; Tosun, Zekeriya; Keskin, Mustafa; Savacı, NedimThe aim of the study is to discuss and compare the early and late micro vascular flap reconstruction's outcomes, importance, risks, advantages and disadvantages with review of our 13 high voltage electrical burn injury cases. Medical records have been reviewed for electrical burns in last three years. 13 cases fitting the criterion were included into the study. Four of them have been hospitalized for late complication such as severe contracture; nine of them have been hospitalized for acute treatment. Five patients had latissimus dorsi muscle flap, three patients had parascapular flap, two patients had latissimus dorsi and scapula osteomusculo-cutaneous flap, two patients had reams abdominis musculocutaneous flap, and one patient had parascapular and scapular flap. Early reconstruction applied group showed a significant difference regarding to flap failure rates. Electrical injuries are more complex than regular burn injuries related with heat, and the reconstruction of these cases also should be special. One of the most important factor for free flap viability in electrical injury cases is surgery timing. All of the complications were seen in the patients who had surgery at 12th and 19th days after the electrical injury. No complication has seen in the group of patients who had surgery on late term period. However microsurgical reconstruction should be considered to cover exposed bony tissues on the extremities in the short term period in order to prevent possible limb shortening procedures.Öğe Ektropion düzeltilmesinde etkin bir yöntem: Kuhnt Szymanowski tekniğinin smith modifikasyonu(2013) Akdağ, Osman; Karabekmez, Furkan Erol; Sütçü, Mustafa; Duymaz, Ahmet; Karameşe, Mehtap; Tosun, ZekeriyaAmaç: Ektropiyon göz kapağı kenarının dışa doğru kıvrılm asıdır. Bu çalışmanın amacı; involüsyonel ve paralitik ektrop i yon onarımında kullanılabilecek kolay ve etkin bir yöntem olan Kuhnt Szymanowski tekniğinin Smith modifikasyonunun etkinliğinin ve estetik olarak kabul edilebilirliğinin değerle n dirilme sidir . Yöntem: Alt göz kapağında ektropiyon şikayeti ile kliniğimize başvuran ve Kuhnt Szymanowski tekniğinin Smith modifikasyonu ile tedavi edilen 5 hasta klinik ve fotoğrafik olarak incelendi. Bulgular : Hiçbir olguda majör bir komplikasyon ya da nüks gözlenmedi. Ortalama 10 ay olan takip süresi sonunda tüm hastalar cerrahi sonuçtan memnundu. Sonuç : Alt göz kapağında horizontal gevşekliğin daha ön planda olduğu involüsyonel ve paralitik ektropiyon olgul arında Kuhnt Szymanowski tekniğinin Smith modifikasyo nu nun uygun bir cerrahi yöntem olduğu kanaatindeyiz.Öğe Management of neglected periorbital squamous cell carcinoma requiring orbital exenteration(Lippincott Williams & Wilkins, 2014) Karabekmez, Furkan Erol; Selimoğlu, Muhammed Nebil; Duymaz, Ahmet; Şen Karameşe, Mehtap; Keskin, MustafaWith its perineural invasion capacity, periorbital squamous cell carcinoma (SCC) may easily invade orbital structures. When SCC invades the orbital musculature or the orbit itself, orbital exenteration, one of the most disfiguring operations on the face, is required. We reviewed elderly patients with periorbitally localized SCC requiring orbital exenteration to evaluate reconstructive options and survival. A chart review of patients' records was conducted to identify all patients older than 65 years with periorbital malignancy requiring orbital exenteration from 2006 to 2011. A total of 9 patients who met the criteria were included in the study. The mean age at surgery was 77 +/- 6.7 years, and the mean defect size was 74.2 cm(2). All patients had a similar history of late presentation to a doctor because of hesitation to undergo surgery. The temporoparietal fascia flap, galeal flap, free gracilis flap, and free vastus lateralis musculocutaneous flap were the treatment options for reconstruction of the defects. All patients died during follow-up, and the mean survival was 15.7 months (range, 6-36 months). Only 2 of them had relapse before the death. Our small series suggest that elderly patients with periorbital SCC requiring orbital exenteration may not have enough survival to relapse because of the death from different causes without relapse or any sign of spreading cancer. Also, prolonged surgery with free flap reconstruction may increase the risk of postoperative intensive care unit requirement. Because local flaps may work very well for reconstructing the orbital exenteration defects, free flap option should be kept for selected cases.Öğe Mandibular corpus horizontal distraction in an edentulous case and its effects on the contralateral coronoid processus-arcus zygomaticus relation(2015) Karabekmez, Furkan Erol; Irgin, Celal; Günbey, Leman Karabekmez; Duymaz, AhmetInteraction between the coronoid processus and the arcus-zygomaticus on contralateral hemi-mandible often drops off the radar in case of distraction osteogenesis of the mandibular corpus. We presented a 42 years old male without any teeth applied to hospital for facial asymmetry, short hemi-mandible and chewing problems. 2D and 3D computerized tomography and stereo-lithographic models were used for planning, predicting possible movements on the contralateral condyle and anticipate the relation of contralateral coronoid process the with zygomatic arc. Maximum safe amounts of distraction were calculated with cooperation with orthodontics and radiology. The rotation angle on the axis of the contralateral condyle is calculated in order to measure the defect to be corrected to take the maxillary and mandibular midlines to the same plane. Total calculated defect were shortened for preventing any interaction between the coronoid processus and the arcuszygomaticus on contralateral hemi-mandible. Patient was satisfied and started to use new dentures two months after removal of the distraction device. In order to achieve successful distraction without any problem regarding to opposite side rotation angles of the condyle, and position changes in the coronoid processus, collaboration and multidisciplinary approach are essential with orthodontics and radiologist in case of unilateral mandibular corpus distraction.Öğe Pediküllü rektus abdominis kas deri flebinin uyluk ve sırt defektlerinde kullanımı(2014) Duymaz, Ahmet; Karabekmez, Furkan Erol; Keskin, MustafaAMAÇ: Daha önce tanımlanmış, fakat az kullanılan "ekstended" veya vertical rektus abdominis muskulokutan ("Ekstended" RAM, VRAM) fleplerinin çok nadir endikasyonlardaki kullanımları incelendi. GEREÇ VE YÖNTEM: Beş hastada, 28x8 ile 35x10 cm ebatlarında cilt adası içeren flepler kullanıldı. Dört flep uyluk ve diz proksimal bölgedeki defekt onarımları için inguinal ligamentin altından, bir flep lomber gölgedeki defekt onarımı için transabdominal olarak defekt alanlara taşındı. BULGULAR: Hiçbir olguda flep kaybı görülmedi. Bir olguda yara yeri enfeksiyonu gelişti ve cerrahi ile tedavi edildi. Uyluk ve lomber bölge defektleri onarımlarında düşük komplikasyon oranlarıyla "ekstended" RAM ve VRAM fleple başarılı transfer gerçekleştirildi ve çok güvenli ve uygun bir seçenek olduğu sunuldu.SONUÇ:Avantajları bol miktarda ve iyi kanlanan doku taşımasını sağlar, flep kolay ve hızlı hazırlanır ve mikrocerrahi deneyimi gerektirmezÖğe A RARE ANOMALY OF THE UROGENITAL REGION: PENOSCROTAL TRANSPOSITION(Medknow Publications & Media Pvt Ltd, 2012) Karabekmez, Furkan Erol; Duymaz, Ahmet; Hirik, ErkanPenoscrotal transposition which is a rare anomaly of the external genital system has incomplete and complete variants. Since patients treated in their childhood because of the additional anomalies, almost no adult penoscrotal transposition cases were seen in the literature. In this study, 35 years old patient with incomplete penoscrotal transposition presented, and accompanying anomalies which require attention in patient presented with penoscrotal transposition, surgical technique and possible complications are discussed in the light of the literature.Öğe Reconstruction of nearly total defects of lower eyelid with combined use of supraorbital island flap and tarsoconjunctival advancement flap(2013) Karabekmez, Furkan Erol; Duymaz, Ahmet; Yılmaz, EnginA 44-year-old male and 75 year old woman has a lesion on their lower eyelid presented to our clinic. Biopsies revealed basal cell carcinoma and patients undergo general anesthesia for excision of the tumors and repair. The full-thickness nearly total lower eyelid defects were reconstructed with the modified Hughes tarsoconjunctival flap for posterior lamellar reconstruction combined with a Frickesupraorbital island flap for anterior lamellar coverage. Supraorbital flap had provided a good support to prevent ectropion with sling effect in our cases. This combination allowed us to do second stage surgery for separating tarsoconjunctival flap earlier (10 to 12 days) than usual and provided an acceptable cosmetic result for lower eyelid defects in our two cases. Combination of modified Hughes tarsoconjunctival flap and Fricke supraorbital island flap may become a good alternative for reconstruction of bilamellar lower lid defects reaching 75 percent.Öğe RECONSTRUCTION OF NEARLY TOTAL DEFECTS OF LOWER EYELID WITH COMBINED USE OF SUPRAORBITAL ISLAND FLAP AND TARSOCONJUNCTIVAL ADVANCEMENT FLAP(Medknow Publications & Media Pvt Ltd, 2013) Karabekmez, Furkan Erol; Duymaz, Ahmet; Yilmaz, EnginA 44-year-old male and 75 year old woman has a lesion on their lower eyelid presented to our clinic. Biopsies revealed basal cell carcinoma and patients undergo general anesthesia for excision of the tumors and repair. The full-thickness nearly total lower eyelid defects were reconstructed with the modified Hughes tarsoconjunctival flap for posterior lamellar reconstruction combined with a Fricke supraorbital island flap for anterior lamellar coverage. Supraorbital flap had provided a good support to prevent ectropion with sling effect in our cases. This combination allowed us to do second stage surgery for separating tarsoconjunctival flap earlier (10 to 12 days) than usual and provided an acceptable cosmetic result for lower eyelid defects in our two cases. Combination of modified Hughes tarsoconjunctival flap and Fricke supraorbital island flap may become a good alternative for reconstruction of bilamellar lower lid defects reaching 75 percent.Öğe Unikameral kemik kistinin nadir lokalizasyonu: el proksimal falanksı(2014) Duymaz, Ahmet; Karabekmez, Furkan Erol; Çobanoğlu, Mutlu; Karataş, Cengiz; Karabekmez, Leman GünbeyA unicameral bone cyst (UBC), also known as a simple or solitary bone cyst, is benign tumor that consists of a cavity filled with a yellow-colored fluid. It is typically seen in children aged 5 to 15, and affects males twice more than females. Although UBC can be located in any bone of the body, the most common location of the lesions is the proximal humerus, followed by the proximal femur. Both account for nearly 90% of all UBC sites. Other sites involve the tibia, pelvis, calcaneus, scapula, spine, patella, metatarsals. But, according to our knowledge, four cases of lesions in the hand have been reported in the literature before. And also only two of them were in phalanx of the hand. We herein reported two cases with UBC of the proximal phalanx of the hand. We also reviewed the literature related to UBC with special emphasis on general characteristic of the lesions.Öğe UNUSUAL LOCATION OF THE UNICAMERAL BONE CYST: A PROXIMAL PHALANX OF THE HAND(Medknow Publications & Media Pvt Ltd, 2014) Duymaz, Ahmet; Karabekmez, Furkan Erol; Cobanoglu, Mutlu; Karatas, Cengiz; Karabekmez, Leman GunbeyA unicameral bone cyst (UBC), also known as a simple or solitary bone cyst, is benign tumor that consists of a cavity filled with a yellow-colored fluid. It is typically seen in children aged 5 to 15, and affects males twice more than females. Although UBC can be located in any bone of the body, the most common location of the lesions is the proximal humerus, followed by the proximal femur. Both account for nearly 90% of all UBC sites. Other sites involve the tibia, pelvis, calcaneus, scapula, spine, patella, metatarsals. But, according to our knowledge, four cases of lesions in the hand have been reported in the literature before. And also only two of them were in phalanx of the hand. We herein reported two cases with UBC of the proximal phalanx of the hand. We also reviewed the literature related to UBC with special emphasis on general characteristic of the lesions.Öğe Ürogenital bölgenin nadir görülen bir anomalisi: penoskrotal transpoziyon(2012) Karabekmez, Furkan Erol; Duymaz, Ahmet; Hirik, ErkanDış genital sistemin nadir görülen bir anomalisi olan penoskrotal transpozisyonun komplet ya da inkomplet varyantları vardır. Hastalar çocukluk çağında ek anomaliler nedeniyle tedavi edildiğinden erişkin penoskrotal transpozisyon olgusuna literatürde nerdeyse hiç rastlanmamaktadır. Bu çalışmada 35 yaşında inkomplet penoskrotal transpozisyon nedeniyle başvuran hasta sunularak, penoskrotal transpozisyon ile başvuran hastalarda dikkat edilmesi gereken eşlik eden anomaliler, cerrahi sırasında kullanılacak teknik ve olası komplikasyonlar literatür ışığında tartışılmıştır.Öğe Using pedicled rectus abdominis musculocutaneous flaps in thigh and lumber defects(Turkish Assoc Trauma Emergency Surgery, 2014) Duymaz, Ahmet; Karabekmez, Furkan Erol; Keskin, MustafaBACKGROUND: A series of previously described but rarely used variations of the pedicled, extended or vertical rectus abdominis musculocutaneous flap ( Extended RAM, VRAM) were reviewed. METHODS: Skin paddle dimensions, ranged 8 to 28 cm in width and 10 to 35 cm in length, were used in five consecutive patients. Four flaps were placed deep to the inguinal ligament to repair the thigh as proximal to the knee region; the remaining one flap was passed transabdominally to cover the defect of the lumbar region. RESULTS: No flaps necrosis were seen and in one case wound healing problems required minimal operative intervention. Successful transfer of the VRAM and extended RAM with low rate of complication for the thigh and lumbar region defects were demonstrated to be safe and reasonable options of flap reconstruction. DISCUSSION: The flaps had the advantages of being robust and well- vascularized, easy and fast to harvest, and not requiring microsurgery experience.
