Browsing by Author "Yoleri L."
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Item Modified temporalis muscle transfer for paralytic eyelids(Lippincott Williams and Wilkins, 1999) Yoleri L.; Songür E.The major problems in paralytic eyelids are the inability to close the eye, lower lid sagging, and epiphora. The upper eyelid is responsible for most of the opening and closing of the eye, whereas a lower eyelid positioned properly against the globe is necessary for collection and flow of the tear fluid. Modification of temporalis muscle transfer, a classic technique, was planned to restore these functions selectively in paralytic eyelids. Twelve unilateral and one bilateral irreversible facial paralysis patients with different degrees of lagophthalmos and ectropion were included. Twice as much muscle mass (in thickness) to the upper eyelid than the lower was taken and passed submuscularly 5 to 6 mm away from the limbus for stronger motion of the upper eyelid, and a thinner muscle mass was passed subcutaneously beneath the lower cilia for longevity of the correction of ectropion and epiphora. Fixation of these strips was performed to the medial canthal ligament and 3 to 4 mm above it. The average duration of follow-up was 35.5 months. Excellent eyelid closure and correction of ectropion and epiphora were achieved with one procedure in all patients without creating a cosmetic deformity.Item Immediate hair transplantation into a newly closed wound to conceal the final scar on the hair-bearing skin(Lippincott Williams and Wilkins, 2000) Seyhan A.; Yoleri L.; Barutçu A.A surgical incision after suturing usually leaves a visible scar on the hair-bearing skin, even after optimal wound conditions. The conspicuousness of such a scar results from its linear continuity and hairlessness. To prevent this effect, a row of micrografts or minigrafts was inserted between the wound edges immediately after wound closure. The hair grafts that were transplanted were dissected from the discharged skin in the same surgical procedure, if feasible. Otherwise, a mini donor strip was harvested from the mastoid scalp to dissect the hair grafts. The final linear scar was interrupted and concealed sufficiently with the growth of the transplanted hairs. Tension-free closure is required to obtain a satisfactory result with this technique.Item Blue naevus with satellitosis mimicking malignant melanoma(2001) Sahin M.T.; Demir M.A.; Yoleri L.; Can M.; Öztürkcan S.Blue naevus is an acquired benign melanocytic naevus. It is a firm, sharply defined dark blue to grey-black papule or nodule, which is likely to arise from the arrested dermal melanocytes in the dermis. In the last few years, blue naevus has attracted much attention due to the recognition of new entities and to its confusion with malignant melanoma. We report a 69-year-old man who developed a blue-black nodular lesion with satellitosis on his scalp. Although clinically it was thought to be a malignant melanoma, histopathological investigation and conservative methods such as dermatoscopy and power Doppler ultrasonography did not confirm this diagnosis. Histopathological examination excluded malignant melanoma, as there were no cellular atypia and mitotic activity in either the nodular lesion or the satellitosis. Doppler ultrasonography confirmed the benign nature of the lesion. Dermatoscopic examination showed homogeneous steel-blue pigmentation with individual blue globules, dots and some brown veils, and confirmed the histopathological diagnosis. To the best of our knowledge, our case is the third reported case of a blue naevus with satellitosis mimicking malignant melanoma.Item Cross-facial nerve grafting as an adjunct to hypoglossal-facial nerve crossover in reanimation of early facial paralysis: Clinical and electrophysiological evaluation(Lippincott Williams and Wilkins, 2001) Yoleri L.; Songür E.; Mavioǧlu H.; Yoleri Ö.Reanimation of a spontaneous and synchronous smile, and sufficient depressor mechanism of the lower lip presents a surgical challenge in facial paralysis. Hypoglossal-facial nerve crossover and cross-facial nerve grafting are the best options if the mimetic muscles around the mouth are still viable in patients in whom the facial nerve was sacrificed at the brainstem. Although good muscle tone and facial motion have been obtained by hypoglossal-facial nerve crossover, smile is dependent on conscious tongue movement. Cross-facial nerve grafting provides a voluntary and emotion-driven smile, but requires two coaptation sites, which leads to substantial axonal loss and a long regeneration time. This method was not successful in activating the depressor mechanism. The first stage is the classic "baby-sitting" procedure, in which the bulk of the mimetic muscles was maintained by the rapid reinnervation of the hypoglossal-facial nerve crossover during the regeneration period of the cross-facial nerve graft, and temporalis muscle transfer to the eyelids is performed. During the second stage, the cross-facial nerve graft that used the thickest zygomaticobuccal branch on the healthy side was coapted with the corresponding branches on the paralyzed side. The hypoglossal-facial nerve crossover continued to innervate the depressor muscles. Good spontaneous smile and sufficient depressor mechanism were achieved by cross-facial nerve grafting and hypoglossal-facial nerve crossover respectively, and these techniques are demonstrated by the authors clinically and electrophysiologically.Item The significance of venous dominance in color Doppler ultrasound for the diagnosis of primary nodular skin lesions: A new perspective in classification(Elsevier Inc., 2006) Özkol M.; Yoleri L.; Demir M.A.; Demireli P.; Pabuşçu Y.The aim of this study was to investigate the significance of color Doppler ultrasound (CDUS) findings in the differential diagnosis of suspicious nodular skin lesions and to compare the results according to the Giovagnorio 1999 classification and the modified classification. Forty nodular skin lesions were evaluated with CDUS and US. The number of arteries and veins was recorded in hypervascular lesions. Findings were compared with histopathological results. The specificity and predictivity of the modified classification were higher than those of the Giovagnorio 1999 classification. © 2006 Elsevier Inc. All rights reserved.Item Modification of tension on muscle insertion improves smile in free-muscle transplantation(2006) Yoleri L.A functional free muscle without creation of different vectors and tension adjustment is an insufficient substitute for the mimetic muscles in the reanimation of facial paralysis. Placement of the lower 3 slips of the serratus anterior muscle and their tension adjustment were revised in 2 patients with facial paralysis to provide stronger upper lip movement and coordinated movement of the corner of the mouth superiorly and laterally. The slips were harvested with gradually decreasing lengths and separated from each other on both sides of their common neurovascular pedicle. The 9th slip was oriented at 55 to 60 degrees to the upper lip with the greatest tension. The 8th slip exerted original strength of tension to the modiolus at 45 degrees. The 7th slip was placed horizontally with the least tension. The results were evaluated according to open and closed lip smile and excursion of the modiolus. Stronger upper lip elevation and sufficient elevation of the modiolus with a proper 3-directional movement were demonstrated. Copyright © 2006 by Lippincott Williams & Wilkins.Item Late diagnosis of a lateral abdominal wall hematoma presenting with nonspecific findings: Report of a case(2007) Ilkgül Ö.; Özden S.; Özsoy Y.; Yoleri L.; Erhan Y.; Aydede H.We report a case with a late diagnosis of posttraumatic lateral abdominal wall hematoma. The patient was admitted with a giant hematoma presenting with pleural effusion, anemia and weight loss on postoperative 30th day after a blunt trauma. Computerized tomography analysis revealed a hematoma extending from axilla to the gluteus. Fine-needle aspiration revealed an exudative fluid and five l i t e rs of fluid collection was drained. Misdiagnosed lateral abdominal wall hematomas can be diagnosed with nonspecific findings as in this case.Item A 46-year-old male with an ulcerated linear lesion on his neck(King Faisal Specialist Hospital and Research Centre, 2008) Yoleri L.; Ozden S.; Kandiloglu A.[No abstract available]Item Case report of a late onset bowenoid papulosis progressing to squamous cell carcinoma: Letter to the editor(Turkiye Klinikleri, 2009) Aydin N.; Türel Ermertcan A.; Öztürkcan S.; Bilaç C.; Yoleri L.; Temiz P.[No abstract available]Item Radiological findings of chronic morel lavallee syndrome: Case report; [Kronik morel lavallee sendromunun radyolojik bulgulari: Olgu sunumu](2011) Örgüç Ş.; Başara I.; Özkarakaş P.; Yoleri L.Morel Lavallee Syndrome is defined as a soft tissue injury consisting of a closed internal degloving of the subcutaneous tissue creating a cavity filled with bloody serous liquid. This syndrome is usually not recognized by general or orthopedic surgeons and is therefore frequently missed or diagnosed late. If Morel Lavallee Syndrome is clinically misdiagnosed, findings appear as a chronic growing painful mass. With these symptoms, it can mimic hemangioma, synovial sarcoma, post traumatic fat necrosis or hematoma. However, if there is a history of trauma, characteristic magnetic resonance imaging findings can be helpful in the diagnosis of these cases. In the literature, sporadic cases have been reported without a clear etiopathogenic explanation.Item Remodeling of a nontreated displaced parasymphyseal fracture of a child(2011) Kerem H.; Usluer A.; Yoleri L.There have been considerable advances in the management of craniomaxillofacial injuries in children. Conservative approaches such as close observation, a liquid-to-soft diet, and analgesics can be used for the management of mandibular fractures without displacement and malocclusion. However, displaced fractures need to be an anatomic reduction and immobilization. The basic principle of displaced mandibular fractures in both children and adults is the stabilization of fracture fragments forming the pretraumatic contour and occlusion state until osteosynthesis occurs. The major differences of pediatric fractures from adults are the flexibility of bones and very rapid healing pattern. Therefore, reduction in pediatric age group must be accomplished earlier. This case was an 11-year-old boy presented with a severely displaced parasymphyseal mandibular fracture resulting from a fall. He was given a soft diet and analgesic, given anti-inflammatory treatment of edema, and scheduled for operation. Subsequently, it was surprisingly observed that there was a significant improvement in the fracture line on the 12th posttraumatic day. The comparison of maxillofacial computed tomographic scans of the first and 12th posttraumatic days revealed a noteworthy remodeling and a remarkable approximation of the fracture lines. It can be concluded that bone remodelization in the pediatric age groups is perfect and very rapid, even in severely displaced fractures. © 2011 by Mutaz B. Habal, MD.Item Use of cytarabine and idarubicin in a newly diagnosed AML patient with a severe wound(2011) Bozoglan H.; Ergene U.; Yoleri L.Acute myeloid leukemia (AML) is malignant tumor of haemopoietic precursor cells of non-lymphoid lineage. AML can atypically present with non-spesific cutaneous lesions or wounds. There are rare acute leukemia cases which present with genital ulcerations or pyoderma gangrenosum in the literature. The effect of acute leukemia on wound healing is not known, but it is thought that cytopenias and chemotherapy can impair wound healing in patients with leukemia. The effects of chemotherapeutic agents on wound healing are arguable. Here we present wound care strategies and simultaneously applied chemotherapy in an AML patient. © 2011 Elsevier Ltd.Item Nonsyndromic giant basal cell carcinoma with follicular differentiation and multifocal localized basal cell carcinoma(2013) Usluer A.; Yoleri L.; Kandiloğlu A.R.; Bali Z.; Demirer O.; İnanr I.Basal cell carcinoma is the most common malignant tumor of the skin. The most important feature is its very slow growth rate. It takes many years to reach gigantic dimensions. Various syndromes have been defined in which basal cell carcinoma exists in multiple localizations in a single patient. A case of basal cell carcinoma with multiple localizations and gigantic dimensions which is not classified as a syndrome is described in this case report. © 2013 Lippincott Williams & Wilkins, Inc.Item Tension adjusted multivectorial static suspension with plantaris tendon in facial paralysis(Lippincott Williams and Wilkins, 2013) Yoleri L.; Güngör M.; Usluer A.; Çelik D.Facial paralysis in the midface causes loss of cheek tonus, asymmetry at rest, and inability to smile. Static suspension is generally performed in patients who cannot tolerate time-consuming dynamic reanimation. Current methods for static slings are overly simplistic. A sling, which is generally fascia lata or palmaris tendon, is placed between the modiolus and the zygomatic arch or the temporalis fascia, with further extension to the midline of the upper end lower lips in 1 vector. Recently, sutures are placed in a multivectorial approach, but suture failure via breakage is the main problem. In this study, the long, thin, and powerful plantaris tendon was used and divided into 3 slips. Placement of these slips and their tension adjustment were revised to provide strong and long-lasting upper lip and the modiolus pull, along with creation of a well-defined nasolabial fold, and to create sufficient cheek tonus. The first slip was positioned at 35 to 45 degrees to the horizontal plane between the modiolus and the upper preauricular area, second slip at 55 to 60 degrees between the upper lip and the deep temporal fascia, and the third slip at 0 to 10 degrees between the lower lip and lower preauricular area with gradually decreasing tension from above to below in 9 patients. Upper 2 slings were also sutured to the dermis of the nasolabial fold to define it optimally. Results were assessed both objectively and subjectively. Symmetry at rest, sufficient cheek tightness to prevent drooling, and a well-defined fold were obtained. Copyright © 2013 by Mutaz B. Habal, MD.Item Eccrrin porocarcinoma: Our clinical experiences in treatment and follow-up of this rare lesion with a high incidence of local and regional recurrences; [Ekrin porokarsinom: Nadir görörülen, lokal ve bölgeselöl nüks orani yüksek olan lezyonun takip ve tedavisinde klinik deneyimlerimiz](2014) Kerem H.; Yaman M.; Bali U.; Öksüz M.; Yoleri L.Introduction: Eccrin porocarcinoma is a rare tumor originating from intraepithelial parts of eccrin sweat glands. It has a bad prognosis and very different biological behaviors with a high recurrence rate and metastasis to both local skin and lymphatics. Five cases with different clinical and histopathological properties treated in our clinic were presented to add some contribution to the literature. Material and Methods: Five cases of eccrin porocarcinoma patients treated in our clinic between 2009 and 2013 were analyzed according to age, sexuality, tumor localization and histopathological records. Results: All patients were women and their mean age was 77. Localization of tumors was as follows: medial of thigh, upper lip, deltoid region, gluteal region and left cheek. Sizes of the tumors were between 3 and 16 cm. Two patients had concurrent regional lymph node metastasis and they had lymphatic dissection procedures. One patient with local recurrence was lost after a two-year follow-up period. Conclusions: Eccrin porocarcinoma is a rare tumor and there are insufficient numbers of reports about its diagnosis, treatment, results and follow-up protocols in the literature. The patients have to be in a close follow-up about the local and regional recurrences.Item The cranially based contralateral nasolabial flap for reconstruction of paranasal and periorbital surgical defects(Churchill Livingstone, 2014) Kerem H.; Bali U.; Sönmez E.; Manavbaşi Y.I.; Yoleri L.The importance of the paranasal and periorbital regions on the aesthetics of the face presents a variety of reconstructive challenges for surgical and traumatic defects of those regions. We used the cranially based nasolabial flap in patients with full-thickness soft-tissue defects of the paranasal and periorbital regions harvested from the contralateral side of the present defect. We present our experience in 25 patients of geriatric population (13 females and 12 males with a mean age of 76) with complex soft-tissue defects in the paranasal and periorbital regions whose defects were reconstructed with contralateral nasolabial skin flaps. Sizes of the defects changed between 2 × 3 cm and 6 × 7 cm. The flap sizes varied from a width of 2 to 5 cm (average 3 cm) and a length of 7 to 11 cm (average 8 cm). Primary closure of the donor sites of the flaps was possible in 24 of the patients in this series. Twenty-one flaps of this series (84%) healed without any necrosis and completely survived. The contralateral nasolabial flap is a very convenient, safe and reliable flap that can be used in medium to large paranasal and periorbital defects. Optimal aesthetic results for a variety of central facial defects could be obtained with this flap, especially when the ipsilateral nasolabial flap cannot be used due to various reasons. © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.Item Asymmetry, handedness and auricle morphometry; [Asimetría, lateralidad y morfometría de la oreja](Universidad de la Frontera, 2015) Tatlisumak E.; Yavuz M.S.; Kutlu N.; Asirdizer M.; Yoleri L.; Aslan A.The aims of this study were to determine various morphometric measurements of auricle, to investigate asymmetry and its relation with handedness in both sexes. Main morphometric measurements of both auricles and hand preferences were determined on 200 male and 200 female healthy university students. All measurements of the auricles were larger in males than the corresponding ones in females and all the differences except earlobe widths were statistically significant. All measurements of left and right auricles were statistically significantly different in both sexes except earlobe length in males, and distance from the highest point of the auricle to the bottom of the intertragic notch and earlobe length in females. Auricle length and distance from the highest point of the auricle to the bottom of the intertragic notch had higher values at the left side and all other measurements were larger at the right side. There was no significant difference between the measurements of the corresponding auricles of the righthanded and lefthanded subjects. All measurements were larger at the right side except auricle length and distance from the highest point of the auricle to the bottom of the intertragic notch in righthanded and lefthanded subjects and all differences except earlobe length were significantly different in righthanded subjects as in the total population but in lefthanded subjects the difference of the auricle width was not significant, either. There was an apparent asymmetry of right and left auricles of normal people in the current study which should be taken in to consideration in plastic surgeries of the external ear, designing the ear devices and forensic applications of earprints. © 2015, Universidad de la Frontera. All rights reserved.Item Idiopathic scrotal elephantiasis; [Idiyopatik skrotal elefantiazis](2016) Evrenos M.K.; Özkaya M.; Yaman M.; Yoleri L.[No abstract available]Item True retaining ligaments of face as surgical landmarks; [Los verdaderos ligamentos de retención de la cara como marcadores quirúrgicos](Universidad de la Frontera, 2016) Tatlisumak E.; Yoleri L.The adherence of the overlying tissues to the underlying structures in the face is maintained by the retaining ligaments. True retaining ligaments named orbital, zygomatic and mandibular ligaments are a series of fibrous bands that run from periosteum to the dermis. The tethering effect of true retaining ligaments must be released for achieving a satisfactory movement of facial skin and Superficial Muscular Aponeurotic System (SMAS) during facial rejuvenation procedures. The aim of this study was to define the location of the true retaining ligaments of the face and to discuss their usability as surgical landmarks. The study was made on ten hemi-faces of formaline-fixed cadavers. Dissections resembling face-lift procedures were applied and ligaments were determined. The distances of the ligaments to lateral canthus, tragus and commissure and to the lines from tragus to lateral canthus and commissure were measured. Correlations were investigated statistically. The distances of the zygomatic and mandibular ligaments from the tragus were 66.50±10.78 mm and 114.80±9.76 mm respectively. The distances of the zygomatic ligament from the commissure and the commissure tragus line were 56.30±8.94 mm and 28.40±5.19 mm respectively. The distances of zygomatic and mandibular ligaments from the tragus were strongly correlated with a ratio of 3/5 and there was a strong correlation between the distances of the zygomatic ligament from the commissure and commissure- tragus line with a ratio of 2. The results of this study elucidated the possibility of the use of the true retaining ligaments as surgical landmarks for facial surgery. © 2016, Universidad de la Frontera. All rights reserved.Item Lateral thoracic artery perforator-based flap: a new experimental model(Academic Press Inc., 2016) Bali U.; Gungor M.; Yoleri L.Background: The aim of this study was to describe a new experimental perforator-based flap in rats, supplied by lateral thoracic artery perforator. Methods: Through out the study, two control and two experimental groups were created consisting of six rats in each group. In the first control group (group 1), mid-axillary line and the fourth intercostal space intersection were used as the center of the flap. A 3 × 2 cm flap was designed and elevated above the cutaneous maximus muscle by transecting all connections with the muscle. In the second control group (group 2), the flap was extended caudally, and 3 × 6 cm flap was designed. Then, the flap was elevated in the same manner as it was described for group 1. In the first experimental group (group 3) 3 × 2 cm flap and in the second experimental group (group 4) 3 × 6 cm flap were designed like control groups. The flaps were islanded on a single musculocutan perforator arising from lateral thoracic artery. The surviving skin paddle areas were calculated on postoperative day 7. Results: The flap viability was calculated 0% for control groups (groups 1 and 2), 100% for the first experimental group (group 3), between 33.3% and 37.7% for the second experimental group (group 4; mean ± standard deviation, 34.76% ± 1.92%). Conclusions: This new lateral thoracic artery perforator-based flap has a constant anatomy and reliable survival pattern. Also, easy harvesting and the possibility of designing two flaps per animal make this new flap an appealing model for pathophysiological or pharmacologic researches. © 2016 Elsevier Inc.