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    COMPARISON OF THE EFFECT OF DIFFERENT SURGICAL METHODS IN PROXIMAL AND DISTAL HYPOSPADIAS
    (Medknow Publications & Media Pvt Ltd, 2012) Selcuk, Caferi Tayyar; Aksoy, Kadir; Karamursel, Sebat; Civelek, Birol; Celebioglu, Selim
    Introduction: Hypospadias is a congenital anomaly observed in approximately one in every 200 to 300 male births. To date, there is no method universally agreed upon for repair of hypospadias. The aim of our study is to retrospectively compare the methods chosen according to the location of the meatus and their outcomes in a group of 75 patients. Material and Methods: Between 2002 and 2008, seventy-five patients with primary hypospadias underwent surgical repairs. The age range of the patients was between 8 and 140 months, and the mean age was 61.8 months. The repairs in the patients with distal hypospadias were performed through urethral advancement (n=27) and the Mathieu technique (n=17). The repairs in the patients with proximal hypospadias were performed with onlay preputial island flap urethroplasty (n=8), the Asopa technique (n=19), and skin graft urethroplasty (n=4). Results: Patients where a satisfactory reconstruction was achieved were followed up for an average period of 54.6 months (range: 29-92 months). None of the patients developed any infection, hematoma, wound dehiscence or diverticula. During the follow-up period, the total complication rate was 14.6%, of which 8% were fistulae and 6.6% were meatal stenoses. The lowest complication rates were observed with the onlay preputial island flap method (25%) applied in patients with proximal hypospadias and with the urethral advancement (3.7%) applied in patients of distal hypospadias. Conclusion: In our study, the onlay preputial island flap urethroplasty in patients with proximal hypospadias and the urethral advancement in patients with distal hypospadias were found to be the most effective techniques.
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    Complex Craniofacial Reconstruction With Prostheses as an Alternative Method to Autogenous Reconstruction
    (Lippincott Williams & Wilkins, 2011) Selcuk, Caferi Tayyar; Sahin, Unal; Celebioglu, Selim; Erbas, Orhan; Aydin, Cemal; Yuce, Serdar
    Reconstruction of facial organ and tissue losses using autogenous tissue is a permanent and effective method in plastic surgery. However, in cases where the patient's general condition does not allow for surgical reconstruction or where the patient is in need of reconstruction of complex organs such as the eye, nose, or ear, an epithesis can be considered as an alternative to treatment with autogenous tissue. The purpose of this study was to investigate the factors affecting the success rate of facial reconstructions with an externally retained prosthesis in relation to the defect location and radiotherapy treatment. Between September 2004 and October 2008, 11 patients with facial tissue defects who had been treated with an osseointegrated implant system were evaluated. Because 1 patient with a midfacial defect died 3 months after the surgery, this case was excluded, leaving a total of 10 patients for evaluation. Five patients' facial defects were located in the ear, 2 patients had nasal defects, and 3 patients had defects in the midfacial region. The total numbers of implants applied to these regions were 13, 6, and 25, respectively. A total of 44 implants applied were followed for an average period of 52.4 months (between 6 and 77 months). In cases where the reconstruction was considered satisfactory, no infections were observed, and there were no implant losses in the mastoid region. Implant losses were observed in a total of 14 implants (31.8%), 2 of which were in the glabellar region (4.5%), and 12 were in the midfacial region (27.2%). The implant losses were observed between the first and 18th postsurgical months (with an average of 6 months). The remaining implants were sufficient to retain the prostheses. Because of these results, the use of implant-assisted epitheses can be considered a viable alternative in patients whose facial defects cannot be corrected through reconstructive surgery performed with autogenous tissue.