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    GIANT ADENOID CYSTIC CARCINOMA: A CASE REPORT
    (Medknow Publications & Media Pvt Ltd, 2012) Sari, Elif; Ozakpinar, Hulda Rifat; Eker, Esabil; Durgun, Mustafa; Tellioglu, Ali Teoman
    Adenoid cystic carcinoma (ACC) usually present as tumors of the major and minor salivary glands. Other less frequent primar locations have been described in the breast, bronchi, lacrimal glands, cervix, Bartholin glands of the vulva, prostate, and external auditory canal. The skin can also be involved with adenoid cystic carcinoma through direct or perineural invasion or as a site of distant metastasis. Primary cutaneus adenoid cystic carcinoma is a rare entity. We describe one such a case and present review of literature.
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    Inverted Nipple Correction with Dermal Flaps and Traction
    (Springer, 2014) Durgun, Mustafa; Ozakpinar, Hulda Rifat; Selcuk, Caferi Tayyar; Sarici, Murat; Ceran, Candemir; Seven, Ergin
    Inverted nipple occurs when part of or the entire nipple is abnormally located below the areola. Surgical repair of severe cases involves suture or flap techniques. Complications include recurrence, lactation problems, hypopigmented scar formation in the areola, and loss of sensation. We describe an alternative repair technique using a dermal flap and traction, which leads to less apparent scarring and preserves lactation function and sensation. Between January 2010 and January 2013, we treated 28 inverted nipples in 16 patients using two areola-based triangular dermal flaps and traction. The scar was aligned with the junction of the nipple and the areola. Postoperatively, traction was applied through an apparatus prepared from a 50-cc syringe. Patients were followed up for 8-24 months (mean = 16.5 months). Adequate projection was achieved in all patients and no wound dehiscence or complications such as infection occurred. Unilateral recurrence occurred in one patient on the 10th postoperative day. This patient was reoperated on successfully using the same method. No loss of sensation was observed in any of the patients during the postoperative period. This dermal flap technique for treating inverted nipple was effective and preserved lactation function. The alignment of the scar with the junction of the nipple and the areola led to a more aesthetic appearance with no apparent scarring. The traction method helped maintain traction for a longer period, which in our opinion increased the success rate of the surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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    Our Experience in Progressive Tension Sutures in Abdominoplasty
    (Gazi Univ, Fac Med, 2012) Tellioglu, Ali Teoman; Eryilmaz, Tolga; Inozu, Emre; Ozakpinar, Hulda Rifat; Durgun, Mustafa; Guler, Ilgi
    Objective: The most common local complications following abdominoplasty are flap necrosis, hypertrophic scar formation, seroma, and hematoma. Progressive tension sutures were introduced in order to decrease the local complications. In this study, we present our experience in progressive tension sutures in abdominoplasty patients. Methods: Nineteen female abdominoplasty patients were included in this study. The mean age was 42 years (35-59). The progressive tension sutures were placed from the superficial fascia to the deep fascia as the flap was advanced. Results: The mean follow-up was 11 (6-26) months. No hypertrophic scar formation, flap necrosis, infection, seroma, or hematoma developed. Minimal localized fat necrosis in 1 patient (5%) and pulmonary embolus in 1 patient (5%) occurred. Both patients healed uneventfully. Conclusion: The progressive tension sutures decrease flap necrosis and hypertrophic scarring by preserving the distal flap perfusion. Additionally, it reduces seroma and hematoma formation by reducing the dead space volume. In conclusion, although increasing the operation time, it may be a useful method for decreasing local complications.
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    Repair of Full-Thickness Nasal Alar Defects Using Nasolabial Perforator Flaps
    (Lippincott Williams & Wilkins, 2015) Durgun, Mustafa; Ozakpinar, Hulda Rifat; Selcuk, Caferi Tayyar; Sari, Elif; Seven, Ergin; Inozu, Emre
    Background The repair of full-thickness nasal alar defects presents difficulties because of their complex 3-dimensional structure. Reconstructions using inappropriate methods may lead to asymmetries and dissatisfying functional results. In this study, our aim was to present the repairs of full-thickness alar defects performed using cartilage-supported nasolabial perforator flaps. Materials and Methods Eight patients who presented to our clinic between January 2011 and April 2014 with full-thickness defects in the alar wings were included in this study. The nasolabial perforator flap was prepared on the basis of the closest perforator to the defect area and in a way to include 2 to 3 mm of subcutaneous adipose tissue. The medial section of the flap was adapted to form the nasal lining. In the 7 patients in whom cartilage support was used, the cartilage graft was obtained from the septum nasi. After the cartilage was placed on the flap, the lateral section of the flap was folded over the medial section and the defect was repaired. In 1 patient in whom cartilage support was not required, the flap was folded over itself before the repair was performed. The flap donor area was primarily repaired. Results No detachment around the suture lines, infection, venous insufficiency in the flap, or partial or total flap losses were observed in any of the patients. Retraction developed in 1 patient in whom no cartilage support was used. No retraction was observed in any of the patients in whom cartilage support was used. The results were functionally and esthetically satisfying in all the patients. Conclusions The greatest advantage of perforator-based nasolabial flaps is the greater mobilization achieved in comparison with the other nasolabial flaps. Thus, full-thickness defects can be repaired in 1 session in some patients, no revision is required around the flap pedicle, and much less donor area morbidity occurs. Nasal alar reconstructions performed using this type of flap lead to both esthetically and functionally satisfying results.
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    The Versatile Facial Artery Perforator-Based Nasolabial Flap in Midface Reconstruction
    (Lippincott Williams & Wilkins, 2015) Durgun, Mustafa; Ozakpinar, Hulda Rifat; Sari, Elif; Selcuk, Caferi Tayyar; Seven, Ergin; Tellioglu, Ali Teoman
    Introduction: Defects in the lower two thirds of the face occur due to trauma, tumoral masses, or infections. In this study, repairs of various defects located in the midface using facial artery perforator-based nasolabial flaps are presented. Patients and Methods: Between January 2009 and June 2013, 15 patients with defects in the lower two thirds of the face or the intraoral region underwent repairs with facial artery perforator-based nasolabial flaps. The etiology was malignant skin tumor excisions in 11 patients, infection in 2 patients, and trauma in 2 patients. Among the patients, 10 were male and 5 were female. Their mean age was 65.1 (range: 20-86) years. The mean duration of follow-up was 14 (7-24) months. The defects were located at the upper lip, cheek, lower lip, intraoral region, and the nasal area. The size of the defects varied between 10 x 10mm and 40 x 50 mm. All the flaps were prepared as perforator flaps. The flap donor area was primarily closed. Results: No partial or total flap loss was observed in any of the flaps. The flap donor areas healed without problem. Full patient satisfaction was achieved both aesthetically and functionally. Conclusion: The nasolabial perforator flap has certain advantages such as the 1-stage application, repair using a similar tissue, a wider rotation arc around the pedicle compared to the other regional flaps, and the primary closure of the donor area. Based on these characteristics, itis an ideal alternative for the repairs of the defects located in the lower two thirds of the face or the intraoral region.