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Öğe Apaydin Classification of Spreader Flaps Updated(Thieme Medical Publ Inc, 2024) Capelleras, Marta; Saghir, Meshari; Apaydin, FazilThe use of spreader flaps (SFs) is very helpful in middle vault reconstruction. The aim of the study was to evaluate the versatility of Apaydin classification of SFs on a patient population. This was a retrospective analysis which included 120 rhinoplasty cases. Thorough preoperative planning adhering to precision profileplasty principles was conducted for all patients. The study employed six primary variants of SFs. SFs' types were utilized as follows: type 1 in 41 patients (34.2%), type 2 in 2 patients (1.7%), type 3A in 38 patients (31.7%), types 3B and 3D in 10 cases each (8.3%), type 3C in 2 cases (1.7%), type 4 in 5 cases (4.2%), type 5 in 7 cases (5.8%), and type 6 in 5 cases (4.2%). This study highlights that different SF techniques should be tailored according to the need of the patient when dealing with middle vault reconstruction during reduction rhinoplasty.Öğe Assessment of Approaches of Otorhinolaryngologists in Facial Plastic and Nasal Surgery: A Survey Study(Aves, 2017) Altintas, Ahmet; Yegin, Yakup; Celik, Mustafa; Sozen, Tevfik; Kayabasoglu, Gurkan; Yucel, Omer Taskin; Apaydin, FazilObjective: To assess approaches and experiences of otorhinolaryngologists in facial plastic and nasal surgery. Methods: In total, 234 surgeons (191 males and 43 females; average age, 37.22 +/- 8.4 years; age range, 26-63 years) were included. All participants were given a questionnaire comprising 22 multiple choice and closed-ended questions. All responses to the questionnaires were analyzed. Results: Of 234 participants, 42 (17.9%) were residents and 192 (82.1%) were specialists in otorhinolaryngology. The most challenging cases in rhinoplasty were crooked nose (33.8%), ideal nasal dorsum (18.8%), revision cases (13.2%), and skin deformities (11.1%). The photodocumentation rate by surgeons before and after procedures of facial plastic surgery was 86.3%, whereas the intraoperative photodocumentation rate by surgeons was 47%. The most common facial plastic surgery procedures other than rhinoplasty were otoplasty (68.4%), filler-Botox-fat injections (20.5%), and mentoplasty (18.4%). Conclusion: This survey study is quite important because it assesses approaches of otorhinolaryngologists in facial plastic surgery. Although this study provides more valuable data for determining the current status, further studies with larger number of surgeons are required.Öğe Assessment of Different Middle Vault Reconstruction Techniques in Rhinoplasty from Multiple Patient-Reported Outcome Measures(Thieme Medical Publ Inc, 2022) Sahin, Fetih Furkan; Apaydin, Fazil; Gode, SercanIt is important to assess the patient satisfaction with shape and function by patient-reported outcome measures (PROMs) following structural or dorsal preservation rhinoplasty (DPR) techniques on the middle nasal vault. To analyze the results of different middle vault rhinoplasty techniques with multiple PROMs and compare their differences according to the findings of PROMs. Four different techniques were performed for the middle vault: spreader graft, L-strut graft, DPR with high strip (DPRwHS), DPR with low strip. The outcomes were evaluated preoperatively, 2 and 12 months postoperatively with the following PROMs: Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcomes Evaluation, and Standardized Cosmesis and Health Nasal Outcomes Survey. This study included 129 patients. All techniques provided significant improvements in all PROMs ( p < 0.001), except DPRwHS in NOSE. Between postoperative short- and longer-term, no significant differences were observed in DPR groups ( p > 0.05), unlike structural techniques. In this comparative study of different middle nasal vault rhinoplasty techniques, we did not detect a difference in the improvement of the patient-reported outcomes of DPR techniques from as early as 2 months to 1 year postoperative.Öğe Biomechanics of Septal L-Strut on Lamb Head Models(Thieme Medical Publ Inc, 2022) Erol, Ozan; Soto-Galindo, German Armando; Apaydin, FazilIt is very crucial to know the biomechanics of the septal cartilage and adjacent structures during septoplasty. The aim of this study was to investigate the strength changes of different L-strut models after mucoperichondrium elevation, application of septal extension grafts and spreader grafts on an experimental lamb model. Ten lamb heads were dissected according to a dissection protocol and septal resistances were measured with the newton meter at six zones. Three different L-strut types were designed, and all the L-strut models were created at different widths of 15mm, 10mm, and 5mm. In addition, effects of two different types of septal extension grafts and spreader grafts were compared. After mucoperichondrium elevation and harvesting the septum cartilage, there was a significant decrease in the septum resistance ( p <0.05). As the width of the L-strut decreased, the septum strength decreased significantly ( p <0.05). There was no significant difference between three chondrotomy types at different widths ( p >0.05). There was no significant difference between the overlapping SEG and end-to-end SEG in terms of septum resistance ( p >0.05). This was the first study to measure septal resistance in lamb heads. The mucoperichondrium and L-strut width were important structures for maintaining septal resistance. Chondrotomy style was not crucial, but as the width of the L-strut increased, the septal resistance increased. The septal extension grafts regardless of suturing style and the spreader grafts added strength to the caudal septum.Öğe Bone Recycling in Nasal Septal Reconstruction(Thieme Medical Publ Inc, 2013) Apaydin, FazilSeptal reconstruction alone or together with rhinoplasty can be a very challenging operation. In situations where septal cartilage is used for grafting or is not enough, bony implants taken from the perpendicular plate of the ethmoid and vomer can be used as a filler material between the mucoperichondrial flaps to avoid from unwanted mucosal atrophy, flapping, and septal perforation. These bony implants can also be used for splinting the dorsal and/or caudal segment of the septal cartilage after reshaping by rongeurs. On rare occasions, they can even be used for subtotal reconstruction of the septum.Öğe Cartilage Chips in Rhinoplasty(Thieme Medical Publ Inc, 2022) Apaydin, Fazil; Garcia, Rodrigo Fortunato Fernandez-Pellon; Sahin, Fetih Furkan; Rahavi-Ezabadi, SaraObjective This study reveals that the cartilage chips can be a good solution for camouflage and augmentation in rhinoplasty. Methods In this study, 64 patients who had undergone rhinoplasty from 2014 to 2019 were retrospectively studied. The average age was 31. Forty-nine patients had primary and 15 revision rhinoplasties. Cartilage chips were cut into less than 0.5-mm thickness dimensions changing from 2 to 10 mm. They were used to fill deep radix, depressions at the key area, supratip area, around the grafts to prevent their visibility at the tip. In addition, they were used in the fascia for augmentation. The cartilage chips were sculpted from the septal cartilage in 47, rib in 16, and ear cartilage in one case. Results They were applied on the radix in 25, middle vault in 37, supratip area in 32, and on the tip in 12 cases. In 30 cases, cartilage chips were mixed with cartilage dust for better fixation and camouflage. They were placed in the fascia in three cases for dorsal augmentation. Complications were seen in three cases in the form of irregularities. Conclusion Cartilage chips are found to be a powerful solution in terms of camouflage and augmentation.Öğe Commentary on: Functional and Aesthetic Outcomes of Let Down Dorsal Preservation Rhinoplasty by Sozansky Lujan et al(Mary Ann Liebert, Inc, 2022) Apaydin, Fazil[No Abstract Available]Öğe Defect Reconstruction of the Nose After Surgery for Nonmelanoma Skin Cancer: Our Clinical Experience(Aves, 2017) Kaya, Isa; Uslu, Mustafa; Apaydin, FazilObjective: This study aimed to investigate reconstruction methods according to nasal subunits in patients who were surgically treated with diagnosis of non-melanoma skin cancer of the nose. Methods: All patients were retrospectively investigated. This study was conducted between April 2004 and December 2010; 180 patients who were surgically treated with diagnoses of skin basal cell carcinoma, squamous cell carcinoma, cancer of skin appendages, and precancerous lesions and 194 lesions were included. The types of repair performed were divided into seven main groups: Secondary healing, primary closure, skin graft, local flap, auricular composite graft, subtotal reconstruction and prosthesis application. Results: Among the 180 patients, 110 (61.1%) were males and 70 (38.9%) were females. The mean duration of follow-up was 39.8 (range, 32-81) months. Repair was by a local flap, a primary suture, a skin graft, and an auricular composite graft in 133, 16, 38, and 2 defects, respectively. Four defects were left for secondary healing. A prosthesis was applied to one patient. Totally, 194 defects were treated by surgery. Conclusion: Although nonsurgical treatment options such as radiotherapy or cryotherapy may be effectively used, surgery is the main treatment option for cancer of the nasal skin. Nasal subunits have distinct characteristics; thus, optimal reconstruction should be preferred for each subunit. The objective of the reconstruction is not only closing the defect. Closing the defect appropriately with the optimal flap and in proper with the aesthetic subunits is the most important point in reconstruction of the nose.Öğe Delayed Reconstruction with Full-Thickness Skin Grafts Following Defect Size Reduction in Head and Neck Nonmelanoma Skin Cancer(Thieme Medical Publ Inc, 2020) Sezgin, Baha; Kaya, Isa; Turhal, Goksel; Apaydin, FazilDifferent treatment modalities have been applied for nonmelanoma skin cancers (NMSCs) of the head and neck area. One of the most important points after surgical treatment is the selection of appropriate reconstruction methods. the aim of this study is to investigate the efficacy and feasibility of the use of both defect size reduction with sutures and secondary healing with delayed reconstruction with full-thickness skin grafts in NMSC patients. in total, 18 (42.8%) male and 24 (57.2%) female patients with NMSC were operated. Defect size was measured both after excision and just before repair, and the approximate defect area was calculated with ImageJ software. Reconstruction was performed after 14 days in all patients in the second session, using free skin grafts. There were 18 (42.8%) male and 24 (57.2%) female patients. the mean age was 70.5 (45-82) years. the mean follow-up period was 40.3 (16-68) months. the mean defect area measured after excision was 8.44 +/- 1.91cm (2) . After 14 days of delay, the mean defect area was 5.51 +/- 1.28cm (2) (34.8% reduction) ( p <0.05). Defect-reduction methods applied during the first session, together with proper interval prior to placement of graft, have been shown to be beneficial and acceptable methods, providing an advantage in reconstruction with free skin graft.Öğe Effect of Dorsal Preservation Techniques on Septum Strength: An Experimental Animal Study(Thieme Medical Publ Inc, 2024) Erol, Ozan; Berber, Veysel; Soto-Galindo, German Armando; Apaydin, FazilThis experimental animal model study investigates the impact of different methods employed in preservation rhinoplasty (PR) on the strength of the nasal roof, focusing on three techniques: high strip, low strip, and intermediate strip. Using 15 lamb heads as surgical models, the study addresses key questions related to the strengths of each PR techniques, the influence of septal cartilage harvesting on septum strength, and the effectiveness of spreader grafts for stability. The research involves detailed dissection steps and measurements at various nasal points, evaluating the resistance at each stage. Results indicate that the low strip technique demonstrates the most significant reduction in strength. Furthermore, the combination of PR techniques with structural grafts, specifically spreader grafts, is assessed, revealing the classical rectangular spreader graft to be more effective in stabilizing the dorsum. Despite the limitation of using the lamb heads as models, this study offers valuable insights into the effects of PR on nasal septum strength and provides a foundation for further research on the biomechanics of preservation techniques.Öğe Evidence of an association between mannose binding lectin codon 54 polymorphism and adenoidectomy and/or tonsillectomy in children(Elsevier Ireland Ltd, 2007) Koturoglu, Guldane; Onay, Huseyin; Midilli, Rasit; Pehlivan, Sacide; Eren, Erdem; Itirli, Gulcin; Kurugol, Zafer; Apaydin, Fazil; Özkınay, Cihangir; Özkınay, FerdaMannose binding lectin (MBL) is a calcium-dependent lectin that plays an important role innate immunity by activating the complement pathway. There have been a number of studies describing an association between the MBL genotype and disease susceptibility. MBL deficiency has been described as one of the factors leading to a number of infections in children with recurrent upper respiratory tractus infections (URTI). We hypothesized that MBL deficiency may be associated with recurrent URTI, which requires adenoidectomy and/or adenotonsillectomy. In this study to clarify this hypothesis we investigated whether there may be an association between two tow producing MBL variants and adenoidectomy and/or tonsillectomy due to recurrent URTI in children. Blood samples were collected, adenoidectomy and/or tonsillectomy due to recurrent URTI and 50 controls (mean age 80.53 +/- 32.62 months). In all patients and controls codon 54 and codon 57 polymorphisms of the MBL gene were analyzed. None of the subjects from the patient group and control group carried codon 57 polymorphism of the MBL gene. The frequency of low-level MBL genotypes (AB and BB) for codon 54 polymorphism in the patient group was found to be significantly higher compared to the control subjects (55.7% versus 14%) (p < 0.001). This study shows that the presence of low-level MBL alleles is associated with adenoidectomy and/or tonsillectomy caused by recurrent URTI in children. (c) 2007 Elsevier Ireland Ltd. All rights reserved.Öğe How Should the Cellphone Be Used to Obtain Good Pictures for Rhinoplasty?(Lippincott Williams & Wilkins, 2021) Jaber, Ayman; Saghir, Mishary; Fernandez-Pellon, Rodrigo; Apaydin, Fazil[No Abstract Available]Öğe L-Strut Graft: A Very Versatile Graft in the Management of Crooked and Traumatic Noses(Mary Ann Liebert, Inc, 2020) Apaydin, Fazil; Garcia, Rodrigo Fortunato Fernandez-Pellon; Tas, VedatImportance:Numerous techniques have been described on the correction of nasal septum in crooked nose or badly deviated septum. To our knowledge, no previous study has been published solely on the value of using an L-strut graft for straightening the nasal septum. Objective:To investigate the use of L-strut graft technique for septal reconstruction in patients with a crooked nose or badly deviated septum. Design:A retrospective study was performed in patients with crooked nose or badly deviated septum who underwent correction by using an L-strut graft from the 1st of January 2000 to 1st of May 2019 at a tertiary referral center and a private hospital by the senior author. Intervention:All patients with crooked noses or badly deviated septums who underwent L-strut graft repair were taken into the study group. Main Outcomes and Measures:Straightening the deviated septum was the primary outcome. Secondary outcomes were getting rid of crookedness: mean deviation angles and distances from the midline in perioperative/postoperative pictures in three main landmarks: rhinion, supratip, and tip; and resolution of presenting symptoms of nasal obstruction. Results:One hundred nineteen patients were included: 65 men and 54 women (mean age 30.7 years). Septorhinoplasty was performed in 71 and septoplasty in 48 cases. the material for L-strut graft was cartilaginous in 100, bony cartilaginous in 11, and bony in 8 patients. the pictures of 21 rhinoplasty patients (10 women and 11 men; mean age 33.48 years) were uploaded into Rhinobase 1.1 for measurements. There was a decrease in the mean and median values in all measurements from the midline between pre- and postoperative measurements. Conclusions:In selected cases of crooked and traumatic noses, the L-strut graft can be helpful to splint and correct the deviated L-strut framework and it can act as a caudal septal extension graft to support the tip.Öğe Lateral Crural Turn-in Flap in Functional Rhinoplasty(Amer Medical Assoc, 2012) Apaydin, FazilObjective: To use the trimmed cartilage as a support material for both internal and external valves. Methods: The lateral crural turn-in flap (LCTF) technique is simply to make cephalic trimming of the lateral crura and turn it into a pocket created under the remaining lateral crus. Twenty-four patients with lateral crura wider than 12 mm and in whom this technique was applied took part in this study. The trimmed cartilage was used to reshape and/or support the lateral crus and the internal valve by keeping the scroll intact. The support and suspension of the lateral crura "sandwich" helped not only to prevent stenosis of the internal valve angle but also to widen it in some cases. Results: The LCTF has been used in 24 patients to reshape and/or add structure to the lateral crus with great success. The internal valve was also kept open by keeping the scroll area intact, especially in 1 patient with concave lateral crura in whom this technique helped to widen the internal valve angle. Conclusions: This study shows that the LCTF can be used to reshape and add structure to the lateral crus and to suspend the internal valve. Although it is a powerful technique by itself in functional rhinoplasty, it should be combined with other methods, such as spreader flaps/grafts or alar battens, to obtain the maximum functional result.Öğe Long-term Follow-up of Positive Surgical Margins in Basal Cell Carcinoma of the Face(Lippincott Williams & Wilkins, 2015) Bozan, Aykut; Gode, Sercan; Kaya, Isa; Yaman, Banu; Uslu, Mustafa; Akyildiz, Serdar; Apaydin, Fazil; Ceylan, Can; Ozturk, GunseliBACKGROUND Basal cell carcinoma (BCC) in central facial locations and tumors with positive margins are at a higher risk of recurrence. The most effective treatment is total excision, which includes an adequate pathological margin. OBJECTIVE To evaluate the outcome of the patients who underwent surgery for BCCs of the head and neck and of those who had positive surgical margins where Mohs surgery is not available. METHODS This study was conducted at Ege University Medical School between 2004 and 2014. One hundred thirty patients with 154 BCC who underwent surgical excision were included. In the histopathologic report, the existence of positive margin, BCC subtype, localization of the tumor, and distance of margins to the tumor were evaluated. RESULTS Twenty-three lesions (14.9%) of 22 patients revealed positive surgical margins. Six patients (26.1%) had recurrences on the surgical site. The BCC subtypes of recurrent patients were reported to be multifocal superficial in 2 (33.3%), infiltrative (16.7%) in 1, and micronodular (50%) in 3. CONCLUSION Patients with superficial multifocal or micronodular tumors should undergo reoperation because of high recurrence rates.Öğe Long-term Follow-up of Positive Surgical Margins in Basal Cell Carcinoma of the Face(Lippincott Williams & Wilkins, 2015) Bozan, Aykut; Gode, Sercan; Kaya, Isa; Yaman, Banu; Uslu, Mustafa; Akyildiz, Serdar; Apaydin, Fazil; Ceylan, Can; Ozturk, GunseliBACKGROUND Basal cell carcinoma (BCC) in central facial locations and tumors with positive margins are at a higher risk of recurrence. The most effective treatment is total excision, which includes an adequate pathological margin. OBJECTIVE To evaluate the outcome of the patients who underwent surgery for BCCs of the head and neck and of those who had positive surgical margins where Mohs surgery is not available. METHODS This study was conducted at Ege University Medical School between 2004 and 2014. One hundred thirty patients with 154 BCC who underwent surgical excision were included. In the histopathologic report, the existence of positive margin, BCC subtype, localization of the tumor, and distance of margins to the tumor were evaluated. RESULTS Twenty-three lesions (14.9%) of 22 patients revealed positive surgical margins. Six patients (26.1%) had recurrences on the surgical site. The BCC subtypes of recurrent patients were reported to be multifocal superficial in 2 (33.3%), infiltrative (16.7%) in 1, and micronodular (50%) in 3. CONCLUSION Patients with superficial multifocal or micronodular tumors should undergo reoperation because of high recurrence rates.Öğe Long-term Follow-up of Positive Surgical Margins in Basal Cell Carcinoma of the Face(Lippincott Williams & Wilkins, 2015) Bozan, Aykut; Gode, Sercan; Kaya, Isa; Yaman, Banu; Uslu, Mustafa; Akyildiz, Serdar; Apaydin, Fazil; Ceylan, Can; Ozturk, GunseliBACKGROUND Basal cell carcinoma (BCC) in central facial locations and tumors with positive margins are at a higher risk of recurrence. The most effective treatment is total excision, which includes an adequate pathological margin. OBJECTIVE To evaluate the outcome of the patients who underwent surgery for BCCs of the head and neck and of those who had positive surgical margins where Mohs surgery is not available. METHODS This study was conducted at Ege University Medical School between 2004 and 2014. One hundred thirty patients with 154 BCC who underwent surgical excision were included. In the histopathologic report, the existence of positive margin, BCC subtype, localization of the tumor, and distance of margins to the tumor were evaluated. RESULTS Twenty-three lesions (14.9%) of 22 patients revealed positive surgical margins. Six patients (26.1%) had recurrences on the surgical site. The BCC subtypes of recurrent patients were reported to be multifocal superficial in 2 (33.3%), infiltrative (16.7%) in 1, and micronodular (50%) in 3. CONCLUSION Patients with superficial multifocal or micronodular tumors should undergo reoperation because of high recurrence rates.Öğe Long-term Results of Vermilionectomy in Malignant and Premalignant Lower Lip Lesions(Amer Medical Assoc, 2018) Kaya, Isa; Uslu, Mustafa; Ozturk, Arin; Apaydin, FazilÖğe Nasal Septal Reconstruction Preface(Thieme Medical Publ Inc, 2013) Apaydin, FazilÖğe Nasal Valve Surgery(Thieme Medical Publ Inc, 2011) Apaydin, FazilNasal obstruction can be due to internal and external valve problems that can be seen before and after rhinoplasty. The main scope of this article is to concentrate on surgical solutions to these problems. To overcome nasal obstruction at the internal valve, spreader grafts, spreader flaps, upper lateral splay graft, butterfly graft, flaring suture, M-plasty, Z-plasty, and suspension sutures have been described. The management of the external valve problems is possible by using lateral crural dissection and repositioning, lateral crural strut grafts, alar battens, lateral crural turn-in flap, alar rim grafts, and various other methods. It is not easy to decide which techniques would work best in every case. After a thorough examination and analysis, the underlying cause of the nasal obstruction can be understood, and one or multiple procedures can be chosen according to each individual problem.
