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Öğe An Overlooked Posttraumatic Lesion: Morel Lavallee(2020) Aylanç, Nilüfer; Ertem, Şenay Bengin; Akyürek, MustafaMorel-Lavallee is a soft tissue lesion that occurs after trauma and is seen almost rare. The patients usually refer to the clinic with a palpable mass. In addition, lesions can be detected incidentally during imaging tests performed for different reasons after trauma. While examining the soft tissue lesions of the musculoskeletal system, especially in cases with a history of trauma, the Morel-Lavallee lesion should also be thought, and ultrasonography and magnetic resonance imaging methods that have superiority in soft tissue imaging should be used. In this case report, we aim to attract attention to the fact that MLL, which can be seen rarely, should be kept in mind in cases with pain, palpable mass and a trauma history, even if the process is chronic.Öğe Anatomical Insights and Clinical Outcomes of the Interpectoral Pocket Technique for Exposed Cardiac Pacemaker Revision(Wolters Kluwer Medknow Publications, 2024) Akyürek, Mustafa; Çakır, Bahadır; Hafız, GüneşObjective: The objective of this study was to evaluate the effectiveness and safety of the interpectoral pocket technique in the management of exposed cardiac pacemakers, a complication increasingly observed with the rising use of cardiac implantable electronic devices (CIEDs). Materials and Methods: We conducted a retrospective study of 20 patients who underwent revision surgeries for exposed cardiac pacemakers using the interpectoral pocket technique. Data were collected regarding patient demographics, comorbidities, etiology of exposure, preoperative management, surgical procedure, postoperative care, and follow-up results. Results: The overall success rate of the interpectoral pocket technique was 95%. Out of the 20 patients, 3 patients (15%) experienced minor complications, while 1 patient (5%) required additional revision surgeries. No major complications or mortality were reported during the follow-up period. Conclusions: Our study indicates that the interpectoral pocket technique for exposed cardiac pacemaker management is effective and safe. It has the potential in reducing CIED-related complications, improving therapeutic strategies, and lessening the economic burden. However, larger prospective studies are needed to validate these findings.Öğe Does excision of giant cell tumor from the finger affect sensorineural innervation?(Türk El ve Üst Ekstremite Cerrahisi Derneği, 2024) Akyürek, Mustafa; Kaya, BerkayGiant Cell Tumor of the Tendon Sheath (GCTTS), often manifested as a nodular mass in the hand, presents significant challenges for surgical intervention, particularly when located in the fingers. This study aimed to evaluate the impact of GCTTS excision on sensory function and to explore the relationship between surgical outcomes and factors such as smoking and nerve dissection. A retrospective analysis was conducted on 28 patients diagnosed with GCTTS in the fingers, who underwent surgical excision between March 2017 and March 2023. Preoperative and postoperative sensory functions were assessed using two-point discrimination and Semmes-Weinstein monofilament tests. The results indicated no significant difference in sensory function 6 months post-surgery, suggesting that meticulous surgical technique can mitigate the risk of iatrogenic nerve damage. The study highlights the importance of comprehensive diagnostic methodologies, including thorough medical history, physical examination, and radiological imaging, in guiding surgical strategies. Moreover, it emphasizes the significance of meticulous preoperative planning and the potential for preserving sensory function following GCTTS excision.Öğe Does surgical treatment for complicated pilonidal cyst disease in the sacral region affect anal sphincter functions(Turkish Society of Plastic Reconstructive and Aesthetic Surgery, 2023) Akyürek, Mustafa; Benli, Çağhan; Kaya, Mustafa; Sürmeli, AliIntroduction: Pilonidal cyst disease is characterized by chronic abscess, discharge, and sinus openings. The anal sphincter functions of the patients, who previously undergone recurrent surgical treatment, were compared using a surgical approach. Patients were divided into two groups by whether perianal soft tissues were preserved in the surgery. Materials and Methods: Between 2014 and 2019, 21 male patients who had either undergone insufficient surgery or had complications with multiple sinus openings applied to our clinic. Excision and reconstruction of the patients were performed. The coccyx, dorsal part of sacrum, anococcygeal raphe, and ischiorectal fossa were additionally included in the excision for patients with biopsy reports of squamous cell carcinoma. All patients underwent rectoanal manometry to evaluate anal sphincter function. Preoperative, postoperative 5th week, and 6th-month anal manometry results were recorded and analyzed by the Shapiro - Wilk test and independent t-test. Results: The anal sphincter function regresses in the 5th week after the reconstruction and improves in the 6 month. The results of the independent t-test, which were used to compare the anal manometry results for each group, showed that the difference in the anal sphincter pressure of the two groups was statistically significant (P < 0.05). If the perianal soft tissues were excised, anal sphincter manometry shows poor results. Discussion: The anal sphincter function, which regresses in the 5th week after the reconstruction and improves in the 6 months, depends on the scar tissue occurring in the perianal connective tissue, while the softening caused by the maturation of the scar in the last phase of wound healing improves the function.Öğe Evaluating Auricular Conchal Cartilage Grafts in the Surgical Management of Pediatric Orbital Floor Fractures(Lippincott Williams and Wilkins, 2025) Akyürek, Mustafa; Battal, Buruç Barkın; Hafiz, GüneşPediatric orbital floor fractures present unique challenges due to ongoing craniofacial growth and the need for reconstructive materials that provide stability while minimizing long-term complications. This retrospective study evaluates the outcomes of auricular conchal cartilage grafts in the surgical management of pediatric blowout fractures. Pediatric patients aged 7 to 16 years who underwent orbital floor reconstruction with conchal cartilage grafts between October 2013 and September 2023 were analyzed. Clinical data, computed tomography findings, surgical details, and postoperative outcomes were reviewed. Among 31 patients diagnosed with blowout fractures, 8 underwent surgical repair using conchal cartilage grafts. The mean age of surgically treated patients was 11.8 years, with an approximate orbital defect size of 2.8 cm2. The mean follow-up period was 25 months. No postoperative infections or donor site deformities were observed. In long-term follow-up, 1 patient exhibited both diplopia on inferolateral gaze and enophthalmos. The use of auricular conchal cartilage provided a structurally compatible, low-morbidity alternative to traditional graft materials. Its inherent concave shape and ease of harvest make it a viable option for pediatric orbital floor reconstruction. The findings of this study support the use of conchal cartilage as a reliable autologous graft for orbital floor repair in pediatric patients; however, further studies with larger patient cohorts and comparative analyses are required to better define its long-term outcomes and optimal indications. Copyright © 2025 by Mutaz B. Habal, MD.Öğe Horizontal pillar technique: A single pedicle septum-based approach in reduction mammaplasty with a twist(Elsevier Sci Ltd, 2023) Akyürek, Mustafa; Hafız, GüneşBreast reduction surgery has proven to be a successful treatment for various conditions such as postural disorders, anxiety, dermatological problems, and body image disorders, and is tailored to accommodate each patient's needs and anatomical variations. The author presents a modified approach for reduction mammaplasty using a septum-based superomedial pedicled nipple-areola complex (NAC) flap combined with horizontal dermoglandular pillars. This adjustment enhances desired breast projection, potentially eliminating the need for alternative pedicles in most cases. The limitations and disadvantages of this new technique are discussed. Between July 2015 and July 2021, 85 patients underwent surgery using the horizontal pillar reduction mammaplasty. Clinical data obtained during follow-up visits were recorded. Patients were asked to answer the local version of the Breast-Q, version 2.0, reduction module postoperative scale questionnaire to evaluate breast shape contentment and patient satisfaction at the 1-year follow-up. Necrosis of the NAC was not observed in any patient. The most common complaints in the early postoperative period were pain along the inframammary fold and swelling that extended into the axillary region. The mean values and standard deviations of the postoperative Breast-Q scores were calculated. The postoperative satisfaction with breasts scale mean value was 84.11 +/- 12.86, and the postoperative satisfaction with outcomes scale mean value was 81.08 +/- 9.97. The horizontal pillar reduction mammaplasty technique is safe, reliable, and easy to perform in breast reduction. Although the initial findings are encouraging, future anatomical and clinical studies are necessary to fully explore this modified technique's functional limitations and long-term outcomes.Öğe Influence of palmar plate injury on outcomes of zone 2 flexor tendon repair(Sage Publications Ltd, 2025) Akyürek, Mustafa; Hafız, Güneş; Sayan, MihricanThis study investigates the impact of proximal interphalangeal joint palmar plate injury on outcomes of flexor tendon repair in zone 2, excluding cases with fractures or dislocations. A retrospective review of 47 digits in 45 patients treated between 2014 and 2022 was conducted, analysing surgical notes, ultrasound images and patient photographs. The palmar plate was injured in 17 digits and intact in 30. Outcomes were assessed using the Strickland criteria for active range of movement 6 months postoperatively. Our analysis revealed that palmar plate injuries significantly affect flexor tendon repair outcomes, with a normal palmar plate increasing the likelihood of excellent recovery by 18 times. Although previous studies indicate no consensus on the impact of flexor digitorum superficialis repair, our findings emphasize the importance of palmar plate integrity. Nerve injury and flexor digitorum superficialis repair did not show significant effects on recovery in this cohort. Our study provides valuable insights into the importance of the injury to the palmar plate.Level of evidence: IIIÖğe Modified Dermal-Fat Flap Suspension Technique for Internal Nasal Valve Dysfunction: A Comparative Study With Conventional Cartilage Grafting(Lippincott Williams and Wilkins, 2025) Akyürek, Mustafa; Çakır, Bahadır; Hafız, Güneş; Tavas, OzanIatrogenic internal nasal valve (INV) dysfunction is a significant complication after nasal surgery, often necessitating revision surgeries involving cartilage grafting, which carries high risks of complications such as mucosal synechiae, septal perforations, and chronic inflammation. This study evaluates the efficacy of a modified dermal-fat flap suspension technique as an alternative to conventional cartilage grafting for INV reconstruction. A retrospective review was conducted of 30 patients treated between March 2019 and March 2023, including 8 patients who underwent the modified dermal suspension technique and 22 who received spreader grafts. Preoperative and postoperative nasal obstruction symptom evaluation scores were statistically analyzed using the Mann-Whitney U test. While both groups demonstrated significant postoperative improvements, no statistically significant differences were found between the groups. The modified technique, performed under local anesthesia, was associated with fewer complications and avoided extensive cartilage grafting or mucosal dissection, making it particularly suitable for patients with advanced age, high ASA scores, or complex surgical histories. Common complications included transient orbital edema and rare cases of skin discoloration, which resolved over time. Despite a small sample size and reliance on subjective nasal obstruction symptom evaluation scores, this study highlights the potential of the modified dermal-fat flap suspension technique as a less invasive, effective alternative for managing INV dysfunction, especially in high-risk patients. Further studies with larger cohorts and objective measures are needed to validate these findings. Copyright © 2025 by Mutaz B. Habal, MD.Öğe Our experience with the management of non-melanoma skin cancers with orbital invasion(Springer Science and Business Media Deutschland GmbH, 2023) Akyürek, Mustafa; Benli, Caghan; Esmer, SanerBackground: Skin cancers are the most common malignancies, and orbital and periorbital skin tumors are troublesome areas for surgeons. In this study, a series of patients diagnosed with non-melanoma skin cancer with orbital invasion was analyzed, and the surgical indications of globe-sparing surgery, reconstruction methods, complications, and outcomes were discussed. Methods: This study included a series of 27 patients who underwent surgery for non-melanoma skin cancer (NMSC) with orbital invasion between June 2013 and May 2019. All surgeries were performed by a single surgeon in a single center. Results: The observed success rate of the globe-sparing surgeries performed was 16/18 (89%) for patients diagnosed with BCC. Patients diagnosed with SCC had fewer benefits from their globe-sparing surgery. Half of the patients (4/8) underwent exenteration or died from distant metastasis. An early complication of globe-sparing surgery was chemosis, and all patients suffered from it for an average of 2 weeks. Late complications of globe-sparing surgery were epiphora (20/23), globe movement restriction (20/23), diplopia (17/23), and ectropion (3/23). Conclusions: This study shows that orbital exenteration is a treatment with severe morbidity. Hence, every step during NMSC treatment with orbital invasion is unique to each patient and determined by in-depth and objective criteria. Level of evidence: Level IV, Risk/Prognostic.Öğe Particular type of high-pressure injection injuries: Oil-based paint guns, a retrospective, single center experience(2022) Akyürek, Mustafa; Benli, ÇağhanObjectives: Oil-based high-pressure injection injuries may cause serious hand injuries. Unless proper surgical interven- tions are performed, this situation contains a high possibility of serious sequels. It is aimed to present the management of high-pressure injection injuries with paint gun. Methods: Between 2013 and 2019, five male patients with the mean age of 34,4, admitted to our clinic with hand injuries and subcutaneous oil-based materials injection caused by high-pressure paint guns. Broad debridement was performed by dissection and adventitiectomy of the vessel and nerve bundles under magnification. Postoperative clinical follow-ups, Quantitative Sensory Testing results, and chemical properties of the injected materials are obtained. Results: Pain was the most common complaint in the early postoperative period. Injected materials were oil-based paints and mineral oils, both have a pH between eight and nine. We observed partial skin and subcutaneous tissue necrosis but none of the patients required amputation. Static two-point discrimination values were obtained post-op 12th month, varied between 7 and 11 mm (mean 8 mm) at the pulp of the affected finger innervated by the affected nerve endings. Cold in- tolerance was the most common complaint in the chronic phase. The worst clinical outcome among these patients, one had chronic infection and fistulas around the injected fingers due to late admission to our clinic by the 6th day of post-injury without any emergent treatment prior. Conclusion: To reduce permanent impairments in high-pressure injection injuries of the hand, early decompression and debridement under microsurgical operation settings are important. Therefore, patients should be operated as soon as possible to improve outcomes.Öğe Re: Akyurek M et al. Influence of palmar plate injury on outcomes of zone 2 flexor tendon repair. J Hand Surg Eur. 2024, doi:10.1177/17531934241300510 Reply(Sage Publications Ltd, 2025) Akyürek, Mustafa; Hafız, Güneş; Sayan, Mihrican[No abstract available]Öğe Retrospective analysis of clinical findings and radiologic diagnostic methods of subungual glomus tumor: a single-center study(Springer Science and Business Media Deutschland GmbH, 2023) Akyürek, Mustafa; Hafız, GüneşBackground: Subungual glomus tumors, while benign and straightforward to surgically remove, present unique considerations due to their location and the potential esthetic outcomes of the surgical procedure. Accurate diagnosis is vital, and this study shows a retrospective analysis of clinical and radiological diagnostic methods for these tumors in a single center. Methods: Our study included 28 patients who underwent surgery under the preliminary diagnosis of subungual glomus tumor. We analyzed the correlation between clinical signs, diagnostic tests, and radiological methods, focusing on their sensitivity and specificity. Results: The results indicated a high sensitivity for Love’s pin test and Doppler USG and MRI examinations, but their specificity was low. On the other hand, plain radiography, cold ıntolerance, and Hildreth’s test showed the highest specificity with lower sensitivity. Furthermore, solely nail deformities may lead to inaccurate diagnoses, and 14% of our patients underwent surgery with incorrect indications. Conclusions: The study emphasizes the need for a comprehensive diagnostic approach, employing both highly sensitive tests and highly specific tools, and underscores the importance of a thorough informed consent process given the risks of postoperative nail deformities and unnecessary surgeries. Further research with larger cohorts is needed to better understand and manage these tumors. Level of evidence: Level IV, Therapeutic.
