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    Anatomical Insights and Clinical Outcomes of the Interpectoral Pocket Technique for Exposed Cardiac Pacemaker Revision
    (Wolters Kluwer Medknow Publications, 2024) Akyurek, Mustafa; Cakir, Bahadir; Hafiz, Gunes
    Objective: 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.
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    Modified Dermal-Fat Flap Suspension Technique for Internal Nasal Valve Dysfunction: A Comparative Study With Conventional Cartilage Grafting
    (Lippincott Williams and Wilkins, 2025) Akyurek, Mustafa; Cakir, Bahadir; Hafiz, Gunes; Tavas, Ozan
    Iatrogenic 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.