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Öğe Biocompatibility of vitallium as ossicular reconstruction material in the middle ear: experimental animal study(TAYLOR & FRANCIS AS, 2005) Ulku, CH; Avunduk, MC; Uyar, Y; Arbag, HConclusion. Although long-term data will be necessary for confirmation, the result of this preliminary study indicates that vitallium may be a good alternative material for ossicular replacement prostheses in the middle ear. Objectives. To investigate the biocompatibility of vitallium (Co-Cr-Mo) as ossicular reconstruction material in the rabbit middle ear, and to compare the results with those obtained with titanium, well known as a highly biocompatible material, and non-implanted control groups. Material and methods. Eighteen female New Zealand White rabbits were anesthetized. The tympanomeatal flap was elevated and 12 vitallium and 12 titanium implants were placed in the bulla away from the ossicles in 24 middle ears. Six rabbits were used as non-implanted controls. All animals were sacrificed under general anesthesia on the 180th day after implantation. The temporal bones were removed, fixed in 10% buffered paraformaldehyde and decalcified for a week in EDTA. Tissue samples were then prepared using an Autotechnicon and embedded in paraffin. Sections (30-mum thick) were cut with a microtome, stained with hematoxylin-eosin, von Gieson's stain and fibroblast growth factor (FGF) and examined under a light microscope. The numbers of lymphocytes, collagen fibers and FGF-positive cells were determined in all three groups. Results. There was no significant difference in the numbers of collagen fibers between the groups (P > 0.05). No significant differences were found in the numbers of lymphocytes and FGF-positive cells between the titanium and vitallium groups (p > 0.05). The differences in the numbers of lymphocytes and FGF-positive cells between the control and other groups were found to be significant (p < 0.05).Öğe Glomangioma of the middle ear(TAYLOR & FRANCIS LTD, 2004) Uyar, Y; Ulku, CH; Koral, H; Avunduk, MC; Atici, SSA 62-year-old female was admitted to our clinic in October 1999 with a 6-year history of hearing loss, tinnitus and otorrhea in the right ear. Physical examination showed a polypoid mass arising from the right middle ear and extending into the external auditory canal. Serohemorrhagic otorrhea was also observed. Serious hemorrhage occurred while taking a biopsy. The histopathologic diagnosis was a glomangioma. MRI demonstrated a hypervascular mass (10x15 mm(2)) completely filling the right middle ear. Preoperative embolization of the ascending pharyngeal artery was carried out. The tumor was completely resected via a transmastoid approach. No complications were observed postoperatively. At the most recent follow-up examination, 72 months after the operation, no sign of disease was present. The modified radical mastoidectomy approach used in this case proved to be a safe and efficacious method for removing the glomangioma.Öğe Iatrogenic epidermal inclusion cyst of the parapharyngeal space: Unusual complication of ear surgery(THIEME MEDICAL PUBL INC, 2004) Ulku, CH; Uyar, Y; Kocaogullar, Y; Avunduk, MCA 46-year-old man presented with a 12-month history of a slow-growing mass at the right anterior temporal and superior parotid region. He had a history of chronic otitis media and had undergone a modified radical mastoidectomy for cholesteatoma 5 years earlier. Physical examination revealed a sinus tract and diffuse soft tissue mass measuring 4 cm in diameter spread throughout the region of the right anterior temporal and superior parotid areas. Magnetic resonance imaging (MRI) showed three separate masses, including contrast material in the right superior parotid region and lateral skull base. The patient underwent a preauricular infratemporal approach. Six months later, a sinus tract recurred at the inferior border of the right zygomatic arch. MRI showed multiple masses in the right prestyloid parapharyngeal space, which were resected through a transparotid approach. The histopathologic diagnosis was an epidermal inclusion cyst (EIC). One year after the operation the patient was in good health and there was no sign of disease. EICs are rare tumors that are seen when epidermal elements are included in the dermis, which can follow trauma. EICs are unusual in the parapharyngeal space. Thus, until they become clinically observable, primary benign growths may not be recognized in this region. EICs must be considered in the differential diagnosis of growths in the parapharyngeal space, particularly among patients with a prior history of tympanomastoid surgery on the tumor side.Öğe Management of lipomas arising from deep lobe of the parotid gland(ELSEVIER SCI LTD, 2005) Ulku, CH; Uyar, Y; Unaldi, DObjectives: We would like to present our experience in management of lipomas arising in the deep lobe of the parotid gland, which were diagnosed and operated in our clinic from the point of complication/morbidity, and recurrence, in line with the literature. Material and methods: Five patients with lipoma found in the deep lobe of the parotid gland, diagnosed and treated at our clinic in the 12-year period between March 1992 and March 2004, were included in this study. Limits of the tumors were determined by computed tomography (CT), and/or magnetic resonance imaging (MRI). Preoperative fine needle aspiration biopsy (FNAB) was also performed. Through a classic parotidectomy incision, the parotid gland was exposed, Full exposure of he facial nerve and. its branches, was performed. The removal of deep lobe parotid lipomas was achieved by enucleation in all cases. Postoperative complication/morbidity and recurrence were evaluated. Results: The most common symptom was an otherwise asymptomatic mass on the parotid region and/or upper lateral neck. One of five patients was presented with medial displacement of the lateral pharyngeal wall, and tonsil as the additional physical finding. Preoperative radiologic evaluation results revealed that CT and/or MRI scans accurately localized 100% of the tumors in relation to the deep lobe of the,A parotid gland. FNAB did not enable us to make a diagnosis of lipoma in four of the cases. Total resection was achieved in all cases. Temporary facial nerve paralysis, due to the dissection of the facial nerve, did not occur in any cases. There was no recurrence of the tumors after a mean follow-up of 60 months. Conclusion: Assessment of the exact location of the tumor is an important consideration for selection of the appropriate surgical approach. Different from lipomas found in other locations, those observed in the parotid gland cannot be easily resected by simple dissection. Resection of these tumors requires full exposure of the facial nerve. (c) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Parapharyngeal lipoma extending to skull base: A case report and review of the literature(THIEME MEDICAL PUBL INC, 2004) Ulku, CH; Uyar, YLipomas in the head and neck region usually occur in the immediate subcutaneous tissue. They are extremely rare in the parapharyngeal space. A rare case of aright parapharyngeal space lipoma extending to skull base in an 18-year-old male is reported. The literature is reviewed and the characteristics of disease are discussed.Öğe Reconstruction of a total maxillectomy defect with a zygomatic implant-retained obturator(LIPPINCOTT WILLIAMS & WILKINS, 2005) Uckan, S; Oguz, Y; Uyar, Y; Ozyesil, ATreatment options of maxillary fibrous dysplasia are surgical recontouring or total or partial maxillectomy depending on the site and behavior of the lesion. Among the reconstruction procedures, which include many surgical options, reconstruction using a maxillary obturator is the least invasive one. This report describes a case of aggressive maxillary fibrous dysplasia that was treated with a total maxillectomy and reconstructed with a malar implant-retained maxillary obturator.Öğe Saphenous vein graft for bypass of the external carotid artery to supraclinoid internal carotid artery using a modified technique: An anatomical and technical study(TAYLOR & FRANCIS AS, 2004) Ulku, CH; Ustun, ME; Buyukmumcu, M; Cicekcibasi, AE; Uyar, YObjective - To investigate the use of a saphenous vein graft for bypass of the external carotid artery (ECA) to supraclinoid internal carotid artery (ICA) when the proximal middle cerebral artery (MCA) is not suitable for a bypass procedure. Material and Methods - Five adult cadaver sides were used. Dissection required a frontotemporal craniotomy and a zygomatic arch osteotomy, with a hole being opened 2 - 3 mm lateral to the foramen rotundum extradurally. The ECA was found easily via a second incision in the cervical region. The ophthalmic segment of the ICA was exposed by removal of the anterior clinoid process intradurally. After the dura over the hole was opened, the 7 - 8-cm long bypass graft was passed just behind the mandibula and through the hole inside the dura to reach the ICA. The ECA was then transected proximal to the occipital artery (OA) branch and the distal side of the vein graft was anastomosed end-to-end with the ECA and end-to-side with the supraclinoid ICA. Results - The mean diameter of the ECA proximal to the OA was 3.75 +/- 0.4 mm ( range 3.35 - 4.15 mm) and that of the supraclinoid ICA was 3.4 +/- 0.5 mm ( range 2.9 - 3.9 mm). The mean length of the venous graft was 7.5 +/- 0.5 cm ( range 7 - 8 cm). Conclusion - When high blood flow is needed and the proximal MCA is not suitable for a bypass, the bypass described herein may be an alternative to a superficial temporal to MCA bypass as well as to extracranial carotid artery to MCA or ICA bypasses, which both need long vein grafts.
