Researcher:
Özmen, Selahattin

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Selahattin

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Özmen

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Özmen, Selahattin

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2015 - 2019212020 - 20234

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    Technical aspects and difficulties in the management of head and neck cutaneous malignancies in xeroderma pigmentosum
    (Korean Soc Plastic & Reconstructive Surgery, 2016) Sibar, Serhat; Fındıkçıoğlu, Kemal; Erdal, Ayhan Işık; Barut, İsmail; N/A; Özmen, Selahattin; Faculty Member; School of Medicine; Koç University Hospital; 125951
    Background Xeroderma pigmentosum (XP) is an autosomal recessive disorder characterized by xerosis, ultraviolet light sensitivity, and cutaneous dyspigmentation. Due to defects in their DNA repair mechanism, genetic mutations and carcinogenesis inevitably occurs in almost all patients. In these patients, reconstruction of cutaneous malignancies in the head and neck area is associated with some challenges such as likelihood of recurrence and an aggressive clinical course. The aim of this study is to discuss the therapeutic options and challenges commonly seen during the course of treatment. Methods Between 2005 and 2015, 11 XP patients with head and neck cutaneous malignancies were included in this study. Demographic data and treatment options of the patients were evaluated. Results The mean age of the patients was 32 years (range, 10-43) (4 males, 7 females). The most common tumor type and location were squamous cell carcinoma (6 patients) and the orbital region (4 patients), respectively. Free tissue transfer was the most commonly performed surgical intervention (4 patients). The average number of surgical procedures was 5.5 (range, 1-25). Six patients were siblings with each other, 5 patients had local recurrences, and one patient was lost to follow-up. Conclusions Although genetic components of the disease have been elucidated, there is no definitive treatment algorithm. Early surgical intervention and close follow-up are the gold standard modalities due to the tendency toward rapid tumor growth and possible recurrence. Treatment must be individualized for each patient. In addition, the psychological aspect of the disease is an important issue for both patients and families.
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    Unusual cause of refractory infection in head and neck surgery; retained surgical sponges
    (Ondokuz Mayıs Üniversitesi (OMU), 2016) Kucuker, Ismail; Cukurluoglu, Onur; Eryilmaz, Tolga; Tuncer, Serhan; N/A; Özmen, Selahattin; Faculty Member; School of Medicine; 125951
    Refractory infections are not common in head and neck region. As gossypiboma (retained surgical sponges) is also rare in head and neck surgeries, it is generally ignored as a potential diagnosis. In this article we aimed to call attention to gossypiboma cases in refractory maxillary infections. We present three cases of retained surgical sponges after head and neck surgery occurred in between 2003 and 2011. We also discussed the possible causes and prevention strategies for them.
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    The importance of the condition of the donor teeth and jaws during allogeneic face transplantation
    (Lippincott Williams & Wilkins, 2015) Özel, Aysim Şenol; Güçlü, Zeynep Aslı; Gulsen, Ayşe; N/A; Özmen, Selahattin; Faculty Member; School of Medicine; 125951
    The authors aimed to present dental treatment of the cadaveric tooth in a transplanted maxilla in a patient with facial transplantation with bony framework and soft tissue envelope. The treatment procedure was scheduled after physical examination, and the final plan was designed according to the patient's special medical condition. The authors reported the first successful endodontic treatment of an allogeneic cadaveric donor tooth in a patient with facial transplantation. Dental disease represents a potential risk for infection in patients with allogeneic transplantation, which could affect the success of tissue transplantation and might lead to life-threatening conditions. The (re) treatment of the diseased teeth is possible even after the transplantation. The health of the teeth and jaws of the donor should be evaluated before transplantation, especially when maxilla or mandible transplantation is planned.
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    A practical method for accurate coordination between the plastic surgeon and the pathologist: the clockwork technique
    (Korean Soc Plastic & Reconstructive Surgery, 2018) N/A; N/A; N/A; N/A; N/A; N/A; N/A; Sezgin, Billur; Kapucu, İrem; Yenidünya, Bahar Güliz; Bulutay, Pınar; Armutlu, Ayşe; Özmen, Selahattin; Yavuzer, Cahit Reha; Faculty Member; Researcher; Undergraduate Student; Teaching Faculty; Teaching Faculty; Faculty Member; Other; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 133762; 327602; N/A; N/A; 133565; 133567; 125951; N/A
    Cooperation between the surgeon and the pathologist is essential for the correct diagnosis and treatment of skin tumors [1]. Precise communication between these two specialties allows for the precise evaluation of the tumor borders by the pathologist, which in turn reduces the amount of unnecessary tissue removed, thereby improving functional preservation and the aesthetic outcomes of surgery. Although not every skin tumor excision requires a high level of interdisciplinary interaction, the location and the type of tumor are key elements that can make such a collaboration necessary. This is especially true for tumors located near critical facial aesthetic subunits such as the eyelids, nostrils, and mouth, and for locally aggressive tumors that spread in unpredictable patterns. Mohs micrographic surgery (MMS) is an alternative to conventional surgery in such cases, and allows tissue preservation to be maximized without compromising adequate surgical excision of the tumor [2]. MMS remains an effective, yet not commonly accessible option, as it can only be performed by pathologically trained surgeons. Nevertheless, regardless of the surgical method, establishing the orientation of the specimen is always critical, and accuracy in this regard can be achieved by various techniques, such as using sutures in different lengths or color codes for each side. Surgeons may use hand-drawn pictures, printed maps of the areas in question, and photographs to guide the patholoCOMMUNICATION A practical method for accurate coordination between the plastic surgeon and the pathologist: The clockwork technique Billur Sezgin1 , Irem Kapucu1 , Guliz Yenidunya1 , Pinar Bulutay2 , Ayse Armutlu2 , Selahattin Ozmen1 , Reha Yavuzer1 Departments of 1 Plastic, Reconstructive, and Aesthetic Surgery and 2 Pathology, Koc University School of Medicine, Istanbul, Turkey Correspondence: Billur Sezgin Department of Plastic, Reconstructive, and Aesthetic Surgery, Koç University Hospital, Maltepe Mh., Davutpasa cad. No 4, Topkapı, 34010 Zeytinburnu, Istanbul, Turkey Tel: +90-850-250-8250–20201, Fax: +90-0442-232-5300, E-mail: bsezgin@ku.edu.tr This article was presented as a poster at the 38th Congress of the Turkish Society of Plastic, Reconstructive and Aesthetic Surgeons on 27–30 October, 2016 in Antalya,Turkey. gist. Tissue nicks or poly-angulated drawings can also be used to improve the orientation [3]. These markings are especially useful when determining the need for re-excision; thus, precision is key for minimizing further tissue loss while obtaining tumor-free margins. We present an easily applicable technique that has been developed to increase the precision of surgical margin evaluation in various skin tumors. The ‘clockwork technique’ uses a clock face template for the orientation of the specimen. This method ensures accurate coordination between the surgeon excising the tumor and the pathologist who guides the surgeon in re-excision until tumor-free margins are achieved. The first step is to determine the type of the lesion via biopsies if necessary, as the safety margin will be adjusted according to the characteristics of the primary tumor. Lesions involving facial subunits may be an exception, as the required margin may not be planned accordingly in certain critical locations. The second step is to outline the approximate borders of the visually apparent tumor and to draw a safety margin that will serve as the clock face for the orientation of the specimen. Then, the periphery of the circle is numbered through 12 as in a clock (Fig. 1). The hourly markings go through both the excised specimen and the healthy tissue, so that the surgeon knows which part of the excised tissue corresponds to which ‘hour.’ The lesion is excised as a complete circle and a single suture is placed at a pre-determined hourly interval as a guide if the marking is disrupted. After microscopic examination, the pathologist can state which hour slice corresponds to a tumor-positive margin, and further excision can be carried out only in the area of that hour slice. Plastic surgeons need to work very meticulously alongside pathologists, as every millimeter of skin preserved can be used to achieve better aesthetic and functional outcomes. The clockwork technique can be applied to any type and size of lesion. It is also beneficial for tumors that have unpredictable growth patterns, where it is not possible to agree on a standard optimal safety margin, such as dermatofibrosarcoma protuberans. Moreover, in areas where aesthetic and functional preservation are concerns, it helps to preserve more healthy tissue, as further re-excision can be carried out in only onetwelfth of the excisional border. In conclusion, this technique is advantageous because it is an easily applicable and fast method that facilitates optimal communication between the surgeon and pathologist regarding specimen borders, allowing precise re-excisions that can be limited to intervals corresponding to one-twelfth of the surgical margin.
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    Bilateral vascularized composite skin/bone transplantation models
    (Springer-Verlag London Ltd, 2015) N/A; N/A; Özmen, Selahattin; Faculty Member; School of Medicine; 125951
    It is important to understand the mechanisms of bone marrow based allograft tolerance induction to explain the diverse variables controlling the subsequent outcome of the solid organ and composite tissue allotransplants. To be able to introduce bone marrow transplantation as a routine clinical application, further experimental studies are needed to overcome the problems related to the bone marrow transplantation, including graft versus host disease, immunocompetance, and toxicity of the conditioning regimens. Therefore alternative experimental models are needed. In this study, we introduced different experimental models of modified vascularized skin/bone marrow transplantation technique for tolerance induction, monitoring and maintenance; to be able to provide a reliable research tool for bone marrow based tolerance induction experiments. We investigated the technical feasibility of concurrent or consecutive transplantation of the combination of bilateral vascularized skin, vascularized bone marrow, or vascularized skin/bone marrow transplants in this model. Bilateral skin/bone transplantation model may allow to study new strategies in tolerance induction by modifying the amount of the immunogenic load in the form of skin transplant and by altering the amount of vascularized bone marrow delivery in the form of vascularized bone transplantation allowing for accelerated engraftment of stem and progenitor cells.
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    Use of an epidermal growth factor-infused foam dressing in a complicated case of Adams-Oliver syndrome
    (Ma Healthcare Ltd, 2017) Şibar, Serhat; Fındıkçıoğlu, Kemal; Şencan, Ayşe; Emmez, Hahn; Baykaner, Khan; N/A; N/A; Sezgin, Billur; Özmen, Selahattin; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 133762; 125951
    Adams-Oliver syndrome is a rare disorder with varying degrees of scalp and cranial bone defects as well as limb anomalies, which can range from mild to more pronounced manifestations. In mild cases, closure of these defects can be achieved with a conservative approach. However, surgical closure is recommended in cases where the defect is extensive and includes cranial involvement. Several complicated cases of Adams-Oliver syndrome have been reported, in which flap failures were encountered and other alternatives had to be used to close critical scalp defects. Here, the case of a 4-year-old child with Adams-Oliver syndrome and a complex cranial defect with exposed titanium mesh is described. The patient was successfully treated with epidermal growth factor (EGF) infused foam dressings and subsequent split-thickness skin grafting. The EGF has been highlighted for its essential role in dermal wound repair through the stimulation of the proliferation and migration of keratinocytes, and showed accelerated wound healing when used in partial or full-thickness skin wounds.
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    Credit for truly novel ideas? a critical approach to the intellectual authorship in surgery
    (Thieme Medical Publishers, 2023) Ferreira, Miguel Goncalves; Gubisch, Wolfgang; Pearlman, Steve; Sykes, Jonathan; N/A; Özmen, Selahattin; Faculty Member; School of Medicine; 125951
    The formation of new ideas and techniques in medicine and surgery is crucial to bettering the medical field and the quality of medical care. The transmission of these new ideas is a source of pride and recognition for physicians who devote their lives to patient care. The quality and integrity of the medical literature that results from seminal medical ideas are an essential but unregulated field. From time to time, there are discussions in the medical literature about the authorship of an idea/strategy/technique. In this digital era, where communication works at an unmeasurable speed, the authenticity of medical communication requires honesty and verification. The possibility of unreliable or false information exists, and the need to verify “new” information as accurate and honest is crucial. Rhythm, genuine, and fake (fair/unfair) information circulates at high speed, and suddenly everything one encounters is represented as “true and often represented as new.” Regarding medical science and particularly surgery - we are overloaded daily with new techniques, new names, new strategies, and everything. Several questions regarding the authenticity of any publication or scientific communication exist. A critical approach is done in this article.
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    Setup of columellar height with costal cartilage graft modification in a patient with binder syndrome
    (European Society of Plastic, Reconstructive and Aesthetic Surgery, 2016) Aral, Mübin; Küçüker, İsmail; Uygur, Halil Şafak; Sezgin, Billur; Özmen, Selahattin; Doctor; Faculty Member; Faculty Member; N/A; School of Medicine; School of Medicine; Koç University Hospital; N/A; 133762; 125951
    Binder syndrome is an uncommon disorder of unknown etiology. It is characterized by hypoplasia of the nose and maxilla and altered morphology of the associated soft tissue. We present a surgical technique for setting up the columellar height in a patient with Binder syndrome. / Binder sendromu, etiyolojisi tam olarak bilinmeyen nadir bir bozukluktur. Burun-maksiller hipoplazi ve eşlik eden yumuşak doku anomalileriyle karakterizedir. Bu çalışmada Binder sendromlu bir olguda kolumellar yüksekliğin ayarlanmasında kullandığımız cerrahi teknik sunulmaktadır.
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    Vascularized skin/bone transplantation model
    (Springer-Verlag London Ltd, 2015) N/A; N/A; Özmen, Selahattin; Faculty Member; School of Medicine; 125951
    Developing new strategies for tolerance induction to induce antigen-specific immunologic insensitivity is one of the main purpose of the modern immunology. Tolerance induction would be the most useful treatment modality in dealing with allogeneic and/or xenogeneic transplantations and immune-mediated diseases. Recently, stem cell transplantation, either hematopoietic or from other sources, has gained great popularity and has been used extensively as a therapeutic and research modality. Here, we introduced a new model for vascularized skin and bone marrow transplantation. In this model combined groin skin and femoral bone flaps were transplanted based on the femoral artery and vein. Transplants were evaluated on a daily basis. All flaps survived without problem over 100 days post-transplant. The skin component remained pink, pliable and grew a new hair. Histological examination of the femoral bone revealed active hematopoiesis with a viable compact and cancellous bone components on day 100 post-transplant. This model may serve as an experimental tool for the novel tolerance induction studies across MHC barrier where bone will serve as donor of stem and progenitor cells and skin flap serve as a monitor of graft rejection.
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    Efficacy of adhesive strips to reduce postoperative periorbital edema and ecchymosis following rhinoplasty
    (2018) Tatar, Sedat; Bulam, Mehmet Hakan; N/A; Özmen, Selahattin; Faculty Member; School of Medicine; 125951
    Background/aim: Periorbital edema and ecchymosis may develop following rhinoplasty. The aim of this study was to assess the efficacy of adhesive strip application on the upper and lower eyelids to reduce postoperative edema and ecchymosis following rhinoplasty. Materials and methods: The eyelids of one side were randomly selected, and an adhesive strip of standard size and number was applied at the end of the operation. The strips were removed at postoperative day 3; photos of the eyes were taken at days 3 and 7. Edema and ecchymosis were graded on a scale from 1 to 4. The ecchymosis areas on the lower and upper eyelids were measured and compared in square centimeters. Results: The mean ecchymosis area of the lower eyelid on the side of the adhesive strip and on the side without the strip was 1.63 cm2 and 3.32 cm2 in the early period, respectively. It was 1.15 cm2 on the upper eyelid on the side of the adhesive strip, and 1.87 cm2 on the side without the strip. It was 0.224 cm2 on the side of the adhesive strip, and 0.498 cm2 on the side without the adhesive strip in the late period. Conclusion: Applying adhesive strips reduces periorbital edema and ecchymosis.