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Background: Orofacial clefts are the most common congenital craniofacial anomalies, globally. However, few reports describe cleft demographic, clinical, and surgical information in a Turkish population. Aims and Objectives: The aim of this study is to investigate the demographic, clinical, surgical information and outcomes of cleft lip and/or palate (CL/P) patients in Northwestern Turkey. Materials and Methods: We assessed demographic, clinical, operative characteristics, and postoperative complications data in this retrospective review of electronic medical records at a tertiary referral center from 2005 to 2015. Results: Our study included 150 CL/P patients (88 men, 62 women). Cleft lip and palate (CLP) was the most prevalent type of cleft (60%), followed by isolated cleft palate (31.3%) and isolated cleft lip (8.7%). The rates of maternal folic acid use, smoking, alcohol intake, and consanguinity were 83.3%, 5.3%, 1.3%, and 3.3%, respectively. Nasoalveolar molding was applied mostly in bilateral—not unilateral—CLP patients. The modified, extended Mohler technique was common for cleft lip repairs. Most cleft palate repairs used Bardach's two-flap palatoplasty combined with radical intravelar veloplasty. Most cases required grommet insertion. For cleft palate patients, myringotomy or paracentesis was performed in 12.8% of repairs, and acellular dermal matrix was used in 28.5% of repairs. Conclusion: Knowledge of CL/P characteristics is crucial for treatment planning and satisfactory health care. To our knowledge, this is the first study to assess CLP data in a Turkish population.

Avulsion injuries of the upper extremities are challenging injuries for microsurgeons, and almost always crush and degloving components are present. Due to the severe damage to the neurovascular structures, microsurgical treatment options are quite difficult, but technical advances in microsurgery have resulted in increases in the possibilities of success in crush-avulsion type replantation. Good functional outcomes can be obtained with successful replantation in these cases. In this case report, we present a successful replantation of the totally degloved thumb, the result of a crush-avulsion injury caused by silicone molding machine.

Objective:Mandibular defects are generally observed as composite defects which soft tissue defects are accompanied to bone defects. This situation may cause difficulties in choosing the surgical method during the reconstruction period. The purpose of this paper is to convey our clinical approach and results on composite mandibular defects.Methods:Eleven patients, applying to our clinic between 2011 and 2015, were operated in a single session with the team of otorhinolaryngology, because of oromandibular cancer. Ten of the patients were male and one was woman. The age range was between 7 and 54 ages (Average age 35.5).Results:While mandibular resection was performed on all patients, skin resection was performed on six patients, mucosa resection was applied on eight patients; and floor of mouth resections on four patients. The occurring composite defects were reconstructed with free fibular flap or free anterolateral thigh flap. In postoperative period total flap loss was observed in one patient, an infection got developed in the flap donor area of one patient. In the long term, distant metastasis was observed in two patients and local relapse in one patient.Conclusion:In the repair of composite mandibular defects, fibula free flap can be considered as the first option with regard to its bone length, suitability for osteotomy and low donor area morbidity. However, in these cases, it is necessary to consider the patient’s age, health condition, location and type of defect in the determination of the suitable reconstruction method.