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Öğe Assessment of Outcomes After Limberg Flap Reconstruction for Scrotal Defects in Patients With Fournier's Gangrene(H M P Communications, 2021) Dadaci, Mehmet; Yildirim, Mehmet Emin Cem; Yarar, Serhat; Ince, BilsevBackground. Fournier's gangrene (FG) is a rarely encountered necrotizing fasciitis principally affecting skin and subcutaneous tissues of the genital region, perineum, and abdominal wall. The overall incidence of FG is 1.6 cases per 100 000 per year; the incidence in males is higher. Management techniques described in the literature have both advantages and disadvantages, and there is no gold standard treatment technique. Objective. This study evaluated whether the Limberg flap can be used reliably in scrotal defects with fewer complications than are seen with traditional techniques. The results of unilateral or bilateral Limberg flaps for scrotal reconstruction after FG were assessed. Materials and Methods. This retrospective, single-center study analyzed records from 29 male patients with scrotal defects after multiple debridements who were treated from January 2013 to January 2018. Twenty-one patients (72.4%) with hemiscrotal defects and 8 patients (27.6%) with defects involving greater than 50% of the scrotal surface were included in this study. Demographic data that were analyzed included smoking history, comorbid conditions, time of surgery, and time of follow-up. Flap dimensions were measured. Patients were evaluated in terms of flap viability and postoperative complications. Results. Mean age was 64 years (range, 47-80 years). The mean follow-up period was 16 months (range, 12-26 months). Dehiscence with seroma were detected in 4 patients (13.7%) on postoperative days 4 and 5. The average size of the flaps was 11 cm x 15 cm. Seroma and dehiscence were encountered in 4 patients (13.7%) during postoperative follow-ups. No postoperative infection was observed in any patient, and no partial or total flap loss was reported. Conclusions. These results suggest that use of the Limberg flap technique for scrotal reconstruction following FG has the important benefits of being easily harvested while providing tension-free repair and acceptable cosmetic results.Öğe Comparison between knot and Winograd techniques on ingrown nail treatment(2015) İnce, Bilsev; Dadacı, Mehmet; Bilgen, Fatma; Yarar, SerhatObjective: The aim of this study was to compare the Winograd and knot techniques based on efficiency, complication rate, surgery time, and amount of local anesthetic required. This study also aimed to determine the etiology of ingrown nails, whether due to involvement of the nail or soft tissue.Methods: Seventy-five patients with a total of 90 ingrown nails (stages 2 and 3) who presented at our clinic between 2012-2014 were included in this study. Patients were divided into 2 groups: those treated with the knot technique and those treated with the Winograd technique. Patients in both groups were evaluated for the amount of local anesthetic required, intraoperative pain, effectiveness of preventing/stopping hemorrhage, surgery time, complications, postoperative nail size, recurrence, nail deformities, and secondary surgery rates.Results: The mean surgical time, relapse rate, number of additional surgeries required, and amount of local anesthetic were significantly greater in the Winograd group than in the knot group. The mean nail diameter was significantly decreased, with a mean of 3 mm in the Winograd group. No statistically significant differences were found between the groups in the incidence of infection, intraoperative pain, hematoma, or nail deformity.Conclusion: This study demonstrated that the knot technique, consisting of wedge excision of soft tissue without affecting the nail itself, is a simple technique to treat ingrown nails with a lower complication rate and shorter surgical time. We believe that successful treatment of ingrown nails depends only on excision of soft tissue, with no need to operate on the nail bedÖğe A Different Stabilization Technique of Autogenous Cartilage Grafts in Saddle Nose Deformity: Prevention Warping and Resorption(Lippincott Williams & Wilkins, 2019) Gundeslioglu, A. Ozlem; Yildirim, Mehmet Emin Cem; Yarar, Serhat; Uyar, Ilker; Ismayilzade, MajidBackground: Saddle nose deformity (SND) is a collapse of the cartilage and bone structures forming the dorsal projection of the nose. After the use of autologous cartilage in the treatment of SND, resorption and warping continue to be a problem. Methods: This study presents results from 11 patients with SND types III and IV from 2005 to 2017 treated with autologous cartilage fixed with microplates and microscrews. The patients were monitored for at least 1 year. Resorption and warping were measured using postoperative photographs of the patients in the 3rd and 12th months after treatment. Results: No signs of resorption or warping were noted in the patients. Conclusions: Our findings indicate autologous cartilage use with microplates and microscrews is a viable, long-term treatment option for patients with SND types III and IV.Öğe Effect of cineole, alpha-pinene, and camphor on survivability of skin flaps(Tubitak Scientific & Technological Research Council Turkey, 2018) Ince, Bilsev; Dadaci, Mehmet; Kilinc, Ibrahim; Oltulu, Pembe; Yarar, Serhat; Uyar, MehmetBackground/aim: The aim of this study was to determine the specific component of Rosmarinus officinalis (RO) responsible for increased flap survival and how RO displays its efficacy. Materials and methods: Rectangular random-pattern flaps were elevated from the back of each rat. Group I was the control group. In group II 0.1 mL of cineole, in group III 0.1 mL of alpha-pinene, in group IV 0.1 mL of camphor, in group V 0.1 mL each of alpha-pinene and cineole, in group VI 0.1 mL each of alpha-pinene and camphor, in group VII 0.1 mL each of cineole and camphor, and in group VIII, 0.1 mL each of alpha-pinene, cineole, and camphor was orally administered once a day before surgery. The luminal area of the largest blood vessel in the proximal flap was measured. Interleukin-1, tumor necrosis factor alpha, thiobarbituric acid reactive substances, and vascular endothelial growth factor values were measured. Results: The mean percentage of the viable surface area was significantly greater in groups VIII, III, and V. The mean percentage of vessel diameter was significantly greater in groups V, VIII, and VII. Conclusion: We suggest that alpha-pinene and cineole were the components of RO that were responsible for increased flap survival. The most effective of feature of RO was the antiinflammatory effects.Öğe The effects of a combination treatment with mesenchymal stem cell and platelet-rich plasma on tendon healing: an experimental study(Tubitak Scientific & Technological Research Council Turkey, 2022) Uyar, Ilker; Altuntas, Zeynep; Findik, Siddika; Yildirim, Mehmet Emin Cem; Yarar, Serhat; Aktan, Murat; Avci, AlunetBackground/Aim: The objective of this study was to investigate the effects that the application of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) following tendon repair have on the strength and healing of the tendon and also to examine the possible mechanisms of action that take place. Materials and methods: The Achilles tendons of 80 rats were repaired and divided into eight groups. Following the repairs, MSCs obtained from humans were injected into the rat tendons in groups 1 and 2, a combination of MSCs from humans and PRP from rats was injected into the tendons in groups 3 and 4, and PRP from rats was injected into the tendons in groups 5 and 6. These procedures all took place simultaneously. Groups 7 and 8 did not receive any injections following the repairs. The rats were sacrificed at the end of the first and second months following the procedures, and biomechanical and histopathological analyses were performed. Results: Inflammatory cell density increased most significantly in the combined group when compared to the first and second months. The fibroblast density on the tendon repair region was significantly lower in the second-months groups of each intervention compared to their first-month groups (p = 0.001). For the analysis of the maximum tensile breaking force, the behaviors of the groups over time were significant when compared to the control groups (p = 0.0015). Also, the mean maximum breaking force in the combined group was statistically significantly higher at the end of the second month than at the end of the first month (p = 0.0008). Conclusion: The combination therapy increased tendon strength force. This combination therapy can make a positive contribution to the healing of tendons after surgery.Öğe Evaluation of the effectiveness of the tuba uterina tubular flap in the peripheral nervous system regeneration in rats(Taylor & Francis Ltd, 2022) Yildirim, Mehmet Emin Cem; Dadaci, Mehmet; Ince, Bilsev; Uyar, Ilker; Yarar, Serhat; Oltulu, Pembe; Aygul, RecepNerve conduits could be used to provide a bridge between both nerve endings. In this study, the tuba uterina of female rats were prepared in a vascularized pedicled flap model and it used as a nerve conduit. The aim was to investigate the effectiveness of a vascularized pedicle nerve conduit and its ciliated epithelium in a sciatic nerve defect. The study was conducted between May and August 2018, and used a total of 60, 14-16-week-old female Wistar albino rats. Six groups were created; Cut and Unrepaired Group, Nerve Graft Group, Flap-Forward Group (Tuba uterina tubular flap, forward direction), Flap-Reversed Group (Tuba uterina tubular flap, reverse direction), Graft-Forward Group (Tuba uterina tubular graft, forward direction) and Graft-Reverse Group (Tuba uterina tubuler graft, reverse direction). Nerve regeneration was evaluated 3 months (90 days) after the surgery by the following methods: (1) Sciatic Functional Index (SFI) measurement, (2) Electromyographic (EMG) assessment, (3) Microscopic assessment with the light microscope and (4) Microscopic assessment with the electron microscope. According to the SFI, EMG and microscopic assessments with the light and electron microscope, it was observed that the transfer of tuba uterina tubular conduit as a graft was statistically better in its effect on nerve regeneration than flap transfer, but also indicated that the direction of the ciliated structures had no significant effect. We believe that as this model is improved with future studies, it will shed light on new models, ideas and innovations about nerve conduits.Öğe Facilitating triple rhomboid flaps for meningomyelocele defect closure using a honeycomb structure as a template(Springer, 2016) Karacor-Altuntas, Zeynep; Dadaci, Mehmet; Erdi, Fatih; Ince, Bilsev; Uyar, Ilker; Yarar, SerhatPurpose Various reconstruction options are available for the soft-tissue coverage of meningomyelocele defects. For small defects, primary closure or local single flaps may be sufficient, while large defects require more complex reconstructive techniques. This study suggests an easy way for surgeons to close large meningomyelocele defects using triple rhomboid flaps. Methods The hexagonal structure of a honeycomb was considered when planning for the coverage of large meningomyelocele defects. The intact skin around the defect was imagined as multiple hexagons, which allowed us to plan triple rhomboid flaps correctly and more easily. This technique was used in seven patients with defects ranging from 7 x 5 to 12 x 8 cm in size. Results No major postoperative complications were seen. Minimal dehiscence was observed in two patients and healed secondarily. Conclusions The honeycomb modification for planning triple rhomboid flaps is an easy, practical, and memorable approach for surgeons reconstructing large meningomyelocele defects.Öğe A Heterotopic Digital Replantation in an 18-Month-Old Child(Wolters Kluwer Medknow Publications, 2018) Dadaci, Mehmet; Ince, Bilsev; Bilgen, Fatma; Yarar, SerhatIn multiple digital amputations, it is not always possible to replant the same amputated part. In these cases, heterotopic digital replantation is a suitable option in terms of cosmetic and functional outcomes. In our report, we described a heterotopic digital replantation in an 18-month-old male child who had multiple digital amputation as a result of placing his hand in the ventilator. Heterotopic replantation is an important method that should be kept in mind in multiple finger amputations which can enable a good cosmetic and functional result, especially in cases where the stump of the amputated finger is not suitable/veya convenient.Öğe Hiperbarik oksijen tedavisinin silikon meme protez çevresinde kapsül oluşumu üzerine etkisinin histopatolojik olarak incelenmesi : Deneysel çalışma(Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, 2017) Yarar, Serhat; İnce, BilsevMeme operasyonlarında sık olarak silikon meme protezleri kullanılmaktadır. Silikon meme protezlerinde ağrı, sertleşme, memede asimetriye yol açarak ikinci bir operasyona en sık yol açan komplikasyonlardan biri kapsül oluşumudur. Kapsül kontraktürü implant çevresindeki kollajenin yeniden organize edilmesi esnasında oluşur.Yara yüzeyinde kollajen birikimi oksijen basıncı ile ilişkilidir. Literatür tarandığında kapsül oluşumunu azaltmak amacıyla HBO tedavisine rastlanmamıştır. AMAÇ : HBO tedavisinin yara iyileşmesindeki olumlu etkilerinden yararlanılarak silikon etrafında oluşacak kapsül kalınlığının azaltılması ve böylelikle kapsülün olası olumsuz etkilerinin azaltılmasıdır. GEREÇ VE YÖNTEM : Toplam 60 rat 15'erli olmak üzere 4 gruba ayrılarak çalışmaya başlandı. Pürtüklü yüzeye sahip silikon meme implantı tüm ratların sırt bölgesine kas üstü ve kas altı plana yerleştirildi. Grup 3 ve 4'e postoperatif 1. günden başlanarak 15 gün boyunca günde 1 seans Hiperbarik Oksijen Tedavisi (HBOT) verildi. Postoperatif 60. günde tüm gruplarda silikon çevresinde gelişen kapsül kontraktürü incelenmek üzere çevresindeki kapsül alınarak histopatolojik incelemeye gönderildi. BULGULAR : Histopatolojik inceleme sonrası kapsül kalınlığı HBOT verilen grupların kontrol gruplarına göre oranı p < 0.0118 bulunarak anlamlı fark bulunmuştur. Ayrıca fibroblast ve nötrofil sayısı HBOT verilen grup 3 ve grup 4'de kontrol gruplarına göre istatistiksel olarak anlamlı şekilde düşük bulunmuştur. İncelenen kapsül yapısındaki neovaskülarizasyon oranlarına baktığımızda kontrol gruplarına göre HBOT verilen gruplarda anlamlı şekilde yüksek oran saptanmıştır. SONUÇ : Yaptığımız çalışmada HBOT verilen grup 3 ve 4 de kontrol gruplarına göre daha ince kapsül oluşumu gözlendi. İlerleyen çalışmalar gerekmekle birlikte meme augmentasyon yapılan hastalarda HBOT kapsül oluşumunu azaltabilir. Anahtar kelimeler: silikon, meme protezi, kapsül reaksiyonu, kapsül oluşumu, hiperbarik oksijen tedavisiÖğe Histopathological evaluation of the effect of hyperbaric oxygen therapy on capsule occurrence around silicone breast prosthesis: an experimental study(Taylor & Francis Ltd, 2021) Yarar, Serhat; Arslan, Abdullah; Ince, Bilsev; Yildirim, Mehmet Emin Cem; Oltulu, Pembe; Uyar, Ilker; Dadaci, MehmetBackground In general, capsular contracture is the underlying cause of complications such as pain, stiffening, breast asymmetry, and animation deformity that are seen in the late postoperative period due to the use of silicone breast prostheses. Considering the positive effects of HBO therapy on wound healing, the objective of this study was to investigate the effect of HBO therapy on capsule reaction occurring due to silicone implants. Material and Methods Rats were divided into four groups. 1 cm x 1 cm silicone implants with rough surface were inserted in subcutaneous plane on the m spinotrapezius muscle fascia at just right of the dorsal region midline in rats in Group 1, while implants with same properties were inserted beneath m spinotrapezius muscle in rats in Group 2. Implants with the same properties were inserted in the subcutaneous area on the m spinotrapezius muscle in rats in Group 3 and into the area under the muscle in rats in Group 4. Beginning from the first postoperative day, rats in Groups 3 and 4 received HBO therapy for 90 min under 2.5 ATM pressure as one session a day over 15 days. Results The mean capsule thickness was statistically significantly lower in the groups treated with HBO compared to the control groups. Fibroblast, neutrophil and macrophage counts were statistically significantly lower in the groups treated with HBO compared to the control groups. Conclusion We believe that HBO therapy can be used as an adjuvant treatment options to decrease capsule contraction occurring after silicone implant application.Öğe A New Technique in Tamai Zone 1 Reconstruction: Reverse Dorsal Terminal Vein Flap (Hat Flap)(Georg Thieme Verlag Kg, 2019) Ince, Bilsev; Yildirim, Mehmet Emin Cem; Dadaci, Mehmet; Yarar, SerhatIntroduction The aim of this study was to determine usability of the reverse dorsal terminal vein flap (hat flap) in the reconstruction of Tamai zone 1 defects. Materials and Methods A total of 31 patients with fingertip amputation in Tamai zone 1 defect in the finger operated upon between 2014 and 2016 were included in this study. Flaps were designed from the proximal end of the nail bed to the middle phalanx according to the defect size. After passing through the skin, the proximal parts of the dorsal vein and branches were knotted. The flap was harvested by preserving the paratenon and dorsal digital terminal vein. Then, the flap was rotated and the defect was closed. Results A total of 32 patients were included in this study. The average size of the defects was 2 x 2.2 cm. Loss of epidermis in five patients and partial flap loss in two patients were observed (7/32, 21.8%), but total flap loss was not observed in any patient. Conclusion The reverse flow terminal dorsal vein-based pedicle flaps can be used as a viable surgical technique in the reconstruction of Tamai zone 1 amputations.Öğe A novel missense mutation that may be associated with the polydactyly in the HOXD13 gene: Q241H(Bayrakol Medical Publisher, 2020) Vural, Hasibe; Avci, Ebru; Eroglu, Canan; Cinar, Ilknur; Yarar, Serhat; Gundeslioglu, OzlemAim: HOX gene cluster which is termed as architectural genes and affects the expression of certain genes on DNA are effective in the development of limb. Therefore, mutations are observed in HOX genes, particularly HOXD13, lead to various congenital limb malformations. In this context, it was aimed to determine the expression level of HOXD13 gene and screening of HOXD13 mutations in patients with congenital lower/upper limb malformations who applied to Clinic of Plastic Reconstructive and Aesthetic Surgery of Meram Faculty of Medicine Hospital in this study. Material and Method: The case group of the study was composed of 20 unrelated patients with congenital lower/upper limb malformations and the control group was composed of 20 healthy individuals. Mutation analysis was performed using NGS and Sanger sequencing methods. The expression level of the HOXD13 gene was determined by the qPCR. Results: According to the qPCR results, in the case group, a 3.43 fold decrease was observed in the expression of HOXD13 gene when compared with the control group. However, this result was not statistically significant. According to NGS and Sanger sequencing results, a 723G> T variation that could lead to amino acid changes (Q241H) and could be defined as a missense mutation was detected in a patient. Discussion: 723G> T variation observed in a patient with a polydactyly anomaly was found in the patient's mother. However, more detailed studies are needed to assess this variation, which are not found in the literature, as a missense mutation in HOXD13 associated with polydactyly.Öğe A Rare Case: Primary Venous Malformation in Parietal Bone(Karger, 2021) Yarar, Serhat; Uyar, Ilker; Yildirim, Mehmet Emin Cem; Dadaci, Mehmet; Ince, BilsevPrimary intraosseous vascular malformations (PIVMs) are rare intraosseous lesions, accounting for approximately 0.5-1% of all intraosseous tumours. In this case report, we aimed to present a rare case of intraosseous vascular malformation causing a large lytic area in the parietal bone. A 25-year-old male patient was admitted to the clinic with a mass on the parietal bone. On physical examination, it was observed that the hair density on the mass was decreased, the mass had a soft consistency, and there was no pain on palpation. The patient was operated under local anaesthesia with a provisional diagnosis of a trichilemmal cyst. However, intraoperative diagnosis was a vascular malformation. There was a 3-cm full-thickness defect on the parietal bone caused by the lesion. The mass was excised completely while preserving the integrity of the dura. The resulting defect was reconstructed with bilateral rotation advancement flaps. The calvarial defect was not reconstructed due to equipment inadequacy. No complications were encountered in the postoperative period. Ninety-three PIVM cases have been reported in the skull since 1845. In very few of these cases, the mass is located in the parietal bone. The pathogenesis of PIVMs is not completely understood. The definitive diagnosis is made by histopathological examination. The therapeutic gold standard is surgery. Surgeons should keep in mind that radiological examination before the operation could prevent undesirable complications.Öğe A Rare Congenital Case: Aplasia Cutis Congenita(Thieme Medical Publ Inc, 2021) Uyar, Ilker; Sahin Uyar, Sibel Burcak; Cem Yildirim, Mehmet Emin; Yarar, Serhat; Dadaci, Mehmet[Abstract Not Availabe]Öğe Repairment of lateral malleol defects with distal pedicled peroneus brevis muscle flap(Wolters Kluwer Medknow Publications, 2019) Yarar, Serhat; Kendir, Munur Selcuk; Altuntas, ZeynepThe availability of local tissue in distal 1/3 of the leg and around the ankle is limited, and the difficulty in re-establishing soft-tissue coverage for these defects continues to challenge surgical procedures. In this study, two cases who had the soft-tissue defects around the lateral malleol reconstructed with the distally pedicled peroneus brevis muscle flap were discussed. The first case was a 30-year-old male patient, who had 4 cm x 2 cm soft-tissue defect with bony exposure, inferior to the lateral malleol after a gunshot injury. The second case was a 26-year-old male patient who had 5 cm x 3 cm soft-tissue defect with exposed metal implant, distal to the lateral malleolus after a traffic accident. Both of the patients were quite satisfied with the esthetic results. The distal pedicled peroneus brevis muscle flap should be kept in mind as a reliable and relatively easy flap option for the reconstruction of the soft-tissue defects around the lateral malleol with good results.Öğe Simultaneous flap thinning with ultrasound-assisted liposuction during free flap surgery: Preliminary results(Wiley, 2019) Ince, Bilsev; Yarar, Serhat; Dadaci, MehmetBackground Ultrasound-assisted liposuction (UAL) has been previously used for postoperative flap thinning. Although it had been reported that UAL causes less damage to the vessels, the simultaneous use of UAL with free flap reconstruction has not been reported. The aim of this report was to determine the results and the complication rates of simultaneous use of UAL with free flap reconstruction. Patients and methods Twelve patients who underwent simultaneous flap thinning with UAL during free anterolateral thigh flap surgery between 2014 and 2016 were included in this prospective study. The mean age of the patients was 46.7 (ranging 10-76) years. The mean body mass index of the patients was 26.81 (ranging 25.2-29.8). Flaps were thinned with UAL before harvesting. The mean flap thicknesses were measured using a metal ruler before and after the UAL procedure. Biopsies were performed lateral to the center of the flaps, after completion of the UAL procedure. Vascular and collagen structures were histopathologically examined. The Likert scale, which evaluates the general appearance, shape, color, and texture, was used to assess the aesthetic results of the UAL procedure. Results The average flap size was 13 x 9 cm. The mean pedicle length was 8.3 (ranging 7-10) cm. The mean flap thickness was 23 (ranging 19-27) mm and decreased to a mean of 8.1 (ranging 5-11) mm. Wound dehiscence and partial skin necrosis was observed in 2 patients (2/12, 16.66%). None of the patients had total flap necrosis. Vascular and collagen structures of the biopsied samples were normal. Patients were followed for an average of 13 months post UAL. The mean Likert score was 17.1 (ranging 15-19). Conclusions Flap thinning with UAL can be safely performed during the initial free flap reconstruction operation.Öğe Temporomandibular Eklem Disfonksiyon Tedavisinde Konsantre Büyüme Faktör (CGF) Etkinliği(2017) İnce, Bilsev; Uyar, İlker; Yıldırım, Mehmet Emin Cem; Dadacı, Mehmet; Yarar, SerhatÇene hareketleri sırasında çenede ve çevre dokularda ağrı, çene hareketlerinde kısıtlılık ve/veya klik, krepitasyon gibi sesler, baş, boyun, kulak, diş ağrıları ile semptomlarıyla ortaya çıkan temporomandibular eklem (TME) disfonksiyon tedavisinde PRP uygulamaları ile ilgili yayınlar yer almakla birlikte, konsantre büyüme faktör (CGF) kullanımının etkisine dair herhangi bir çalışma bulunmamaktadır. Bu çalışmada TME disk deplasmanı, redüksiyonlu/ redüksiyonsuz disk dislokasyonu ve eklem dejenerasyonu olan hastalarda konsantre büyüme faktör (CGF) etkinliğinin araştırılması amaçlanmaktadır. 2015-2016 arasında TME’de ağrı, eklemde klik sesi, ağız açıklığında azalma şikayeti olup konservatif tedaviye yanıt vermeyen hastalar çalışmaya alındı. Hastalarda yaş, cinsiyet, önceki tedavi, ağrı, eklemde klik sesi, ağız açıklığı ve enjeksiyon öncesi ve sonrasında yapılan manyetik rezonans görüntüleme bulguları kayıt altına alındı. Hastalarda çene ekleminde hissettikleri ağrı 0’dan 10’a kadar numaralandırıldı ve vizüel analog skalasına (VAS) göre puanlandı. Ağız açıklığı ölçüldü. CGF (Truecell) enjeksiyonu öncesi ve sonrası 6. ayda tüm hastalara TME manyetik rezonans görüntüleme yapıldı. Tüm ölçümler CGF enjeksiyonu sonrası 6. ay ve 1. yıl sonunda tekrarlandı. Çalışmaya katılan 10 hastanın (3 erkek, 7 kadın) ortalama yaşı 30, enjeksiyon öncesi ağız açıklığı ortama 2.1 cm’di. Enjeksiyon sonrası 1. yılda ağız açıklığı ortalama 3 cm olarak ölçüldü. Uygulamadan önce tüm hastalarda klik sesi mevcutken 1. yıl sonunda sadece 2 hastada ses mevcuttu. VAS ortalama skoru enjeksiyon öncesi 8, enjeksiyon sonrası 3 idi. Bu çalışmada eklem içi tek sefer 1 cc CGF enjeksiyonunun TME disk deplasmanı, redüksiyonlu/ redüksiyonsuz disk dislokasyonu ve eklem dejenerasyonu olan hastalarda ağız açıklığının artması, VAS skoru ve klik sesinde azalmayı sağladığı belirlendi. TME disfonksiyonu olan hastalarda CGF enjeksiyonu semptomatik iyileşme sağlayabilir.
