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Öğe A 6-month in vivo study of polymer/mesenchymal stem cell constructs for cranial defects(Sage Publications Ltd, 2011) Aydın, Halil Murat; Korkusuz, Petek; Vargel, İbrahim; Kılıç, Emine; Güzel, Elif; Çavuşoğlu, Tarık; Pişkin, ErhanTwo biodegradable polymers, poly(L-lactide) and poly(epsilon-caprolactone) were blended (50/50) and used to produce polymeric scaffolds by the dual porogen approach using a salt leaching technique to create pores within the matrix, while supercritical-CO2 treatment was used to enhance the interconnectivity and to remove impurities from synthesis steps. The scaffolds were highly porous (porosity >90%) with interconnected pore morphologies. These biodegradable scaffolds were evaluated in Sprague Dawley rats for osteoconductive properties over a 6-month period. Bone specimens were analyzed after 1, 3, and 6 months, for bone healing and tissue response. The cortical bone remodeling by controlled osteoblastic and osteoclastic activities as well as the bone marrow elements recovery were semi-quantitatively examined for each group. Excellent integration and biocompatibility behavior was observed in all groups. No adverse tissue responses were observed.Öğe ALX4 dysfunction disrupts craniofacial and epidermal development(Oxford Univ Press, 2009) Kayserili, Hülya; Uz, Elif; Niessen, Carien; Vargel, İbrahim; Alanay, Yasemin; Tuncbilek, Gokhan; Akarsu, Nurten AyseGenetic control of craniofacial morphogenesis requires a complex interaction of numerous genes encoding factors essential for patterning and differentiation. We present two Turkish families with a new autosomal recessive frontofacial dysostosis syndrome characterized by total alopecia, a large skull defect, coronal craniosynostosis, hypertelorism, severely depressed nasal bridge and ridge, bifid nasal tip, hypogonadism, callosal body agenesis and mental retardation. Using homozygosity mapping, we mapped the entity to chromosome 11p11.2-q12.3 and subsequently identified a homozygous c.793C -> T nonsense mutation in the human ortholog of the mouse aristaless-like homeobox 4 (ALX4) gene. This mutation is predicted to result in a premature stop codon (p.R265X) of ALX4 truncating 146 amino acids of the protein including a part of the highly conserved homeodomain and the C-terminal paired tail domain. Although the RNA is stable and not degraded by nonsense-mediated RNA decay, the mutant protein is likely to be non-functional. In a skin biopsy of an affected individual, we observed a hypomorphic interfollicular epidermis with reduced suprabasal layers associated with impaired interfollicular epidermal differentiation. Hair follicle-like structures were present but showed altered differentiation. Our data indicate that ALX4 plays a critical role both in craniofacial development as in skin and hair follicle development in human.Öğe Application of C-Shaped Osteotomy and Distraction Osteogenesis for Correction of Radial Angulation Deformities of the Hand in Children With Apert Syndrome Review of 10 Years of Experience(Lippincott Williams & Wilkins, 2015) Vargel, İbrahim; Çalış, Mert; Çavusoglu, Tarik; Ekin, Ömer; Öznur, AliApert syndrome is characterized by short, radially deviated thumbs, leading to difficulties in daily life such as holding a fork or a spoon and buttoning up. The main goal of surgery is to achieve thumb to index finger pinch to overcome these difficulties. Seven patients (14 extremities) followed up with Apert syndrome underwent distraction after a C-shaped osteotomy to simultaneously correct the brachydactyly and the angulation deformity of the bilateral thumbs. The patients ranged in age from 4 to 7 years at the distraction operation, with a mean (SD) of 4.7 (1.7) years, and the mean (SD) length of follow-up was 100.6 (14.95) months. The mean (SD) length of the phalanges at the beginning of distraction was 19.1 (3.26) mm, and the mean (SD) length of the distracted phalanx at long-term follow-up visit was 26.2 (5.63) mm. The mean (SD) correction of radial angulation was calculated as 42.6 (9.95) degrees, and the difference was considered as being statistically significant (P < 0.001). Minor complications such as pin loosening were observed in 6 extremities of 4 patients, and 2 patients were treated for pin tract infection. Index-to-thumb pinching was acquired by all the patients after distraction and correction of angulation. The hand features of Apert syndrome are as noteworthy as the craniofacial features and thus may lead to functional impairment and limitations in daily life. Distraction with a C-shaped osteotomy seems to be a promising method to correct both the shortness and the radial angulation of the thumb to achieve functional results.Öğe Bazal hücreli karsinomlarda metastaz baskılayıcı genler ve proteinler(2011) Bozdoğan, Önder; Çavuşoğlu, Tarık; Yuluğ, Önder; Vargel, İbrahim[Abstract Not Available]Öğe Disruption of ALX1 Causes Extreme Microphthalmia and Severe Facial Clefting: Expanding the Spectrum of Autosomal-Recessive ALX-Related Frontonasal Dysplasia(Cell Press, 2010) Uz, Elif; Alanay, Yasemin; Aktas, Dilek; Vargel, İbrahim; Gücer, Şafak; Tunçbilek, Gökhan; Akarsu, Nurten A.We present an autosomal-recessive frontonasal dysplasia (FND) characterized by bilateral extreme microphthalmia, bilateral oblique facial cleft, complete cleft palate, hypertelorism, wide nasal bridge with hypoplasia of the ala nasi, and low-set, posteriorly rotated ears in two distinct families. Using Affymetrix 250K SNP array genotyping and homozygosity mapping, we mapped this clinical entity to chromosome 12q21. In one of the families, three siblings were affected, and CNV analysis of the critical region showed a homozygous 3.7 Mb deletion containing the ALX1 (CART1) gene, which encodes the aristaless-like homeobox 1 transcription factor. In the second family we identified a homozygous donor-splice-site mutation (c.531+1G > A) in the ALX1 gene, providing evidence that complete loss of function of ALX1 protein causes severe disruption of early craniofacial development. Unlike loss of its murine ortholog, loss of human ALX1 does not result in neural-tube defects; however, it does severely affect the orchestrated fusion between frontonasal, nasomedial, nasolateral, and maxillary processes during early-stage embryogenesis. This study further expands the spectrum of the recently recognized autosomal-recessive ALX-related FND phenotype in humans.Öğe Effect of slow-release 5-fluorouracil on capsule formation around silicone breast implants: An experimental study with mice(Springer, 2007) Canter, Halil İbrahim; Konas, Ersoy; Bozdoğan, Önder; Vargel, İbrahim; Özbatir, Bilgen; Öner, Filiz; Erk, YücelBackground: Capsule formation around breast implants, development of tendon adhesions after tendon repair, intestinal brits after laparatomies, hypertrophic scars in skin incisions all are the results of excessive collagen synthesis to the extracellular matrix by fibroblasts. Any intervention that leads to cessation of collagen synthesis in these clinical situations may help to prevent these untoward results of wound healing. Although 5-fluorouracil (5-FU) is used mainly as a cytotoxic drug in chemotherapy protocols, it decreases cellular metabolism and blocks protein synthesis only at lower concentrations. Findings have shown that 5-FU downregulates fibroblast proliferation and differentiation in vitro. It has been used to treat fibroproliferative disorders of the eye and skin and is thought to inhibit thymidylate synthetase, blocking DNA replication. Methods: This study used five treatment groups: (1) gelatin only, (2) silicone only, (3) silicone + gelatin, (4) silicone + gelatin containing 1 mg of 5-FU, and (5) silicone + gelatin containing 5 mg of 5-FU. The release kinetics of 5-FU from gelatin have been investigated by means of ultraviolet spectrophotometric analysis. Specimens were obtained on postoperative day 30. Gross evaluation and histopathologic examination were conducted for capsule formation and the development of inflammation. Results: The silicone group had the most prominent capsule formation among all the groups. The gelatin group was second, and the silicone + gelatin group was third. As compared with the other groups, the 5-FU-containing groups had the least capsule formation. The 5-mg 5-FU-containing group had the most inflammation. The silicone + gelatin group was second in inflammation. Although the silicone, gelatin, and 1-mg 5-FU-containing groups had the same means, the results of the silicone group showed the most divergent data within the group. Conclusions: Because 5-FU loaded to a gelatin carrier for its slow release seems to prevent capsule formation around silicone blocks, it may be used to prevent capsule formation around silicone breast implants.Öğe Focused RF hyperthermia using magnetic fluids(Wiley, 2009) Tasci, T. Onur; Vargel, İbrahim; Arat, Anıl; Güzel, Elif; Korkusuz, Petek; Atalar, ErginHeat therapies such as hyperthermia and thermoablation are very promising approaches in the treatment of cancer. Compared with available hyperthermia modalities, magnetic fluid hyperthermia (MFH) yields better results in uniform heating of the deeply situated tumors. In this approach, fluid consisting of superparamagnetic particles (magnetic fluid) is delivered to the tumor. An alternating (ac) magnetic field is then used to heat the particles and the corresponding tumor, thereby ablating it. However, one of the most serious shortcomings of this technique is the unwanted heating of the healthy tissues. This results from the magnetic fluid diffusion from the tumor to the surrounding tissues or from incorrect localization of the fluids in the target tumor area. In this study, the authors demonstrated that by depositing appropriate static (dc) magnetic field gradients on the alternating (ac) magnetic fields, focused heating of the magnetic particles can be achieved. A focused hyperthermia system was implemented by using two types of coils: dc and ac coils. The ac coil generated the alternating magnetic field responsible for the heating of the magnetic particles; the dc coil was used to superimpose a static magnetic field gradient on the alternating magnetic field. In this way, focused heating of the particles was obtained in the regions where the static field was dominated by the alternating magnetic field. In vitro experiments showed that as the magnitude of the dc solenoid currents was increased from 0 to 1.8 A, the specific absorption rate (SAR) of the superparamagnetic particles 2 cm apart from the ac solenoid center decreased by a factor of 4.5, while the SAR of the particles at the center was unchanged. This demonstrates that the hyperthermia system is capable of precisely focusing the heat at the center. Additionally, with this approach, shifting of the heat focus can be achieved by applying different amounts of currents to individual dc solenoids. In vivo experiments were performed with adult rats, where magnetic fluids were injected percutaneously into the tails (with homogeneous fluid distribution inside the tails). Histological examination showed that, as we increased the dc solenoid current from 0.5 to 1.8 A, the total burned volume decreased from 1.6 to 0.2 cm(3) verifying the focusing capability of the system. The authors believe that the studies conducted in this work show that MFH can be a much more effective method with better heat localization and focusing abilities.Öğe Hypertrophic Frontal Sinus Reduction by Using Anterior Wall Internalization and Galeal Frontalis Flap Obliteration(Lippincott Williams & Wilkins, 2010) Yazıcı, İlker; Çavuşoğlu, Tarik; Karakaya, Esen İbrahim; Vural, Altughan Cahit; Vargel, İbrahimIn this article, we are introducing the use of galeal-frontalis flap to reduce hypertrophic sinus based on 1 case: a 25-year-old amateur boxer who had prominent frontal area due to hypertrophic frontal sinus. Three-dimensional reformatted computed tomography scans were obtained for evaluation of the hypertrophy and the morphology of the frontal sinus. Reduction of the hypertrophic frontal sinus was performed by resection and shaping of the anterior wall and obliteration of the frontal sinus by right-side galeal-frontalis flap excision via bicoronal approach. The trimmed anterior wall was inserted into the frontal sinus and secured with three 3.0 PDS sutures to the bone edges, and the incision was closed. The outcome was satisfactory without any complications during 1-year follow-up, and sixth-month computed tomography scans revealed no bone resorption. Here we are introducing a novel technique to reduce hypertrophic sinus based on a clinical report.Öğe Impact of Vascularization Type on Peripheral Nerve Microstructure(Thieme Medical Publ Inc, 2009) Vargel, İbrahimExperimental and clinical studies have demonstrated that vascularized nerve grafts are superior to nonvascularized nerve grafts with respect to healing. By means of the inherent vascularity in vascularized nerve grafts, Schwann cells remain viable, and endoneurial necrosis and fibrosis are not seen. In this study the effects of three different vascularization patterns oil the vascular microstructure of a nerve segment in the rat based on the femoral artery and vein was investigated. Sixty adult male Wistar Albino rats were divided into five groups. In each group, a 1.5-cm segment of femoral nerve was transected at two sides, without disturbing the unity of the contents of the femoral sheath. The experimental design consisted of prefabricated venous nerve segment, venous nerve segment, arterial nerve segment, no blood flow, and controls groups. To assess the microstructure of the nerve segment, myelin and Schwann cell morphology and fibrosis were examined. There were many Schwann cells with near normal morphology in the venous nerve segment and arterial nerve segment groups. In conclusion, the venous nerve segment model in which Schwann cell viability was high due to the presence of sufficient and uninterrupted blood supply to the nerve graft, resulting in successful nerve healing, showed superior results over others.Öğe An intraoperative unexpected respiratory problem in a patient with Apert syndrome(Edizioni Minerva Medica, 2007) Başar, Hülya; Büyükkoçak, Ünase; Kaymak, Çetin; Akpinar, S.; Sert, O.; Vargel, İbrahimWe present a case of a 5-year-old child who underwent four operations (three for syndactyly of the hands and one for craniofacial corrections). At the third hour of his craniofacial operation, his EtCO, started to increase and airway resistance was encountered during manual ventilation. The position of the head and neck was checked. An increase in secretion with oral and endotracheal aspiration and a decrease in saturation were observed. When breath sounds disappeared, the patient was reintubated orally. The nasal tube was obstructed with a mucolytic plug. There was no problem during the other operations. This case is presented since anaesthesiologists should be aware of the high incidence of respiratory complications in Apert syndrome.Öğe İpek Serisin ve Potansiyel Uygulama Alanları(2019) Gök, Zehra Gün; Yiğitoğlu, Mustafa; Vargel, İbrahimİpek, fibroin (lifli protein) ve serisin (globüler, zamklama proteini) olarak isimlendirilen iki ana proteinden oluşmaktadır. Fibroin tekstil üretiminde ve çeşitli biyomalzeme uygulamalarında kullanılırken, serisin tekstil endüstrisinde bir atık malzeme olarak kabul edilmektedir. Serisin, belirsiz bir yapıya sahip çok bileşenli bir protein olması nedeniyle, fibroinden daha az dikkat çekmiştir, ancak bu proteinin de biyolojik aktiviteye sahip olduğu ve biyouyumlu olduğu yapılan çalışmalarla gösterilmiştir. Serisin değişken amino asit bileşimi ve çeşitli fonksiyonel grupları ile biyomedikal uygulamalar için ilgi çekici biyoaktif özelliklere sahiptir. Antioksidan karakteri, nemlendirme yeteneği ve memeli hücreleri üzerindeki mitojenik etkisi nedeniyle, serisinin hücre kültürü ve doku mühendisliğinde yararlı olduğu son yıllarda yapılan çalışmalarla gösterilmiştir. Ayrıca, keratinositler ve fibroblastlar üzerindeki olumlu etkileri, başta yara bakım malzemeleri olmak üzere deri dokusu onarımı için serisin bazlı biyomalzemelerin gelişmesine yol açmıştır. Ek olarak, serisin, kemik benzeri hidroksiapatit nükleasyonunu indükleme kabiliyeti nedeniyle kemik doku mühendisliği için kullanılma potansiyeline de sahip olduğu gösterilmiştir. Filmler, süngerler ve hidrojeller gibi kararlı ipek serisin biyomalzemeleri, çapraz bağlama veya diğer polimerler ile karıştırılarak hazırlanmaktadır. Serisin aynı zamanda ilaç salımı için de kullanılma potansiyeline sahiptir, çünkü kimyasal reaktivitesi ve pH yanıtı, serisin bazlı nano-mikropartiküllerin, hidrojellerin ve konjuge moleküllerin üretimini kolaylaştırmakta ve ilaçların biyoaktivitesini arttırmaktadır. Bu çalışmada, önemli bir protein olan ipek serisinin özellikleri ve kullanım alanları özetlenmiştir.Öğe Marjolin Ülseri Eksizyonuna Bağli Popliteal Defektin Lateral Sural Arter Perforatör Flebiyle Onarımı(Kırıkkale Üniversitesi, 2009) Yazıcı, İlker; Çavuşoğlu, Tarık; Karakaya, Esen İbrahim; Vural, Altuğhan Cahit; Vargel, İbrahimMarjolin ülserleri Yassı Hücreli Kanser için premalin lezyonlardır. Eksizyonları ve patolojik incelenmeleri önerilir. Bu tip lezyonların yerlerine gore de rekonstrüksiyon seçenekleri çeşitlidir. Biz bu vaka sunumunda popliteal yerleşimli bir marjolin ülserinin eksizyonu sonrası lareal sural arter bazlı perforator ada flebiyle onarım yaptığımız bir vakayı sunmaktayız. Bu vakadan elde ettiğimiz deneyime gore popliteal defektlerin onarımında pediküllü lateral sural arter perforator flebi kullanımını mikrocerrahi anastomoz gerektirmemesi, kolay cerrahi disseksiyonu ve düşük donor saha morbiditesi sebebiyle öneririzÖğe Massive oculofacial myiasis infestation with Lucilia sericata(Mosby-Elsevier, 2009) Çavuşoğlu, Takir; Apan, Teoman; Eker, Esabil; Vargel, İbrahim; Saray, Aydin…Öğe Meridian Pedicle-Based Breast Shaping in Reduction Mammaplasty: A Technical Modification(Springer, 2013) Yazıcı, Ilker; Demir, Ünsal; Fariz, Sevin; Vural, Altughan Cahit; Karakaya, Esen İbrahim; Cavuşoğlu, Tarık; Vargel, İbrahimWe present a technical modification of vertical reduction mammaplasty which provides a reliable pedicle that can be used in large and highly ptotic breasts with confidence when compared to vertical mammaplasty techniques without sacrificing conical breast shape and projection, in contrast to Wise pattern reduction techniques. Thirty-two patients under general anesthesia were operated on using this modification between 2008 and 2012. The surgical technique is as follows: after general anesthesia induction and local anesthetic infiltration, skin incisions are made according to preoperative drawings. The breast meridian is prepared by superior and inferior plication of the vertical pedicle, including two dermal and one central attachment to the chest wall. Lateral and medial tissue resections are performed, thus preparing medial and lateral pillars after skin undermining. The pillars are sutured to the meridian to reconstruct a projectile conical breast shape. Inverted-T scar (87.5 %, n = 28) and vertical scar (12.5 %, n = 4) were used for closure. All patients were satisfied with the outcome regarding breast projection, shape, and size at 12 (n = 30) and 24 months (n = 15) after surgery except for 12 cases that needed reoperations: 2 cases for bottoming out and lower pole deformity, 2 cases needed more reduction by liposuction or re-excision, and 8 scar revisions. Early and late results (up to 2 years) regarding breast shape and projection were found to be satisfactory while providing a reliable pedicle with less postoperative drainage. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .Öğe A newborn with infantile fibrosarcoma of foot: treatment with chemotherapy and extremity-sparing surgery(Nature Publishing Group, 2010) Akyüz, Canan; Sari, Neriman; Vargel, İbrahim; Gedikoğlu, Gökhan; Haliloğlu, Mithat; Büyükpamukçu, MünevverInfantile fibrosarcoma represents less than 1% of all childhood cancers, but it is the most common soft-tissue sarcoma in those under 1 year of age. We report an infant with congenital infantile fibrosarcoma diagnosed as hemangiopericytoma. He was treated with chemotherapy and extremity-sparing surgery. Amputation was avoided. Journal of Perinatology (2010) 30, 63-65; doi: 10.1038/jp.2009.92Öğe Reconstruction of mandibular defects using autografts combined with demineralized bone matrix and cancellous allograft(Lippincott Williams & Wilkins, 2007) Canter, Halil İbrahim; Vargel, İbrahim; Mavili, M. EminFacial bone defects can be managed by a variety of means, such as inlay or onlay applied nonvascularized bone grafts, local pedicled/distal free osteocutaneous/osseous flaps or distraction osteogenesis. Although each method has its own advantages and drawbacks, the indications of using these methods may overlap in certain clinical situations. The use of nonvascularized bone grafts, conceptually and technically simple method, relies on creeping substitution of applied graft with regenerating new bone. However, using vascularized osteocutaneous free flaps provide not only plenty of bony tissue for reconstruction, but also soft tissue coverage over the reconstructed bony segment. Furthermore, bone healing in vascularized osteocutaneous free flaps resembles as the physiologic fracture healing. In selected cases with enough soft tissue coverage over the defective bony segment, on the other hand, using larger nonvascularized bone grafts with osteoinductive growth factors may decrease the risk of graft failure while avoiding the drawbacks of the free tissue transfer. Here we present our results of three cases with facial bone defects, to which nonvascularized iliac bone grafts and demineralized bone matrix with cancellous allograft (Orthoblast II (TM)) as a source of BMP were used together for mandibular reconstruction.Öğe Repeated tissue expansions on solit-thickness skin graft in a patient with neurocutaneous syndrome(Lippincott Williams & Wilkins, 2007) Canter, Halil İbrahim; İğde, Murat; Vargel, İbrahim; Özgür, FigenSoft tissue expansion is a mechanical process that increases the surface area of local tissue available for reconstructive procedures. In most cases, adjacent tissue that matches the recipient site in color, texture, and hair-bearing quality is preferred for tissue expansion. In this particular case with neurocutaneous syndrome, the defects that resulted from removal of parts of a giant hairy nevus overlying the latissimus dorsi muscle bilaterally were grafted with a split-thickness skin graft. Two expanders were then placed under the latissimus dorsi muscles. After full expansion of the grafted area, some part of the remaining nevus surrounding the grafted area was removed and the defects were covered with the expanded skin graft obtained after deflation of the expanders. The expanders placed under the latissimus dorsi muscle in the first operation were reused in the second operation to obtain a second expansion of the skin graft. After the second expansion of the skin graft, the expanders were deflated and another portion of the remaining nevus surrounding the grafted area was removed. The resulting defects were again covered with the excess expanded skin graft. Although repeated expansion of the skin graft is a time-consuming and laborious process, it eliminates the need for taking repeated skin grafts; it decreases skin graft donor site morbidity; it decreases possible infectious complications of tissue expansion by decreasing the number of surgical interventions to the expander pocket; and it increases the aesthetic outcome by keeping all the surgical scars around the grafted Area without extending them into healthy surrounding skin.Öğe Results of botilinum toxin: An application to blepharospasm in Schwartz-Jampel syndrome(Lippincott Williams & Wilkins, 2006) Vargel, İbrahim; Canter, Halil İbrahim; Topaloglu, Haluk; Erk, YücelSchwartz-Jampel syndrome (SJS) is a rare congenital disorder of continuous myotonia, causing visual and eyelid problems such as blepharospasm, acquired ptosis, and blepharophimosis. We report the management of blepharospasm in two sisters with Schwartz-Jampel syndrome with application of botilinum toxin type A (BTX-A), as an alternative to the surgical treatments, such as orbicularis oculi myectomy, levator aponeurosis resection, and lateral canthopexy as described in the literature. Three consequent doses of commercially available BTX-A (Botox(R)-Allergan, Inc. 100 u/via) were injected to orbicularis oculi muscle in two sisters with Schwartz-Jampel syndrome. At the least, the authors waited for a six-month interval to prevent development of sensitivity to BTX-A in patients. No significant improvement was observed after the injection of first dose of BTX-A, with the total dose of 25 units of BTX-A to each orbicularis oculi muscle of the eyes. The muscle tone weakened after the second dose, which was the twice as such of the first applied total dose (50 units of BTX-A to each orbicularis oculi muscle of the eyes) and significant functional and cosmetic improvements were achieved after injection of the third dose, in which the total applied dose was the same as the one applied in second dose. The blepharospasm and eyelid alterations caused by Schwartz-Jampel syndrome should be treated to provide functional and cosmetic improvements. Application of BTX-A to orbicularis oculi muscle for the treatment of blepharospasm could be considered as an alternative to levator resection, and lateral canthopexy in Schwartz-Jampel syndrome.Öğe Results of GM-CSF treatment in chemotherapeutic extravasation ulcers(Imprimatur Publications, 2010) Vargel, İbrahim; Canter, H. İbrahim; Erdem, Adnan; Altundağ, Mustafa K.…Öğe Rijid eksternal distraksiyon sistemi ile orta yüz ilerletilmesi yapılan pfeiffers sendromlu bir olgu(2009) Akcan, Cenk Ahmet; Kocadereli, İlken; Anacar, Ayhan; Tunçbilek, Gökhan; Vargel, İbrahimKraniyofasiyal dizostozisli hastalarda hem estetik problemler hem de görme bozukluklarını, obstrüktif uyku apnesini ve büyüme sorunlarını içeren fonksiyonel problemler gelişmektedir. Bu problemler değişik yöntemlerle tedavi edilebilmektedir. Rijit Eksternal Distraksiyon ile orta yüz ilerletmesi, tek bir işlemle bu sorunların tamamının düzeltilmesine imkan sağlamaktadır. Bu vaka raporunda, monoblok osteotomi ve Rijit Eksternal Distraksiyon Sistemi (RED-II) kullanılarak distraksiyonu gerçekleştirilmiş Pfeiffers sendromlu, 4 yaşındaki hasta sunulmaktadır. Bu hastada frontofasiyal ilerletme RED-H kullanılarak başarılı bir şekilde elde edilmiş, böylece tek operasyonla eksoftal-mus ve üst hava yolu sorunları düzeltilmiştir.
