Person: ŞENGENÇ, ESMA
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Publication Metadata only Late Diagnosis of MELAS Can Lead to A Serious Brain Edema that Ultimately Requires Decompressive Craniectomy(2019-11-01T00:00:00Z) Nizam, Oznur Gokce; ŞENGENÇ, ESMA; YEŞİLBAŞ, OSMAN; Sahin, Seyma Sonmez; İŞCAN, AKIN; İÇAĞASIOĞLU, DİLARA FÜSUN; ŞENGENÇ, ESMA; YEŞİLBAŞ, OSMAN; İŞCAN, AKIN; İÇAĞASIOĞLU, DİLARA FÜSUNPublication Metadata only Management of Medially Displaced Sub-Condylar Mandibular Fractures in Pediatric Population Using Novel Atraumatic Approach(2021-05-01T00:00:00Z) Aksoyler, Dicle; Dogan, Fatih; Bolletta, Alberto; ŞENGENÇ, ESMA; Sonmez, Taha; Yavan, Mehmet Ali; ŞENGENÇ, ESMAThe appropriate treatment of pediatric mandibular condyle fractures is subject to much debate and concern among surgeons, with improper treatment potentially resulting in a number of adverse outcomes. Such outcomes include the disruption of mandible growth, decreased posterior facial height, facial asymmetry, and temporomandibular joint ankylosis. Several surgical and nonsurgical approaches to these fractures have been described in the literature; however, each one carries its own risk of various complications. In this study, the authors illustrate a new atraumatic approach for mild to moderately displaced subcondylar fractures, with least possible complications and unexpected outcomes. In this study, 6 patients (2 female and 4 male) with unilateral medially displaced condylar base and neck fractures, angulated between 30 and 45 degrees, were treated using a novel intraoral approach. The follow-up period varied from 12 to 18 months. All patients achieved normal occlusion and had painless functioning of the temporomandibular joint with proper mouth opening (>35 mm) without any recurrence at long term follow up. This minimally invasive approach could eliminate the possibility of major complications and be considered a safe and feasible surgical technique for certain cases of pediatric mandibular condyle fracture.Publication Open Access First Case of MELAS Syndrome Presenting with Local Brain Edema Requiring Decompressive Craniectomy(2022-01-01T00:00:00Z) YEŞİLBAŞ, OSMAN; ŞENGENÇ, ESMA; Olbak, Melike Ersoy; Bako, Derya; Nizam, Oznur Gokce; SEYİTHANOĞLU, MEHMET HAKAN; Pehlivan, Davut; Ceylaner, Serdar; Icagasioglu, Dilara; Aydin, Kursad; ŞENGENÇ, ESMA; SEYİTHANOĞLU, MEHMET HAKAN; İÇAĞASIOĞLU, DİLARA FÜSUNMitochondrial encephalomyopathy, lactic acidosis, and recurrent stroke-like episodes (MELAS) syndrome is a rare but one of the most common maternally inherited multisystem disorder. Although patients with MELAS present a variable clinical profile, stroke like lesions have been detected in 90% of cases, with stroke being the first presenting symptom in 25% of cases. However, cases of local brain edema requiring decompressive craniectomy has not been reported. A 12-year-old male patient was admitted to our pediatric intensive care unit with altered mental status, seizures, and vision loss. The patient was stuporous and presented neck stiffness. Complete blood count, serum electrolytes, biochemistry (including lactate level), acute phase reactants, and repeated blood gas analysis were unremarkable. Brain magnetic resonance imaging (MRI) revealed an edematous stroke-like lesion in the right occipital lobe accompanied by brain swelling. Intravenous ceftriaxone, acyclovir, intravenous immunoglobulin (IVIG), and pulse steroid therapy were started for possible diagnosis of viral/bacterial/autoimmune encephalitis; levetiracetam, phenytoin, and an infusion of sodium thiopental were started for refractory status epilepticus; and a 3% NaCl infusion was started for local brain edema. The results of serum autoimmune encephalitis panel were negative. Further investigations for rheumatic, vascular, and metabolic disorders were unremarkable. Despite these supportive treatments, the patient was clinically decompensated due to brain swelling that progressed to the left midline shift, and he underwent decompressive craniectomy. Histologic examination of brain biopsy specimen revealed non-specific encephalitis findings. A pathogenic variant of the MT-TL1 gene (m.3243A>T), responsible for MELAS, was detected. The patient-s condition dramatically improved after specific treatment for MELAS. If the diagnosis and treatment are delayed, MELAS syndrome can cause serious brain edema, which may ultimately require decompressive craniectomy.