ObjectivesThe aim of this study was to demonstrate in a prospective multicentre study that Barbed... more ObjectivesThe aim of this study was to demonstrate in a prospective multicentre study that Barbed Reposition Pharyngoplasty (BRP) procedure is safe and effective in management of obstructive sleep apnoea/hypopnea syndrome (OSAHS) patients.DesignProspective study.SettingMulticentre study.ParticipantsPatients suffering from obstructive sleep apnoea.Main outcomes measuresValues of postoperative apnoea‐hypopnea index (AHI), oxygen desaturation index (ODI), epworth sleepiness scale (ESS).Results111 Barbed Reposition Pharyngoplasty procedures standing alone or as a part of multilevel surgery for OSAHS, performed between January and September 2016, were analysed in 15 different centres. The average hospitalisation period was 2.5 ± 0.5 days. The mean patient age was 46.3 ± 10.5 years. The average body mass index at the time of the procedure was 27.9 ± 3.2, and the majority of the patients were men (83%). The mean preoperative and postoperative apnoea/hypopnea index was 33.4 ± 19.5 and 13.5 ...
Thyroid carcinoma, treatment strategies in thyroid cancer, thyroid cancer surgery, thyroid cancer... more Thyroid carcinoma, treatment strategies in thyroid cancer, thyroid cancer surgery, thyroid cancer diagnosis, thyroid cancer biomarkers, radionuclide I 131, thyroid cancer radiotherapy, thyroid cancer targeted therapy In this Research Topic of manuscripts on New Strategies In Treatment of Thyroid Carcinoma (TC), edited by the journal Frontiers in Endocrinology, papers have been gathered that, from the perspective of basic sciences, can potentially contribute to provide issues for a better understanding of clinical problems. Moreover, molecular biology and studies designed to improve the intrinsic behavior of papillary carcinoma are pivotal in the development of targeted therapies. The study by Yang el al. tries to ellucidate the role of estrogen receptors on the stimulation of cancer cells, through a significant decrease on the levels of endogenous PPARg ligands PGJ2 and 15(S)-HETE. These findings open a venue to development of endogenous ligands PGJ2 and 15(S)-HETE, to treat papillary thyroid cancer. The role of primary cilia alterations in differentiated TC and its absence in the anaplastic variety is described, as well as its relationship to the presence of the Aurore kinase protein, which is linked to disassembly of these cilia in TC. The article by Ma et al. describes these phenomenae, as well as the possibility of other biochemical pathways implicated with these organelles like Nek1 and Plk1, with the possibility of developing drugs which could restore the physiology of primary cilia of thyroid cells like U0126 and ganetespib. TC has increased its incidence and prevalence during the last 20 years. This is secondary to a better understanding of its presentation, as well as of diagnostic studies performed at present, from which, different image tests like high definition ultrasound, CT scan and aspiration biopsy represent the most relevant ones. On the other hand, a significant number of reports attest to efforts to improve the diagnosis potential of the aforementioned tests. In this e-book the report by Zhang et al., establishes the modification of plasma N-glycome alteration in Thyroid Carcinoma and Frontiers in Endocrinology frontiersin.org 01
Aspirin desensitization (AD) treatment at doses of up to 1300 mg/day improves outcomes in aspirin... more Aspirin desensitization (AD) treatment at doses of up to 1300 mg/day improves outcomes in aspirin-exacerbated respiratory disease (AERD). The aim of this study was to investigate the efficacy of aspirin 300 mg/day in the treatment of patients with AERD. The study included 40 patients diagnosed in our clinic as AERD that were desensitized and treated with aspirin 300 mg/day between December 2005 and December 2012. Changes from the baseline status were analyzed at 1 year and at 3 years of follow-up. Of the 40 patients included, 24 (60%) were female and median (interquartile range [IQR]) age was 45 (40-51) years. Median (IQR) duration of AD was 31.5 (10.5-48.5) months. In total, 29 patients continued treatment for at least 1 year and 18 patients for at least 3 years. The annual rate of use of systemic corticosteroid regimens, episodes of sinusitis, and surgery was significantly lower both at 1 year (P = 0.002, P = 0.01, and P < 0.001, respectively) and at 3 years (P = 0.001, P = 0.03, and P = 0.002, respectively). Significant improvement was observed in the nasal congestion score (P = 0.01) and sense of smell score (P = 0.05) at 1 year and in the postnasal drainage score (P = 0.01) at 3 years. Daily treatment with aspirin 300 mg had beneficial effects in patients with AERD, especially for the control of upper airway disease.
PurposeTo compare conventional and endoscopic probing for congenital nasolacrimal duct obstructio... more PurposeTo compare conventional and endoscopic probing for congenital nasolacrimal duct obstruction in infants.MethodsConventional probing was performed in 22 eyes of 18 patients, age range 7–14 months (mean 11.4 months). Probing was done with intranasal endoscopic visualization in 18 eyes of 14 patients, age range 7–13 months (mean 11.2 months). All were primary probing cases.ResultsAfter conventional probing 2 of the 22 cases required reprobing. After endoscopic probing only 1 of the 18 cases required reprobing.ConclusionsIn most cases of congenital nasolacrimal duct obstruction endoscopy is not required; however, in failed cases direct visualization of the inferior meatus with endoscopic guidance may be helpful.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
Indian Journal of Otolaryngology and Head & Neck Surgery, Mar 26, 2022
A 61-year-old male patient came to our hospital with complaints of unilateral transparent nasal d... more A 61-year-old male patient came to our hospital with complaints of unilateral transparent nasal discharge increasing while bending down. He was tested for Covid-19 PCR a month ago due to symptoms similar to flu. Shortly after the tests, his complaints about unilateral rhinorrhea have started. The Beta-2 transferrin test applied in order to understand the rhinorrhea etiology came up positive for CSF. No other specialty has been identified in the patient's history. There was no history of nasal surgery or nasal trauma. The checks for chronic sinusitis and allergic rhinitis were negative. Anterior rhinoscopy and fiber optical nasopharyngoscopy were also normal. In the paranasal computed tomography (CT) opacifications inside the left sphenoid sinus (Fig. 1) were detected. In the magnetic resonance imaging (MRI) cisternography, encephalocele herniated inside the sinus via bone defection on the inferolateral wall of sphenoid sinus. Under the light of these indications, repairment of defects through endoscopic sinus surgery (ESS) was scheduled for our patient. Intracheal fluorescein was given to the patient before the operation. After opening the ethmoid cells, the sphenoid sinus ostium was located and fluorescein was seen inside it. No additional pathology causing rhinorrhea in the cribriform plate, fovea etmoidalis and lateral lamella was detected. Graft prepared from temporal fascia was laid
ObjectiveThis study was performed on fresh frozen cadavers to investigate the role of angular art... more ObjectiveThis study was performed on fresh frozen cadavers to investigate the role of angular artery damage.MethodsLateral osteotomies (‘high-low-high’ method) were carried out bilaterally, with a 4 mm guarded lateral osteotome, after the creation of a subperiosteal tunnel. Following completion of the lateral osteotomy, a skin incision was made in the midline dorsum. The dermis and subcutaneous tissues were carefully dissected, taking care not to damage the angular artery. Overlying tissues were cut and retracted to show the course of the angular artery.ResultsThe angular artery was not damaged in any of the cadavers. The angular artery was always lateral to the lateral osteotomy line.ConclusionThe high-low-high lateral osteotomy does not damage or traumatise the angular artery. The ecchymosis and oedema are related to other factors.
INTRODUCTION Surgical treatment of medium and large sized nasal septal perforation is challenging... more INTRODUCTION Surgical treatment of medium and large sized nasal septal perforation is challenging. Techniques with and without interposition grafts are used. OBJECTIVE The aim of this study is to explain how we apply the sandwich graft technique that we use in medium and large nasal septal perforations as well as to present the results. METHODS We retrospectively reviewed the patients who were operated with the sandwich graft technique between January 2014 to December 2018 and followed up for at least 6 months. The demographic data, symptom scores, examination, and surgical findings of the patients were taken from the hospital records. Surgical outcomes were presented according to both perforation etiologies (idiopathic or iatrogenic) and sizes (Group A: < 2 cm, Group B: ≥ 2 cm). RESULTS We reviewed 52 cases and 56 surgeries. The average diameter of the perforations was 19.2 mm. The success rate after initial surgeries was 84.6% (44/52). After 4 revision surgeries, the perforation was closed in 88.5% of the cases (46/52). Success rates for Group A and Group B were 90.0% and 86.4%, respectively (p = 0.689). The success rates in idiopathic and iatrogenic cases were 93.3% and 86.5%, respectively (p = 0.659). CONCLUSION This study showed that the success rate of sandwich graft technique was higher in medium-sized perforations than large-sized ones and in idiopathic perforations compared to iatrogenic ones, but the latter rate was not statistically significant. This demonstrated that perforation size was not as important in the sandwich graft technique as in flap techniques.
Hereditary hemorrhagic talengiectasia is a rare disorder characterized by vascular talengiectases... more Hereditary hemorrhagic talengiectasia is a rare disorder characterized by vascular talengiectases in mucocutaneous tissues. Septodermoplasty is one of the treatment options for controlling recurrent and prolonged epistaxis. The principle of septodermoplasty is to replace the fragile nasal mucosa with split-thickness skin graft. In this report we aimed to describe a new suture technique that can be applied for securing the graft. From September 2014 to March 2016, we performed 6 septodermoplasty operations by using a new suture technique. Securing the graft in septodermoplasty operation by suturing provides an efficient and safe fixation of graft in all of the patients. We would recommend this cost effective technique as an alternative method for septodermoplasty operations. Key words: Hereditary hemorrhagic talengiectasia, septodermoplasty, epistaxis
The results of isosorbide treatment which was used in twenty patients who had been diagnosed as M... more The results of isosorbide treatment which was used in twenty patients who had been diagnosed as Meniere’s disease were presented. Isosorbide was found most effective on the control of vertigo (% 70). The hearing improvement was observed in five patients, however it was temporary, returning to . its ' pretreatment levels after treatment. Isosorbide is a drug which should be chosen in the treatment of the acute attack of Meniere’s disease.
Dorsal cyst, one of the long-term complications of rhinoplasty, is rare, and very few cases have ... more Dorsal cyst, one of the long-term complications of rhinoplasty, is rare, and very few cases have been reported in the literature. These cysts are mostly mucous cysts and are caused by the transplantation of the mucosa into the ectopic subcutaneous structures or by different materials that cause a foreign body reaction. Here, we present a case of a 28year-old female patient with a nasal dorsal cyst that developed 10 years after a primary rhinoplasty. Since the cyst, which grew progressively over time, caused deformity and deformity in the nasal roof, it was totally excised and revision rhinoplasty was performed. No complications were seen during and after the surgery.
Objective: Osteomas represent the most common benign tumors of the paranasal sinuses. In spite of... more Objective: Osteomas represent the most common benign tumors of the paranasal sinuses. In spite of being slowgrowing and usually asymptomatic, osteomas can cause symptoms depending on their size, location, and extension to the adjacent anatomical structures. The aim of this study was to investigate and discuss the clinical features and surgical management of patients with paranasal sinus osteomas who were treated in one center. Material and Methods: A retrospective chart review of 40 patients undergoing surgical treatment for paranasal sinus osteoma between January, 2005 and December, 2019 was carried out. Patients' demographic characteristics, presenting symptoms, osteoma size and location, imaging findings, and surgical outcomes were analyzed. Results: The mean duration of follow-up was 31 months (range, 6-122 months). The most frequently affected site was the frontal sinus (55%), followed by the frontoethmoid region (27.5%) and the ethmoid sinus (7.5%). Headache was found to be associated with frontal sinus osteomas (p=0.014). Besides, extra-sinusal extension was observed in 10 (25%) patients. While 20 (50%) patients were treated with a purely endonasal endoscopic technique, an external technique was most commonly used for frontal sinus osteomas (p=0.035). There were no major surgical complications in 33 patients (85%); complete resection, however, could not be successfully achieved in 6 patients (15% residual tumor rate), 2 of whom subsequently underwent revision surgery (5% revision rate). Conclusion: Paranasal sinus oteomas are benign, slow-growing, and usually asymptomatic lesions with potentially important complications. That being said, surgical removal remains the treatment of choice for symptomatic or rapidly growing osteomas of the paranasal sinuses.
Heart rate variability (HRV) is a non-invasive and sensitive method used to evaluate autonomic fu... more Heart rate variability (HRV) is a non-invasive and sensitive method used to evaluate autonomic function of the heart based on specific polysomnographic parameters. This study aimed to determine the effect of expansion sphincter pharyngoplasty (ESP) on HRV and the apnea hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). Materials and Methods This retrospective cohort study included patients that presented to Hacettepe University Hospital, Department of Otorhinolaryngology, were diagnosed as OSA, and underwent ESP. Patient medical records, including demographic data, polysomnography findings, and HRV parameters were reviewed. The predictor variable was the effect of ESP on the AHI and the primary outcome variables were HRV parameters. Descriptive and bivariate statistics were computed using the chi-square test, t-test, and Mann-Whitney U test. Results Mean age of the 28 patients (20 male and 8 female) was 43 ± 9.9 years. Surgical success (AHI <20 and a 50% decrease in the AHI) was achieved in 16 (57.1%) patients. The AHI decreased in 22 (78.6%) patients, versus increased in 6 (21.4%) patients following ESP.
Kulak burun boğaz ihtisas dergisi : KBB = Journal of ear, nose, and throat, 2006
This study was designed to compare two endoscopic examination methods, the Muller maneuver (MM) a... more This study was designed to compare two endoscopic examination methods, the Muller maneuver (MM) and fiberoptic pharyngoscopy during sleep, both of which are used to detect obstructed segments in patients with obstructive sleep apnea. The study included 28 patients (23 males, 5 females; mean age 44.6 years; range 28 to 59 years) who underwent uvulopalatopharyngoplasty (UPPP) for snoring or obstructive sleep apnea. Obstruction was examined both at the level of the soft palate and tongue base while the patients were awake and asleep and was scored. The Muller maneuver was performed in the sitting and supine positions. In addition, fiberoptic pharyngoscopy was performed right after induction of anesthesia. The results of the two methods were compared. Changes in body position were not associated with significant differences in the results of MM. The two methods were found to be highly discordant, in that a greater degree of obstruction was noted especially at the level of the soft palat...
ObjectivesThe aim of this study was to demonstrate in a prospective multicentre study that Barbed... more ObjectivesThe aim of this study was to demonstrate in a prospective multicentre study that Barbed Reposition Pharyngoplasty (BRP) procedure is safe and effective in management of obstructive sleep apnoea/hypopnea syndrome (OSAHS) patients.DesignProspective study.SettingMulticentre study.ParticipantsPatients suffering from obstructive sleep apnoea.Main outcomes measuresValues of postoperative apnoea‐hypopnea index (AHI), oxygen desaturation index (ODI), epworth sleepiness scale (ESS).Results111 Barbed Reposition Pharyngoplasty procedures standing alone or as a part of multilevel surgery for OSAHS, performed between January and September 2016, were analysed in 15 different centres. The average hospitalisation period was 2.5 ± 0.5 days. The mean patient age was 46.3 ± 10.5 years. The average body mass index at the time of the procedure was 27.9 ± 3.2, and the majority of the patients were men (83%). The mean preoperative and postoperative apnoea/hypopnea index was 33.4 ± 19.5 and 13.5 ...
Thyroid carcinoma, treatment strategies in thyroid cancer, thyroid cancer surgery, thyroid cancer... more Thyroid carcinoma, treatment strategies in thyroid cancer, thyroid cancer surgery, thyroid cancer diagnosis, thyroid cancer biomarkers, radionuclide I 131, thyroid cancer radiotherapy, thyroid cancer targeted therapy In this Research Topic of manuscripts on New Strategies In Treatment of Thyroid Carcinoma (TC), edited by the journal Frontiers in Endocrinology, papers have been gathered that, from the perspective of basic sciences, can potentially contribute to provide issues for a better understanding of clinical problems. Moreover, molecular biology and studies designed to improve the intrinsic behavior of papillary carcinoma are pivotal in the development of targeted therapies. The study by Yang el al. tries to ellucidate the role of estrogen receptors on the stimulation of cancer cells, through a significant decrease on the levels of endogenous PPARg ligands PGJ2 and 15(S)-HETE. These findings open a venue to development of endogenous ligands PGJ2 and 15(S)-HETE, to treat papillary thyroid cancer. The role of primary cilia alterations in differentiated TC and its absence in the anaplastic variety is described, as well as its relationship to the presence of the Aurore kinase protein, which is linked to disassembly of these cilia in TC. The article by Ma et al. describes these phenomenae, as well as the possibility of other biochemical pathways implicated with these organelles like Nek1 and Plk1, with the possibility of developing drugs which could restore the physiology of primary cilia of thyroid cells like U0126 and ganetespib. TC has increased its incidence and prevalence during the last 20 years. This is secondary to a better understanding of its presentation, as well as of diagnostic studies performed at present, from which, different image tests like high definition ultrasound, CT scan and aspiration biopsy represent the most relevant ones. On the other hand, a significant number of reports attest to efforts to improve the diagnosis potential of the aforementioned tests. In this e-book the report by Zhang et al., establishes the modification of plasma N-glycome alteration in Thyroid Carcinoma and Frontiers in Endocrinology frontiersin.org 01
Aspirin desensitization (AD) treatment at doses of up to 1300 mg/day improves outcomes in aspirin... more Aspirin desensitization (AD) treatment at doses of up to 1300 mg/day improves outcomes in aspirin-exacerbated respiratory disease (AERD). The aim of this study was to investigate the efficacy of aspirin 300 mg/day in the treatment of patients with AERD. The study included 40 patients diagnosed in our clinic as AERD that were desensitized and treated with aspirin 300 mg/day between December 2005 and December 2012. Changes from the baseline status were analyzed at 1 year and at 3 years of follow-up. Of the 40 patients included, 24 (60%) were female and median (interquartile range [IQR]) age was 45 (40-51) years. Median (IQR) duration of AD was 31.5 (10.5-48.5) months. In total, 29 patients continued treatment for at least 1 year and 18 patients for at least 3 years. The annual rate of use of systemic corticosteroid regimens, episodes of sinusitis, and surgery was significantly lower both at 1 year (P = 0.002, P = 0.01, and P &lt; 0.001, respectively) and at 3 years (P = 0.001, P = 0.03, and P = 0.002, respectively). Significant improvement was observed in the nasal congestion score (P = 0.01) and sense of smell score (P = 0.05) at 1 year and in the postnasal drainage score (P = 0.01) at 3 years. Daily treatment with aspirin 300 mg had beneficial effects in patients with AERD, especially for the control of upper airway disease.
PurposeTo compare conventional and endoscopic probing for congenital nasolacrimal duct obstructio... more PurposeTo compare conventional and endoscopic probing for congenital nasolacrimal duct obstruction in infants.MethodsConventional probing was performed in 22 eyes of 18 patients, age range 7–14 months (mean 11.4 months). Probing was done with intranasal endoscopic visualization in 18 eyes of 14 patients, age range 7–13 months (mean 11.2 months). All were primary probing cases.ResultsAfter conventional probing 2 of the 22 cases required reprobing. After endoscopic probing only 1 of the 18 cases required reprobing.ConclusionsIn most cases of congenital nasolacrimal duct obstruction endoscopy is not required; however, in failed cases direct visualization of the inferior meatus with endoscopic guidance may be helpful.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
Indian Journal of Otolaryngology and Head & Neck Surgery, Mar 26, 2022
A 61-year-old male patient came to our hospital with complaints of unilateral transparent nasal d... more A 61-year-old male patient came to our hospital with complaints of unilateral transparent nasal discharge increasing while bending down. He was tested for Covid-19 PCR a month ago due to symptoms similar to flu. Shortly after the tests, his complaints about unilateral rhinorrhea have started. The Beta-2 transferrin test applied in order to understand the rhinorrhea etiology came up positive for CSF. No other specialty has been identified in the patient's history. There was no history of nasal surgery or nasal trauma. The checks for chronic sinusitis and allergic rhinitis were negative. Anterior rhinoscopy and fiber optical nasopharyngoscopy were also normal. In the paranasal computed tomography (CT) opacifications inside the left sphenoid sinus (Fig. 1) were detected. In the magnetic resonance imaging (MRI) cisternography, encephalocele herniated inside the sinus via bone defection on the inferolateral wall of sphenoid sinus. Under the light of these indications, repairment of defects through endoscopic sinus surgery (ESS) was scheduled for our patient. Intracheal fluorescein was given to the patient before the operation. After opening the ethmoid cells, the sphenoid sinus ostium was located and fluorescein was seen inside it. No additional pathology causing rhinorrhea in the cribriform plate, fovea etmoidalis and lateral lamella was detected. Graft prepared from temporal fascia was laid
ObjectiveThis study was performed on fresh frozen cadavers to investigate the role of angular art... more ObjectiveThis study was performed on fresh frozen cadavers to investigate the role of angular artery damage.MethodsLateral osteotomies (‘high-low-high’ method) were carried out bilaterally, with a 4 mm guarded lateral osteotome, after the creation of a subperiosteal tunnel. Following completion of the lateral osteotomy, a skin incision was made in the midline dorsum. The dermis and subcutaneous tissues were carefully dissected, taking care not to damage the angular artery. Overlying tissues were cut and retracted to show the course of the angular artery.ResultsThe angular artery was not damaged in any of the cadavers. The angular artery was always lateral to the lateral osteotomy line.ConclusionThe high-low-high lateral osteotomy does not damage or traumatise the angular artery. The ecchymosis and oedema are related to other factors.
INTRODUCTION Surgical treatment of medium and large sized nasal septal perforation is challenging... more INTRODUCTION Surgical treatment of medium and large sized nasal septal perforation is challenging. Techniques with and without interposition grafts are used. OBJECTIVE The aim of this study is to explain how we apply the sandwich graft technique that we use in medium and large nasal septal perforations as well as to present the results. METHODS We retrospectively reviewed the patients who were operated with the sandwich graft technique between January 2014 to December 2018 and followed up for at least 6 months. The demographic data, symptom scores, examination, and surgical findings of the patients were taken from the hospital records. Surgical outcomes were presented according to both perforation etiologies (idiopathic or iatrogenic) and sizes (Group A: < 2 cm, Group B: ≥ 2 cm). RESULTS We reviewed 52 cases and 56 surgeries. The average diameter of the perforations was 19.2 mm. The success rate after initial surgeries was 84.6% (44/52). After 4 revision surgeries, the perforation was closed in 88.5% of the cases (46/52). Success rates for Group A and Group B were 90.0% and 86.4%, respectively (p = 0.689). The success rates in idiopathic and iatrogenic cases were 93.3% and 86.5%, respectively (p = 0.659). CONCLUSION This study showed that the success rate of sandwich graft technique was higher in medium-sized perforations than large-sized ones and in idiopathic perforations compared to iatrogenic ones, but the latter rate was not statistically significant. This demonstrated that perforation size was not as important in the sandwich graft technique as in flap techniques.
Hereditary hemorrhagic talengiectasia is a rare disorder characterized by vascular talengiectases... more Hereditary hemorrhagic talengiectasia is a rare disorder characterized by vascular talengiectases in mucocutaneous tissues. Septodermoplasty is one of the treatment options for controlling recurrent and prolonged epistaxis. The principle of septodermoplasty is to replace the fragile nasal mucosa with split-thickness skin graft. In this report we aimed to describe a new suture technique that can be applied for securing the graft. From September 2014 to March 2016, we performed 6 septodermoplasty operations by using a new suture technique. Securing the graft in septodermoplasty operation by suturing provides an efficient and safe fixation of graft in all of the patients. We would recommend this cost effective technique as an alternative method for septodermoplasty operations. Key words: Hereditary hemorrhagic talengiectasia, septodermoplasty, epistaxis
The results of isosorbide treatment which was used in twenty patients who had been diagnosed as M... more The results of isosorbide treatment which was used in twenty patients who had been diagnosed as Meniere’s disease were presented. Isosorbide was found most effective on the control of vertigo (% 70). The hearing improvement was observed in five patients, however it was temporary, returning to . its ' pretreatment levels after treatment. Isosorbide is a drug which should be chosen in the treatment of the acute attack of Meniere’s disease.
Dorsal cyst, one of the long-term complications of rhinoplasty, is rare, and very few cases have ... more Dorsal cyst, one of the long-term complications of rhinoplasty, is rare, and very few cases have been reported in the literature. These cysts are mostly mucous cysts and are caused by the transplantation of the mucosa into the ectopic subcutaneous structures or by different materials that cause a foreign body reaction. Here, we present a case of a 28year-old female patient with a nasal dorsal cyst that developed 10 years after a primary rhinoplasty. Since the cyst, which grew progressively over time, caused deformity and deformity in the nasal roof, it was totally excised and revision rhinoplasty was performed. No complications were seen during and after the surgery.
Objective: Osteomas represent the most common benign tumors of the paranasal sinuses. In spite of... more Objective: Osteomas represent the most common benign tumors of the paranasal sinuses. In spite of being slowgrowing and usually asymptomatic, osteomas can cause symptoms depending on their size, location, and extension to the adjacent anatomical structures. The aim of this study was to investigate and discuss the clinical features and surgical management of patients with paranasal sinus osteomas who were treated in one center. Material and Methods: A retrospective chart review of 40 patients undergoing surgical treatment for paranasal sinus osteoma between January, 2005 and December, 2019 was carried out. Patients' demographic characteristics, presenting symptoms, osteoma size and location, imaging findings, and surgical outcomes were analyzed. Results: The mean duration of follow-up was 31 months (range, 6-122 months). The most frequently affected site was the frontal sinus (55%), followed by the frontoethmoid region (27.5%) and the ethmoid sinus (7.5%). Headache was found to be associated with frontal sinus osteomas (p=0.014). Besides, extra-sinusal extension was observed in 10 (25%) patients. While 20 (50%) patients were treated with a purely endonasal endoscopic technique, an external technique was most commonly used for frontal sinus osteomas (p=0.035). There were no major surgical complications in 33 patients (85%); complete resection, however, could not be successfully achieved in 6 patients (15% residual tumor rate), 2 of whom subsequently underwent revision surgery (5% revision rate). Conclusion: Paranasal sinus oteomas are benign, slow-growing, and usually asymptomatic lesions with potentially important complications. That being said, surgical removal remains the treatment of choice for symptomatic or rapidly growing osteomas of the paranasal sinuses.
Heart rate variability (HRV) is a non-invasive and sensitive method used to evaluate autonomic fu... more Heart rate variability (HRV) is a non-invasive and sensitive method used to evaluate autonomic function of the heart based on specific polysomnographic parameters. This study aimed to determine the effect of expansion sphincter pharyngoplasty (ESP) on HRV and the apnea hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). Materials and Methods This retrospective cohort study included patients that presented to Hacettepe University Hospital, Department of Otorhinolaryngology, were diagnosed as OSA, and underwent ESP. Patient medical records, including demographic data, polysomnography findings, and HRV parameters were reviewed. The predictor variable was the effect of ESP on the AHI and the primary outcome variables were HRV parameters. Descriptive and bivariate statistics were computed using the chi-square test, t-test, and Mann-Whitney U test. Results Mean age of the 28 patients (20 male and 8 female) was 43 ± 9.9 years. Surgical success (AHI <20 and a 50% decrease in the AHI) was achieved in 16 (57.1%) patients. The AHI decreased in 22 (78.6%) patients, versus increased in 6 (21.4%) patients following ESP.
Kulak burun boğaz ihtisas dergisi : KBB = Journal of ear, nose, and throat, 2006
This study was designed to compare two endoscopic examination methods, the Muller maneuver (MM) a... more This study was designed to compare two endoscopic examination methods, the Muller maneuver (MM) and fiberoptic pharyngoscopy during sleep, both of which are used to detect obstructed segments in patients with obstructive sleep apnea. The study included 28 patients (23 males, 5 females; mean age 44.6 years; range 28 to 59 years) who underwent uvulopalatopharyngoplasty (UPPP) for snoring or obstructive sleep apnea. Obstruction was examined both at the level of the soft palate and tongue base while the patients were awake and asleep and was scored. The Muller maneuver was performed in the sitting and supine positions. In addition, fiberoptic pharyngoscopy was performed right after induction of anesthesia. The results of the two methods were compared. Changes in body position were not associated with significant differences in the results of MM. The two methods were found to be highly discordant, in that a greater degree of obstruction was noted especially at the level of the soft palat...
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