Background Endoscopic sinus surgery is accepted as an effective surgical approach in the manageme... more Background Endoscopic sinus surgery is accepted as an effective surgical approach in the management of chronic rhinosinusitis. Different clinical pictures can be observed in chronic rhinosinusitis with nasal polyps (CRSwNP). Unfortunately, the eradication of the disease is impossible in all cases even if it is performed by experienced surgeons. In a significant number of patients, the polyps may regenerate and symptoms may reappear more or less in different durations. Due to the complex pathophysiology of the disease, revision sinus surgery is accepted as a multifactorial problem. We investigated the possible host and surgical factors which are related to increased frequency and earlier revision surgeries in CRSwNP. Methodology Patients operated on two or more times between 2010 and 2020 were retrospectively identified. A total of 49 patients with CRSwNP (38 male, 11 female) were statistically analyzed. The effects of host and surgical factors on the frequency and duration of revision surgery in CRSwNP were assessed. Results Samter's syndrome was noted to be a significant host factor affecting recurrence and revision surgeries. In addition, we observed significantly more frequent scarring and adhesions in patients with a higher number of operations. Conclusions Patients with Samter's syndrome should be informed of possible revision surgeries. The soft and mucosapreserving technique is important for less scarring and good postoperative results.
OBJECTIVE: The most frequent and critical complications of thyroid surgery are recurrent laryngea... more OBJECTIVE: The most frequent and critical complications of thyroid surgery are recurrent laryngeal nerve palsy and hypocalcemia. In first years of the 21st century, intraoperative neuromonitoring (IONM) was introduced as a new technique to avoid the recurrent laryngeal nerve (RLN) injury. However, the role and the benefits of IONM are still controversial. In this study, we aimed to compare the postoperative complication rates during thyroid surgery with IONM usage (Group 1) and conventional direct visual technique without IONM usage (Group 2). METHODS: We conducted retrospective review of all patients undergoing thyroid surgery in Lütfiye Nuri Burat State Hospital General Surgery Department between 2014 and 2016 years. Patients have been classified in to two groups: Group 1 and 2. RESULTS: Overall, 191 patients were included in the study; Group 1 comprised 79 patients and Group 2 comprised 112 patients. Unilateral RLN paralysis was observed in 7 patients in Group 1 (8.9%) and 15 patients in Group 2 (13.4%) without any significant difference between the groups (p=0.368). Hypocalcemia was encountered in 5 patients (6.3%) in Group 1 and 18 patients (16.1%) in Group 2; this difference was statistically significant (p=0.045). Other complications (such as hematoma and suture reaction) were not significantly different. Operation time was found to be significantly shorter in Group 1 (Mean time, 93.08 min) than in Group 2 (116.54 min) (p=0.03). CONCLUSION: Proven effect of IONM on RLN paralysis is still controversial. However, easy identification of RLN, which gives more confidence to surgeon, and shorter operation time may be factors to lower hypocalcemia rates.
Objective Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be among the viral age... more Objective Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be among the viral agents that affect the audio-vestibular system. This study aimed to investigate vestibular symptoms and videonystagmographic examinations in recovered coronavirus disease 2019 (Covid-19) patients compared with the control group. Method The patients were evaluated with Vertigo Symptom Scale questionnaire and audiometric, tympanometric, stapedial reflex and videonystagmographic examinations. Results A total of 92 of the patients in the coronavirus disease 2019 patients group and 25 of the volunteers in the control group were included in the study. The mean Vertigo Symptom Scale score was found to be significantly higher (p < 0.001) in the coronavirus disease 2019 group. Furthermore, one of the hospitalised patients was diagnosed with vestibular neuritis. Conclusion The vestibular system may also be affected in some coronavirus disease 2019 patients. Although this may be seen as dizziness i...
Introduction Crooked nose deformity is a vertical axis deviation of the nasal pyramid; despite al... more Introduction Crooked nose deformity is a vertical axis deviation of the nasal pyramid; despite all advancements, it remains a significant problem to resolve. In this study, we present our I- and C-shaped crooked nose rhinoplasty results with this new osteotomy technique. Method This study included 25 patients with I- or C-shaped crooked nose deformities who underwent correction with a closed-approach let-down procedure. In this technique, the middle vault is preserved, the bony cap is mobilized and preserved, and the lateral nasal bones are equalized by a piezo device or classical osteotomes. By the mobilization of the bony cap, tension on the dorsal septum is released, and slight asymmetries are hidden behind this mobile bony cap. Results The postoperative angles for both type I and C deformities were closer to the ideal angle, and the difference was statistically significant. All patients were satisfied with their aesthetic and functional results. Conclusion In this procedure, we ...
TEZ8529Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2011.Kaynakça (s. 47-53) var.viii, 54 s. :... more TEZ8529Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2011.Kaynakça (s. 47-53) var.viii, 54 s. : res. (bzs. rnk.), tablo ; 29 cm.Aim: Larynx cancer is one of the most common cancer in the upper respiratory and gastrointestinal system. The treatment of larynx cancer is changed in last 3 or 4 decades by the improvements in conservative surgery, chemotherapy and radiotherapy. This study aimed to determine negative prognostic factors in larynx cancer after laser surgery. Materials and Methods: In this study we retrospectively analyzed 40 larynx cancer patients who were surgically treated with transoral microendoscopic laser surgery in Cukurova University Faculty of Medicine Otolaryngology Department. Patients were dived in to two groups in the name of recurrent and non-recurrent group. Patients in these groups are compared according to tumor extension to the subregions of the larynx (anterior commisure, ventricle floor and subglottic regions) and immunohistochemical expression of p53, ...
Objective:To evaluate the diagnostic value of echo-planar diffusion-weighted magnetic resonance i... more Objective:To evaluate the diagnostic value of echo-planar diffusion-weighted magnetic resonance imaging in pre-operative detection of suspected primary acquired, residual and/or recurrent cholesteatoma.Materials and methods:Fifty-eight chronic otitis media patients with suspected cholesteatoma were thus evaluated two weeks pre-operatively, and divided into group one (41 patients, no previous surgery, suspected primary acquired cholesteatoma) and group two (17 patients, previous surgery, scheduled ‘second-look’ or revision surgery for suspected residual or recurrent cholesteatoma). Patients' operative, histopathology and radiological findings were compared.Results:Cholesteatoma was found in 63 per cent of group one patients and 58 per cent of group two patients at surgery. Histopathological examination of surgical specimens indicated that imaging accurately predicted the presence or absence of cholesteatoma in 90 per cent of group one (37/41; 23 true positives, 14 true negatives)...
Epistaxis is a very common medical problem in otolaryngology practice and can usually be controll... more Epistaxis is a very common medical problem in otolaryngology practice and can usually be controlled with conservative interventions. Rarely, uncontrolled and life threatening epistaxis occurs. We present the case of a 29-year-old male who developed intractable intermittent epistaxis due to post-traumatic pseudoaneurysms arising from the cavernous segment of the left internal carotid artery. The patient was successfully treated with endovascular embolization.
International Journal of Pediatric Otorhinolaryngology, 2012
Acute invasive fungal rhinosinusitis (AIFR) is an aggressive fungal infection in immunocompromise... more Acute invasive fungal rhinosinusitis (AIFR) is an aggressive fungal infection in immunocompromised patients with high mortality rates. The aim of this study is to present our experiences on endonasal treatment in immunocompromised pediatric hematology-oncology patients with AIFR. Thirteen pediatric hematology-oncology patients treated for AIFR between March 2006 and December 2011 were analyzed retrospectively. We reviewed the following data for all patients: age, gender, predisposing disease, initial symptoms, pathological diagnosis, microbiological results, laboratory findings, surgical procedure, number of operations and treatment outcomes. Nine of 13 patients with lesions confined to sinonasal cavity were operated with endoscopic approach. Open surgery was performed in four patients, three of them had palatal and buccal lesions and one had facial skin involvement. Endoscopic approach was also used for sinonasal lesions of these four patients. A total of 7 patients died: 4 patients with progression of the underlying disease, 2 patients with sepsis and 1 patient due to renal failure. Survival rate in surgically treated patients was found 46% (6/13 patients). Endonasal endoscopic approach is both feasible and efficient technique, also enables excellent local control with less morbidity compared to open surgery. This approach is suitable for patients who are diagnosed in the early stages of AIFR and also presents a less traumatic option for patients with poor health status. Open surgical procedure should be preferred in patients with disease extending out of the sinonasal cavity.
The journal of international advanced otology, 2015
OBJECTIVE To evaluate the satisfaction of patients with a cochlear implant using a Parents' P... more OBJECTIVE To evaluate the satisfaction of patients with a cochlear implant using a Parents' Perspective Questionnaire and analyze the significant parameters. MATERIALS AND METHODS Patients who received a cochlear implant in Çukurova University between March 2002 and November 2012 were included in the study. Parents were asked to answer the Parents' Perspective Questionnaire. RESULTS The age ranges of 62 patients were 2-5 years and of 99 patients were 6-11 years and over. In total, 144 parents were satisfied with the cochlear implant. Patients who attended school had more self-confidence, and users of an implant aged over 18 months had better social relations and self-confidence. CONCLUSION Cochlear implants' positive effect on the quality of life is a fact, but parents have concerns in the preoperative and postoperative periods. Patients and parents should be informed carefully about cochlear implants. Also, patients' satisfaction is correlated with increasing durati...
118 Copyright 2018 by The Medical Bulletin of University of Health Sciences Haseki Training and R... more 118 Copyright 2018 by The Medical Bulletin of University of Health Sciences Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayınevi. Telif Hakkı 2018 Sağlık Bilimleri Üniversitesi Haseki Eğitim ve Araştırma Hastanesi Haseki Tıp Bülteni, Galenos Yayınevi tarafından basılmıştır. AddressforCorrespondence/Yaz›flmaAdresi:Ahmet Kocakusak University of Health Sciences, Haseki Training and Research Hospital, Clinic of General Surgery, İstanbul, Turkey Phone: +90 532 448 48 05 E-mail: [email protected] ORCID ID: orcid.org/0000-0001-9685-6660 Received/GeliflTarihi:16 September 2017 Accepted/KabulTarihi:28 October 2017 Total Tiroidektomide İntraoperatif Sinir Monitörizasyonunun Ses Kalitesine Etkisi
Amac: Rekurren laringeal sinir (RLN) paralizisi tiroid ameliyatinin bilinen bir komplikasyonudur.... more Amac: Rekurren laringeal sinir (RLN) paralizisi tiroid ameliyatinin bilinen bir komplikasyonudur. RLN paralizisi riskini azaltmak icin son yillarda intraoperative sinir monitorizasyonu (IONM) yontemi kullanilmaktadir. Bu calismanin amaci IONM kullanilmasinin RLN paralizisinin azaltilmasindaki potansiyel rolunu degerlendirmektir. Yontemler: Ocak 2015-Ocak 2017 tarihleri arasinda cift merkezli, retrospektif klinik bir calismada Lutfiye Nuri Burat Devlet Hastanesi ve Haseki Egitim ve Arastirma hastanesinde yapilan tiroidektomi ameliyatlari incelendi. Hastalar IONM kullanilarak yapilan troidektomi (Grup A, n=100) ve direkt gorsel teknik kullanilarak yapilan troidektomi (Grup B, n=232) olarak calismaya dahil edildi. Hastalarin dosyalari incelenerek yas, vucut kitle indeksi, cinsiyet, ASA skoru, kalsiyum seviyeleri, komplikasyonlar, ameliyat sureleri, takip sureleri incelendi. Postoperatif komplikasyonlar esas cikti olarak belirlendi. Bulgular: Calismaya tiroid operasyonu yapilan yas orta...
Thyroid gland surgery has possible serious complications. Advancements in technology have led to ... more Thyroid gland surgery has possible serious complications. Advancements in technology have led to improvements in complications but significant challenges in airway and voice security still remain. The purpose of this study was to evaluate the voice quality following total thyroidectomy under neuromonitorization and effect of intraoperative neuromonitorization (IONM) for identification of recurrent laryngeal nerve (RLN) and external branch of superior laryngeal nerve (EBSLN). Methods: A total of 80 patients planned for total thyroidectomy between May 2015 and March 2016 were included into the study. All RLN and EBSLN were identified. Voice assessment included preoperative and postoperative fiberoptic laryngoscopy, analysis of Jitter, Shimmer, fundamental frequency and ratings of voice handicap index-10. Results: Eighty patients were included in this study (71 females/9 males). The mean EMG initial and post-dissection amplitudes of both RLN and EBSLN were not significantly different. The rate of postoperative transient RLN palsy per nerve at risk was 4.375% (7/160) and null for permanent RLS palsy (0% 0/160). Conclusion: Both subjective and objective assessment revealed the preservation of voice quality in patients after total thyroidectomy under neuromonitorization. IONM may be used effectively and safely in order to identify EBSLN during thyroid surgery.
The general prognostic factors in larynx tumors are believed to be tumor stage, anatomical locati... more The general prognostic factors in larynx tumors are believed to be tumor stage, anatomical location, histological differentiation and the presence of neck metastasis. Effects of tumor invasion to sub-regions of larynx (anterior commissure, ventricle, subglottic space) and over-expression of p53, c-erb-B2 and Ki67 detected immunohistochemically on development of recurrence in patients were investigated in this study. Twenty patients (Group 1) in whom recurrence had developed and 20 others (Group 2) without recurrence during follow-up were included in this study. Both the anterior commissure and ventricle involvements were found to be more frequent in patients with recurrence. But statistically significant difference was detected with only ventricular involvement (p=0.025). After Immunohistochemical evaluation none of the 3 immunohistochemical parameters were found to be higher in the recurrence group and not any of them showed a statistically significant difference between two groups. Only ventricle involvement may be a predictor factor for recurrence.
Background Endoscopic sinus surgery is accepted as an effective surgical approach in the manageme... more Background Endoscopic sinus surgery is accepted as an effective surgical approach in the management of chronic rhinosinusitis. Different clinical pictures can be observed in chronic rhinosinusitis with nasal polyps (CRSwNP). Unfortunately, the eradication of the disease is impossible in all cases even if it is performed by experienced surgeons. In a significant number of patients, the polyps may regenerate and symptoms may reappear more or less in different durations. Due to the complex pathophysiology of the disease, revision sinus surgery is accepted as a multifactorial problem. We investigated the possible host and surgical factors which are related to increased frequency and earlier revision surgeries in CRSwNP. Methodology Patients operated on two or more times between 2010 and 2020 were retrospectively identified. A total of 49 patients with CRSwNP (38 male, 11 female) were statistically analyzed. The effects of host and surgical factors on the frequency and duration of revision surgery in CRSwNP were assessed. Results Samter's syndrome was noted to be a significant host factor affecting recurrence and revision surgeries. In addition, we observed significantly more frequent scarring and adhesions in patients with a higher number of operations. Conclusions Patients with Samter's syndrome should be informed of possible revision surgeries. The soft and mucosapreserving technique is important for less scarring and good postoperative results.
OBJECTIVE: The most frequent and critical complications of thyroid surgery are recurrent laryngea... more OBJECTIVE: The most frequent and critical complications of thyroid surgery are recurrent laryngeal nerve palsy and hypocalcemia. In first years of the 21st century, intraoperative neuromonitoring (IONM) was introduced as a new technique to avoid the recurrent laryngeal nerve (RLN) injury. However, the role and the benefits of IONM are still controversial. In this study, we aimed to compare the postoperative complication rates during thyroid surgery with IONM usage (Group 1) and conventional direct visual technique without IONM usage (Group 2). METHODS: We conducted retrospective review of all patients undergoing thyroid surgery in Lütfiye Nuri Burat State Hospital General Surgery Department between 2014 and 2016 years. Patients have been classified in to two groups: Group 1 and 2. RESULTS: Overall, 191 patients were included in the study; Group 1 comprised 79 patients and Group 2 comprised 112 patients. Unilateral RLN paralysis was observed in 7 patients in Group 1 (8.9%) and 15 patients in Group 2 (13.4%) without any significant difference between the groups (p=0.368). Hypocalcemia was encountered in 5 patients (6.3%) in Group 1 and 18 patients (16.1%) in Group 2; this difference was statistically significant (p=0.045). Other complications (such as hematoma and suture reaction) were not significantly different. Operation time was found to be significantly shorter in Group 1 (Mean time, 93.08 min) than in Group 2 (116.54 min) (p=0.03). CONCLUSION: Proven effect of IONM on RLN paralysis is still controversial. However, easy identification of RLN, which gives more confidence to surgeon, and shorter operation time may be factors to lower hypocalcemia rates.
Objective Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be among the viral age... more Objective Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be among the viral agents that affect the audio-vestibular system. This study aimed to investigate vestibular symptoms and videonystagmographic examinations in recovered coronavirus disease 2019 (Covid-19) patients compared with the control group. Method The patients were evaluated with Vertigo Symptom Scale questionnaire and audiometric, tympanometric, stapedial reflex and videonystagmographic examinations. Results A total of 92 of the patients in the coronavirus disease 2019 patients group and 25 of the volunteers in the control group were included in the study. The mean Vertigo Symptom Scale score was found to be significantly higher (p < 0.001) in the coronavirus disease 2019 group. Furthermore, one of the hospitalised patients was diagnosed with vestibular neuritis. Conclusion The vestibular system may also be affected in some coronavirus disease 2019 patients. Although this may be seen as dizziness i...
Introduction Crooked nose deformity is a vertical axis deviation of the nasal pyramid; despite al... more Introduction Crooked nose deformity is a vertical axis deviation of the nasal pyramid; despite all advancements, it remains a significant problem to resolve. In this study, we present our I- and C-shaped crooked nose rhinoplasty results with this new osteotomy technique. Method This study included 25 patients with I- or C-shaped crooked nose deformities who underwent correction with a closed-approach let-down procedure. In this technique, the middle vault is preserved, the bony cap is mobilized and preserved, and the lateral nasal bones are equalized by a piezo device or classical osteotomes. By the mobilization of the bony cap, tension on the dorsal septum is released, and slight asymmetries are hidden behind this mobile bony cap. Results The postoperative angles for both type I and C deformities were closer to the ideal angle, and the difference was statistically significant. All patients were satisfied with their aesthetic and functional results. Conclusion In this procedure, we ...
TEZ8529Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2011.Kaynakça (s. 47-53) var.viii, 54 s. :... more TEZ8529Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2011.Kaynakça (s. 47-53) var.viii, 54 s. : res. (bzs. rnk.), tablo ; 29 cm.Aim: Larynx cancer is one of the most common cancer in the upper respiratory and gastrointestinal system. The treatment of larynx cancer is changed in last 3 or 4 decades by the improvements in conservative surgery, chemotherapy and radiotherapy. This study aimed to determine negative prognostic factors in larynx cancer after laser surgery. Materials and Methods: In this study we retrospectively analyzed 40 larynx cancer patients who were surgically treated with transoral microendoscopic laser surgery in Cukurova University Faculty of Medicine Otolaryngology Department. Patients were dived in to two groups in the name of recurrent and non-recurrent group. Patients in these groups are compared according to tumor extension to the subregions of the larynx (anterior commisure, ventricle floor and subglottic regions) and immunohistochemical expression of p53, ...
Objective:To evaluate the diagnostic value of echo-planar diffusion-weighted magnetic resonance i... more Objective:To evaluate the diagnostic value of echo-planar diffusion-weighted magnetic resonance imaging in pre-operative detection of suspected primary acquired, residual and/or recurrent cholesteatoma.Materials and methods:Fifty-eight chronic otitis media patients with suspected cholesteatoma were thus evaluated two weeks pre-operatively, and divided into group one (41 patients, no previous surgery, suspected primary acquired cholesteatoma) and group two (17 patients, previous surgery, scheduled ‘second-look’ or revision surgery for suspected residual or recurrent cholesteatoma). Patients' operative, histopathology and radiological findings were compared.Results:Cholesteatoma was found in 63 per cent of group one patients and 58 per cent of group two patients at surgery. Histopathological examination of surgical specimens indicated that imaging accurately predicted the presence or absence of cholesteatoma in 90 per cent of group one (37/41; 23 true positives, 14 true negatives)...
Epistaxis is a very common medical problem in otolaryngology practice and can usually be controll... more Epistaxis is a very common medical problem in otolaryngology practice and can usually be controlled with conservative interventions. Rarely, uncontrolled and life threatening epistaxis occurs. We present the case of a 29-year-old male who developed intractable intermittent epistaxis due to post-traumatic pseudoaneurysms arising from the cavernous segment of the left internal carotid artery. The patient was successfully treated with endovascular embolization.
International Journal of Pediatric Otorhinolaryngology, 2012
Acute invasive fungal rhinosinusitis (AIFR) is an aggressive fungal infection in immunocompromise... more Acute invasive fungal rhinosinusitis (AIFR) is an aggressive fungal infection in immunocompromised patients with high mortality rates. The aim of this study is to present our experiences on endonasal treatment in immunocompromised pediatric hematology-oncology patients with AIFR. Thirteen pediatric hematology-oncology patients treated for AIFR between March 2006 and December 2011 were analyzed retrospectively. We reviewed the following data for all patients: age, gender, predisposing disease, initial symptoms, pathological diagnosis, microbiological results, laboratory findings, surgical procedure, number of operations and treatment outcomes. Nine of 13 patients with lesions confined to sinonasal cavity were operated with endoscopic approach. Open surgery was performed in four patients, three of them had palatal and buccal lesions and one had facial skin involvement. Endoscopic approach was also used for sinonasal lesions of these four patients. A total of 7 patients died: 4 patients with progression of the underlying disease, 2 patients with sepsis and 1 patient due to renal failure. Survival rate in surgically treated patients was found 46% (6/13 patients). Endonasal endoscopic approach is both feasible and efficient technique, also enables excellent local control with less morbidity compared to open surgery. This approach is suitable for patients who are diagnosed in the early stages of AIFR and also presents a less traumatic option for patients with poor health status. Open surgical procedure should be preferred in patients with disease extending out of the sinonasal cavity.
The journal of international advanced otology, 2015
OBJECTIVE To evaluate the satisfaction of patients with a cochlear implant using a Parents' P... more OBJECTIVE To evaluate the satisfaction of patients with a cochlear implant using a Parents' Perspective Questionnaire and analyze the significant parameters. MATERIALS AND METHODS Patients who received a cochlear implant in Çukurova University between March 2002 and November 2012 were included in the study. Parents were asked to answer the Parents' Perspective Questionnaire. RESULTS The age ranges of 62 patients were 2-5 years and of 99 patients were 6-11 years and over. In total, 144 parents were satisfied with the cochlear implant. Patients who attended school had more self-confidence, and users of an implant aged over 18 months had better social relations and self-confidence. CONCLUSION Cochlear implants' positive effect on the quality of life is a fact, but parents have concerns in the preoperative and postoperative periods. Patients and parents should be informed carefully about cochlear implants. Also, patients' satisfaction is correlated with increasing durati...
118 Copyright 2018 by The Medical Bulletin of University of Health Sciences Haseki Training and R... more 118 Copyright 2018 by The Medical Bulletin of University of Health Sciences Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayınevi. Telif Hakkı 2018 Sağlık Bilimleri Üniversitesi Haseki Eğitim ve Araştırma Hastanesi Haseki Tıp Bülteni, Galenos Yayınevi tarafından basılmıştır. AddressforCorrespondence/Yaz›flmaAdresi:Ahmet Kocakusak University of Health Sciences, Haseki Training and Research Hospital, Clinic of General Surgery, İstanbul, Turkey Phone: +90 532 448 48 05 E-mail: [email protected] ORCID ID: orcid.org/0000-0001-9685-6660 Received/GeliflTarihi:16 September 2017 Accepted/KabulTarihi:28 October 2017 Total Tiroidektomide İntraoperatif Sinir Monitörizasyonunun Ses Kalitesine Etkisi
Amac: Rekurren laringeal sinir (RLN) paralizisi tiroid ameliyatinin bilinen bir komplikasyonudur.... more Amac: Rekurren laringeal sinir (RLN) paralizisi tiroid ameliyatinin bilinen bir komplikasyonudur. RLN paralizisi riskini azaltmak icin son yillarda intraoperative sinir monitorizasyonu (IONM) yontemi kullanilmaktadir. Bu calismanin amaci IONM kullanilmasinin RLN paralizisinin azaltilmasindaki potansiyel rolunu degerlendirmektir. Yontemler: Ocak 2015-Ocak 2017 tarihleri arasinda cift merkezli, retrospektif klinik bir calismada Lutfiye Nuri Burat Devlet Hastanesi ve Haseki Egitim ve Arastirma hastanesinde yapilan tiroidektomi ameliyatlari incelendi. Hastalar IONM kullanilarak yapilan troidektomi (Grup A, n=100) ve direkt gorsel teknik kullanilarak yapilan troidektomi (Grup B, n=232) olarak calismaya dahil edildi. Hastalarin dosyalari incelenerek yas, vucut kitle indeksi, cinsiyet, ASA skoru, kalsiyum seviyeleri, komplikasyonlar, ameliyat sureleri, takip sureleri incelendi. Postoperatif komplikasyonlar esas cikti olarak belirlendi. Bulgular: Calismaya tiroid operasyonu yapilan yas orta...
Thyroid gland surgery has possible serious complications. Advancements in technology have led to ... more Thyroid gland surgery has possible serious complications. Advancements in technology have led to improvements in complications but significant challenges in airway and voice security still remain. The purpose of this study was to evaluate the voice quality following total thyroidectomy under neuromonitorization and effect of intraoperative neuromonitorization (IONM) for identification of recurrent laryngeal nerve (RLN) and external branch of superior laryngeal nerve (EBSLN). Methods: A total of 80 patients planned for total thyroidectomy between May 2015 and March 2016 were included into the study. All RLN and EBSLN were identified. Voice assessment included preoperative and postoperative fiberoptic laryngoscopy, analysis of Jitter, Shimmer, fundamental frequency and ratings of voice handicap index-10. Results: Eighty patients were included in this study (71 females/9 males). The mean EMG initial and post-dissection amplitudes of both RLN and EBSLN were not significantly different. The rate of postoperative transient RLN palsy per nerve at risk was 4.375% (7/160) and null for permanent RLS palsy (0% 0/160). Conclusion: Both subjective and objective assessment revealed the preservation of voice quality in patients after total thyroidectomy under neuromonitorization. IONM may be used effectively and safely in order to identify EBSLN during thyroid surgery.
The general prognostic factors in larynx tumors are believed to be tumor stage, anatomical locati... more The general prognostic factors in larynx tumors are believed to be tumor stage, anatomical location, histological differentiation and the presence of neck metastasis. Effects of tumor invasion to sub-regions of larynx (anterior commissure, ventricle, subglottic space) and over-expression of p53, c-erb-B2 and Ki67 detected immunohistochemically on development of recurrence in patients were investigated in this study. Twenty patients (Group 1) in whom recurrence had developed and 20 others (Group 2) without recurrence during follow-up were included in this study. Both the anterior commissure and ventricle involvements were found to be more frequent in patients with recurrence. But statistically significant difference was detected with only ventricular involvement (p=0.025). After Immunohistochemical evaluation none of the 3 immunohistochemical parameters were found to be higher in the recurrence group and not any of them showed a statistically significant difference between two groups. Only ventricle involvement may be a predictor factor for recurrence.
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