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Öğe Anesthesia Management in Patients With Choanal Atresia(Lippincott Williams & Wilkins, 2016) Yildirim, Zeynep Baysal; Akdag, Mehmet; Celik, Feyzi; Baysal, ElifBackground:In this study, the anaesthetic management of newborn and infant patients who underwent surgery for choanal atresia between 2009 and 2016 is discussed in the light of recently published literature.Methods:The diagnoses, demographic data, anaesthetic risk and duration, additional anomalies, airway management, and complications that arose in 41 patients with choanal atresia who were operated on between 2009 and 2016 were evaluated retrospectively by examining their medical and anaesthesia records.Results:The patients were divided into 2 groups: Group Ibilateral choanal atresia and Group IIunilateral choanal atresia. Of the 41 patients included in the study, 24 (58.53%) were in the bilateral group, and 17 (41.46%) were in the unilateral group. Fifteen (34.1%) of the patients were male, and 26 (59.1%) of the patients were female. The mean age of the 24 patients in Group I was 25.86 days (3-72), and the mean age of the 17 patients in Group II was 171.08 days (81-365). Additional congenital anomalies were present in 13 of the patients in the bilateral choanal atresia group and 3 of the patients in the unilateral choanal atresia group.Seven patients from Groups I and 2 patients from Group II were determined to have difficult airways. The laryngoscopic images from these patients were classified as grades 3 and 4 according to the Cormack-Lehane classification system. When the durations of anesthesia in the groups were compared, the duration of anesthesia in Group I was found to be significantly longer (Table 3). Anesthesia-related complications were observed in 9 patients (37.5%) from the bilateral choanal atresia group and in 4 patients (2.3%) from the unilateral atresia group. Steroids were used as prophylactics in these patients.Conclusions:Congenital anomalies and their associated risks, as well as intubation and ventilation problems and the complications that might arise, must be considered in addition to anesthetic management when repairing choanal atresia in newborn and infant patients.Öğe Assessment of Technetium-99m Labeled Macroaggregated Albumin Rhinoscintigraphy for the Measurement of Nasal Mucociliary Transport Rate: Intratest, Interobserver, and Intraobserver Reproducibility(Hindawi Ltd, 2014) Dostbil, Zeki; Dag, Yusuf; Cetinkaya, Ozlem; Akdag, Mehmet; Tasdemir, BekirObjectives. The measurement of mucociliary transport velocity by rhinoscintigraphy with Tc-99m-macroaggregated albumin (Tc-99m-MAA) is reliable measure of mucociliary clearance. The aim of this study is to assess the intratest, interobserver, and intraobserver reproducibility of nasal mucociliary transport rate (NMTR) measurement. Materials and Methods. Twenty-two subjects were evaluated to determine intratest reproducibility and a group of 35 subjects was examined to determine inter and intraobserver reproducibility. Rhinoscintigraphy with Tc-99m-MAA was used to measure NMTR in all study subjects. Paired NMTR measurements were compared using a range of statistical methodologies. Intraclass correlation coefficients (ICC) and repeatability coefficients and Bland-Altman plots were applied to assess the degree of intratest, interobserver, and intraobserver variation. Results. Statistical analysis of test and retest experiments demonstrated the statistical equivalence of intratest NMTR measurements, interobserver NMTR measurements, and intraobserver NMTR measurements. The intratest ICC, interobserver ICC, and intraobserver ICC were 0.96, 0.83, and 0.91, respectively, indicating that intratest and intraobserver reproducibility are excellent and interobserver reproducibility is good. Conclusions. Rhinoscintigraphy using Tc-99m-MAAresults in highly reproducible measurement of NMTR. The use of radionuclide imaging in measuring NMTR results in excellent intratest and intraobserver reproducibility and good interobserver reliability.Öğe Can deep learning replace histopathological examinations in the differential diagnosis of cervical lymphadenopathy?(Springer, 2024) Can, Sermin; Turk, Omer; Ayral, Muhammed; Kozan, Gunay; Ari, Hamza; Akdag, Mehmet; Baylan, Muezeyyen YildirimIntroductionWe aimed to develop a diagnostic deep learning model using contrast-enhanced CT images and to investigate whether cervical lymphadenopathies can be diagnosed with these deep learning methods without radiologist interpretations and histopathological examinations.Material methodA total of 400 patients who underwent surgery for lymphadenopathy in the neck between 2010 and 2022 were retrospectively analyzed. They were examined in four groups of 100 patients: the granulomatous diseases group, the lymphoma group, the squamous cell tumor group, and the reactive hyperplasia group. The diagnoses of the patients were confirmed histopathologically. Two CT images from all the patients in each group were used in the study. The CT images were classified using ResNet50, NASNetMobile, and DenseNet121 architecture input.ResultsThe classification accuracies obtained with ResNet50, DenseNet121, and NASNetMobile were 92.5%, 90.62, and 87.5, respectively.ConclusionDeep learning is a useful diagnostic tool in diagnosing cervical lymphadenopathy. In the near future, many diseases could be diagnosed with deep learning models without radiologist interpretations and invasive examinations such as histopathological examinations. However, further studies with much larger case series are needed to develop accurate deep-learning models.Öğe Cultural adaptation of an olfactory test: the odour in bottle test (vol 52, pg 172, 2014)(Int Rhinologic Soc, 2014) Gul, Aylin; Akdag, Mehmet; Ozkurt, Fazil Emre; Yilmaz, Beyhan; Sengul, Engin; Bakir, Salih; Topcu, Ismail[Abstract Not Available]Öğe Does Short Term Usage of Fresh Pomegranate Juice (FPJ) Protect Cochlear Hair Cells after Cisplatin-Based Chemo-Irradiation?(Aves, 2014) Akdag, Mehmet; Dasdag, Suleyman; Alabalik, Ulas; Yilmaz, Beyhan; Altas, Sevcan; Zincircioglu, Seyit Burhanedtin; Gul, AylinOBJECTIVE: The aim of this study was to investigate the protective effect of short-term usage of fresh pomegranate juice (FPJ) on ototoxicity after cisplatin-based chemo-irradiation. MATERIALS and METHODS: The study was carried out on 56 adult Wistar Albino rats, which were divided into 8 groups (n: 7 for each group). The first group was accepted as the sham control group. However, rats in the seven experimental groups were treated with FPJ; cisplatin; irradiation; irradiation plus FPJ; cisplatin plus FPJ; both cisplatin and irradiation; and combined use of cisplatin, irradiation, and FPJ, respectively. Ototoxicity was evaluated by Distortion Product Otoacoustic Emissions (DPOA), histopathology, and paracochlear protein carbonyl content. RESULTS: The results of the study showed that cisplatin, irradiation, and both cisplatin and irradiation treatments affected hair cells dramatically. However, the results of cisplatin plus FPJ and combined use of cisplatin, irradiation, and FPJ indicated that FPJ plays an important role in protecting hair cells in the inner ear. Additionally, the findings of signal-noise ratio and protein carbonyl values also supported the results stated above. CONCLUSION: Fresh pomegranate juice treatment can be a supportive agent to reduce hair cell injury in the inner ear of patient treated by cisplatin, radiotherapy, or cisplatin-based chemo-irradiation. However, more performance is necessary for further studies, especially on long-term treatment with FPJ.Öğe Does usage of a room air freshener affect the nasal mucosa?(Sage Publications Inc, 2014) Akdag, Mehmet; Bakir, Salih; Alabalik, Ulas; Ozkurt, Fazil Emre; Topcu, IsmailBackground: Effects of chemicals emitted from the room air freshener sprays (RAFSs) on nasal mucosa are still unclear. The purpose of this study was to investigate effects of RAFSs on the nasal mucosa of rats for different time intervals. Methods: Twenty-eight rats were randomly divided into four experimental groups: group 1 (n = 7) was the control group and not exposed to RAFS or other chemicals, group 2 (n = 7) was exposed to RAFS for 1 month, group 3 (n = 7) was exposed to RAFS for 2 months, and group 4 (n = 7) was exposed to RAFS for 3 months. Samples from the nasal septum were stained using hematoxylin and eosin solution, examined by a pathologist using a light microscope, and analyzed with Fisher's exact test. Results: We observed that distinct histopathological differences in the nasal mucosa of exposed rats depends on different time intervals (p < 0.05). Increased congestion was found after the 1st month of exposure (group 2). Although edema and mild inflammatory cell infiltration, including some eosinophils, was seen after the 2nd month (group 3), squamous metaplasia, numerous eosinophils, and intense inflammatory cell infiltration began after 3 months of exposure (group 4). Conclusion: Our results showed that continuous use of RAFS can cause inflammation and eosinophilic infiltration in rats, which begins after 2 months of exposure and may lead to metaplasia after 3 months. Because of differences in body size, geometry, and physiological responses of rats, the extrapolation of these results to humans is not straightforward. However, any such comparison should be made with caution. Finally, more performance is necessary to clarify this subject.Öğe Effects of caffeic acid phenethyl ester on wound healing of nasal mucosa in the rat: an experimental study(W B Saunders Co-Elsevier Inc, 2014) Kinis, Vefa; Ozbay, Musa; Akdag, Mehmet; Alabalik, Ulas; Gul, Aylin; Yilmaz, Beyhan; Ozkan, HakanPurpose: Wound healing of the nasal mucosa is a highly complex process that restores the anatomical and functional integrity of tissue that has been exposed to trauma. In this experimental study, our aim was to use histopathological examination to investigate the effects of caffeic acid phenethyl ester on the wound healing of rat nasal mucosa after mechanical trauma. Materials and methods: The rats were randomly divided into 3 experimental groups: a non-treated group (n = 7), a control saline group (n = 7) and a caffeic acid phenethyl ester group (n = 7). The non-treated group received no treatment for 15 days. The second group was administered saline (2.5 mL/kg, intraperitoneal) once a day for 15 days. The third group received caffeic acid phenethyl ester intraperitoneally at a dose of 10 mu mol/kg once a day for 15 days. At the beginning of the study, unilateral mechanical nasal trauma was induced on the right nasal mucosa of all rats in the three groups using a brushing technique. Samples were stained using hematoxylin and eosin solution and were examined by a pathologist using a light microscope. Results: The severity of inflammation was milder in the caffeic acid phenethyl ester group compared with that in the non-treated and saline groups (P < 0.05). The subepithelial thickness index was lower in the experimental group (P < 0.05). Goblet cell and ciliated cell loss was substantially reduced in the experimental group compared with the non-treated and saline groups (P <0.05). Conclusions: Caffeic acid phenethyl ester decreases inflammation and the loss of goblet cells and ciliated cells. Therefore, caffeic acid phenethyl ester has potential beneficial effects on the wound healing of nasal mucosa in the rat. (C) 2014 Elsevier Inc. All rights reserved.Öğe The effects of oral isotretinoin (13-Cis retinoic acid) on the inner ear: A prospective clinical study(Canadian Soc Clinical Investigation, 2014) Akdag, Mehmet; Akkurt, Zeynep M.; Gul, Aylin; Ucmak, Derya; Yilmaz, Beyhan; Sengul, Engin; Topcu, IsmailPurpose: The purpose of this study was to investigate the effect of oral isotretinoin, a drug used in the treatment of acne vulgaris, on hearing function determined by serial audiology examinations. Methods: Forty patients with acne vulgaris were included in this study. Nine patients were excluded from the study because of inconsistent follow-up. The hearing of each participant was tested with pure tone audiometry and transient evoked autoacoustic emissions before and two and four weeks after treatment with isotretinoin (0.3-0.6 mg/kg/day) in the remaining 31 patients (62 ears). Results: Th e di ff erences between the mean values of the pre- treatment and post-treatment pure tone hearing thresholds at 1000, 2000, 4000 and 6000 Hz frequencies were statistically signi fi cant (p< 0.05), but there was no signi fi cant di ff erence between the pretreatment and post- treatment values at 250 and 500 Hz frequencies (p> 0.05). The difference between the pre-treatment and post-treatment signal-noise ratio values of the transient evoked autoacoustic emissions was not significantly different (p> 0.05). Conclusion: Our results suggest that the use of isotretinoin may cause bilateral hearing threshold changes. Further animal and human studies are required to investigate and characterize isotretinoin- induced neurophysiological alterations in hearing.Öğe THE EFFICACY OF DOPPLER ULTRASOUND ON CHRONIC SUPPURATIVE OTITIS MEDIA(Carbone Editore, 2015) Gul, Aylin; Akdag, Mehmet; Ozkurt, Fazil Emre; Aguloglu, Bulent; Ozkan, Hakan; Akturk, Adem; Yilmaz, BeyhanAims: The diagnostic techniques used in the diagnosis of lateral sinus thrombosis are invasive and pose a risk of stroke. For this reason, we aimed to evaluate the efficiency of Doppler ultrasonography, a simple, fast, and non-invasive technique in this field. Materials and methods: Patients presenting at our clinic with one-sided, chronic suppurative otitis media were included in the study. Internal jugular vein and internal carotid artery Doppler tests were conducted on the patients. The healthy ears of the patients were used as the control group. The values were compared statistically. Results: A total of 40 patients were included in the study 17 male (42.5%) and 23 female (57.5%). Seventeen patients had suppurative otitis media with cholesteatoma, and 23 patients had suppurative otitis media without cholesteatoma. According to Doppler ultrasonography parameters, no statistically significant differences were observed. However, when the chronic suppurative otitis media patients were compared to those without cholesteatoma, the internal jugular vein diameter was found to be reduced significantly in the group with cholesteatoma (p=0.047). Conclusion: The results of our study suggest that Doppler ultrasonography can be considered as a useful, fast, easy, and non-invasive method in the prognosis of cases with suspected lateral sinus thrombosis.Öğe Efficacy of N-Acetylcysteine on Wound Healing of Nasal Mucosa(Lippincott Williams & Wilkins, 2015) Yilmaz, Beyhan; Turkcu, Gul; Sengul, Engin; Gul, Aylin; Ozkurt, Fazil Emre; Akdag, MehmetPostoperative nasal mucosa healing is a highly complex and organized process, and the success rates of endoscopic sinus surgery and septoplasty surgeries are closely associated with the postoperative wound healing processes. In this experimental study, the authors' aim was to use histopathologic examination to investigate the effects of N-Acetylcysteine (NAC) on the wound healing of rat nasal mucosa after mechanical trauma. Twenty-one Sprague-Dawley rats were randomly divided into 3 groups: the nontreated group (N = 7), the control saline group (N = 7), and the NAC group (N = 7). No treatment was given to the nontreated group for 15 days. The control saline group received intraperitoneal injection of saline (2.5 mL/kg, intraperitoneal) for 15 days and the NAC group was intraperitoneally injected with NAC at a dose of 300 mg/kg/day for 15 days. At the beginning of the study, unilateral mechanical nasal trauma was induced with an interdental brush inserted through the right nostril in all rats. Samples were stained using hematoxylin and eosin solution, and were examined by a pathologist using a light microscope. The severity of inflammation was milder in the NAC group compared with that in the nontreated and saline groups (P < 0.05). The subepithelial thickness index was lower in the experimental group (P < 0.05). Goblet cell loss was reduced in the experimental group compared with the nontreated and saline groups (P < 0.05). NAC decreases inflammation and goblet cell loss. Therefore, NAC has potential beneficial effects on the wound healing of nasal mucosa in rats.Öğe Evaluation of Hearing and Outer Hair Cell Function of Cochlea in Patients With Psoriatic Arthritis(Korean Soc Otorhinolaryngol, 2015) Akdag, Mehmet; Ucmak, Derya; Ozkurt, Fazil Emre; Bozkurt, Mehtap; Akkurt, Zeynep Meltem; Topcu, IsmailObjectives. The aim of this study was to investigate hearing and outer cells function in patients with psoriatic arthritis. Our investigation was a prospective case control study. Methods. A total of 31 psoriatic arthritis patients (62 ears) and 31 healthy control subjects (62 ears) were enrolled in the study. We investigated hearing changes of patients and controls via pure tone audiometry, speech discrimination scores, tympanometry, acoustic reflex, and transient product otoacoustic emission. Results. The mean age of psoriatic arthritis patients was 36.1 +/- 8.5 years (range, 14 to 62 years). The average age of the control group was 37.9 +/- 8.1 years (range, 16 to 62 years). There were statistically significant differences between pure tone audiometry in all frequencies and right and left emission at the 4.0 and 1.0 in psoriatic arthritis patients versus controls (P < 0.05). This difference was evident, especially at high frequencies. There was no statistically significant difference between the ages and genders of the patient and control groups (P > 0.05). Both audiological and otoacoustic emissions were not significantly different between right and left ear (P > 0.05). Conclusion. Based on the audiological and otoacoustic findings; it is likely that the cochlear outer hair cells become subtly damaged in psoriatic arthritis patients, consequently leading to changes in hearing thresholds. These data suggest that it is important to screen psoriatic arthritis patients for hearing changes with otoacoustic emissions and audiologic tests regularly.Öğe Evaluation of symptoms of preopoperative and postoperative psychosomatic screening in children with adenoidectomy and adenotonsillectomy(Elsevier Ireland Ltd, 2020) Sizer, Bilal; Akdag, Mehmet; Sizer, Esra; Yilmaz, Umit; Demir, SongulIntroduction: Adenoidectomy and adenotonsillectomy are very common operations in childhood. It is important to clarify their effects on this age group; in this study, we aimed to investigate the effects of the causative agent on children's mental health by using scales that help to screen for indications of mental disorders in children, who have had adenoidectomy or adenotonsillectomy, both before and after surgery. In this way, we aimed to investigate the effects of this factor on children's mental health. Materials and methods: The study included 82 children aged 6-12 years with signs of upper respiratory tract obstruction or recurrent adenotonsilitis. Adenotonsillectomy was performed in 41 patients included in the study and adenoidectomy was performed in 41 patients included in the study. 40 healthy children matched with the patient groups in terms of age and gender were included in the control group. Patients, were divided into three groups, those who underwent adenoidectomy, patients undergoing adenotonsillectomy and those in the control group Preoperative and postoperative questionnaires were used to investigate the effect of tonsillectomy or adenoidectomy on the mental health of children. The Parents' Form for the Strengths and Difficulties Questionnaire, the Parental Form for the Children's Anxiety Screening Scale, the Sleeping Scale for Children and the Quality of Life Scale for Children were used in the screening. Results: In children, who underwent adenoidectomy/adenotonsillectomy due to recurrent infection and adeno/adenotonsillar hypertrophy; it was seen that there was a significant decrease in the scores for the Strengths and Difficulties Questionnaire, the Anxiety Screening Scale in Children, and the Sleep Scale in Children, and a significant increase in Quality of Life Scale for Children scores. Outcome: In conclusion, adenoidectomy/adenotonsillectomy in children with sleep apnea due to recurrent episodes of infection and adeno/adenotonsillar hypertrophy was thought to prevent further neurobehavioral problems, likely to become more complex in the future, and to improve quality of life.Öğe Exposure to non-ionizing electromagnetic fields emitted from mobile phones induced DNA damage in human ear canal hair follicle cells(Taylor & Francis Inc, 2018) Akdag, Mehmet; Dasdag, Suleyman; Canturk, Fazile; Akdag, Mehmet ZulkufThe aim of this study was to investigate effect of radiofrequency radiation (RFR) emitted from mobile phones on DNA damage in follicle cells of hair in the ear canal. The study was carried out on 56 men (age range: 30-60years old)in four treatment groups with n=14 in each group. The groups were defined as follows: people who did not use a mobile phone (Control), people use mobile phones for 0-30min/day (second group), people use mobile phones for 30-60min/day (third group) and people use mobile phones for more than 60min/day (fourth group). Ear canal hair follicle cells taken from the subjects were analyzed by the Comet Assay to determine DNA damages. The Comet Assay parameters measured were head length, tail length, comet length, percentage of head DNA, tail DNA percentage, tail moment, and Olive tail moment. Results of the study showed that DNA damage indicators were higher in the RFR exposure groups than in the control subjects. In addition, DNA damage increased with the daily duration of exposure. In conclusion, RFR emitted from mobile phones has a potential to produce DNA damage in follicle cells of hair in the ear canal. Therefore, mobile phone users have to pay more attention when using wireless phones.Öğe THE HISTOMORPHOLOGIC EFFECTS OF HYPERBARIC OXYGEN THERAPY ON SUBMANDIBULAR, THYROID GLANDS AND TRACHEA(Diagnosis Press Ltd, 2013) Akdag, Mehmet; Gul, Aylin; Bakir, Salih; Ozkurt, Fazil Emre; Alabalik, Ulas; Topcu, IsmailThe aim of this experimental study was to investigate the efficacy of hyperbaric oxygen (HBO) therapy in the neck region of rats based on morphologic changes induced in the exocrine and endocrine glands and trachea. Samples of submandibular glands, thyroid gland and trachea were collected following sacrifice and neck dissection of the animals. The samples were processed for light microscopy and morphometric analysis. HBO administered rats were placed into a large pressure chamber and received 100 % oxygen at 253.3125 kPa (2.5 ata) for 60 min per day for a period of seven days. HBO-treated rats showed no statistically significant differences from the control group, according to the analysis of the histopathological scores (p = 0.930). HBO could probably be considered as neither helpful, nor harmless, on the submandibular glands, thyroid glands and trachea in rats.Öğe Long-term effect of radiofrequency turbinoplasty in nasal obstruction(Taylor & Francis Ltd, 2014) Akdag, Mehmet; Dasdag, Suleyman; Ozkurt, Fazil Emre; Celik, Mehmet Yusuf; Degirmenci, Aydin; Demir, Huseyin; Meric, FarukThe aim of this retrospective study is to investigate long term (two years) effect of radiofrequency tissue volume reduction (RFVTR) on nasal obstruction associated with inferior turbinate hypertrophy, which is not respond to medical treatment. This retrospective study carried out on 98 patients with nasal obstruction treated by RFVTR (56 males, 42 females, from 17 to 70 years of age). Visual analogue scales (VAS) and nasal endoscopic view score (NES) were used for nasal obstruction to evaluate the efficacy of the treatment. Results of one, three, six, twelve and twenty four months after RFVTR treatment were compared with pre-exposure values. Turbinate edema and nasal obstruction in the treated patients were recovered after one month of treatment (p < 0.01). Maximum improvement were determined at the end of third month (p < 0.01). However, eficacy of RFVTR declined twelve months after treatment. Final percentage of imrovement was found as 51 % at the end of second year of treatment because of co-factors was not eliminated by some patients. On the other hand, no statistical significant difference was observed between the right and left nasal cavity (p < 0.001). In conclusion, the result of this study indicated that patients who have not eliminate co-factors such as smoking, obesity and allergic rhinitis may need re-application of RFTVR. However, further studies on radiofrequecy energy level and elimination of other co-factors are necessary to illuminate the eficacy of RFVTR.Öğe Long-term Follow-up Results of the Patients Suffering from Sudden Hearing Loss(Mediterranean Soc Otology & Audiology, 2013) Akdag, Mehmet; Gul, Aylin; Bakir, Salih; Gun, Ramazan; Ozbay, Musa; Kinis, Vefa; Yorgancilar, EdizObjective: The aim of this follow-up study was to evaluate the time-dependent course of hearing recovery in idiopathic SHL patients. Materials and Methods: Forty-four unilateral idiopathic SHL patients treated with the same standard regimen for 10 days were retrospectively reviewed, then they were invited to return to our hospital for their last visit and last audiogram during the study period. Gender, age, duration and severity of hearing loss, the shape of the audiogram and, the presence of tinnitus were evaluated. Thus, the long-term audiometric data, the final hearing outcome and, the rates of hearing recovery was obtained. Results: There was a significant difference in the degree of hearing loss and the rates of hearing recovery between early stage and long-term follow-up (p<0,001). The most common audiogram shape was flat. Hearing was significantly worse in SHL patients with tinnitus compared to SHL patients without tinnitus (p<0,001). Conclusion: Our results revealed that even if the failure of an initial 10-day course of treatment, a delayed recovery continues and there may still be enough time for complete recovery except profound SHL. Tinnitus on presentation with SHL and profound SHL has been identified as a negative prognostic indicator.Öğe Management of Orbital Complications of Sinusitis in Pediatric Patients(Lippincott Williams & Wilkins, 2013) Kinis, Vefa; Ozbay, Musa; Bakir, Salih; Yorgancilar, Ediz; Gun, Ramazan; Akdag, Mehmet; Sahin, MuhammedThe most common reason of orbital infections is sinusitis. Orbital complications of sinusitis are mostly seen in children. Loss of vision and intracranial infections are among the complications of sinusitis. Prompt diagnosis and treatment is very important in the management of orbital complications. The orbital complication can be in the form of cellulitis or abscess. A retrospective review of 26 pediatric patients with orbital complications due to sinusitis was presented in this study. Of 26 patients, there were 13 cases of preseptal cellulitis, 2 cases of orbital cellulitis, and 11 cases of subperiosteal abscess. We grouped the preseptal and orbital cellulites in one category and the subperiosteal abscess in the other. All patients in the cellulitis group recovered by medical treatment. All the patients were treated by surgical drainage. Early diagnosis and appropriate treatment method are vital for the treatment of orbital complications secondary to sinusitis.Öğe Managment of orbital complications of sinusitis(Consel Brasil Oftalmologia, 2014) Ozkurt, Fazil Emre; Ozkurt, Zeynep Gursel; Gul, Aylin; Akdag, Mehmet; Sengul, Engin; Yilmaz, Beyhan; Yuksel, HarunPurpose: We reported on the clinical approaches of ophthalmology and otorhinolaryngology departments in the treatment of the orbital complications of sinusitis. We also included an in-depth literature review. Methods: We retrospectively reviewed the medical files of 51 patients from January 2008 to January 2014. The records were evaluated for age, gender, type of orbital complications, symptoms, predisposing factors, imaging studies, medical and surgical management, culture results, and follow-up information. SPSS version 15.0 software (Statistical Analysis, The Statistical Package for Social Sciences Inc, Chicago, IL) was used for the statistical analysis. Results: Fifty-one patients met the criteria, with available medical records, for the study (29 male, 22 female). Thirty-two (62.7%) were diagnosed with preseptal cellulitis and 19 (37.3%) with postseptal cellulitis. After a detailed evaluation, 15 were diagnosed with a subperiosteal abscess (SPA), and 4 were diagnosed with orbital cellulitis. The age and gender was similar for the two groups. Five patients with medial SPA were treated with endoscopic sinus surgery, one patient with inferior SPA was treated with external surgery, and six patients with other localizations were treated with a combination of endoscopic sinus surgery and external surgery. All patients presented with periorbital erythema and edema. The length of hospitalization and duration of symptoms were similar in both groups. Visual acuity was between 1/10 to 10/10 (mean 7/10) and statistically significant for preseptal and postseptal cellulitis groups (p<0.001). All patients received intravenous antibiotics upon the first day of admission. Conclusion: Orbital complications of acute sinusitis required intensive follow-up and a multidisciplinary approach. A contrast-enhanced paranasal sinus computerized tomography (CT) scan can detect the extent of the infection. An initial trial of intravenosus (IV) antibiotics may be appropriate when close monitoring is possible. Surgery may be indicated when there has been no improvement within 48 hours of intravenous treatment, loss of visual acuity (under 8/10), and a non-medial abscess.Öğe Middle Ear Pressure and Factors Affecting It in Intubated Patients Hospitalized in Intensive Care(Galenos Yayincilik, 2014) Akdag, Mehmet; Cetin, Muzeyyen; Baysal, Zeynep Yildirim; Kadiroglu, Ali Kemal; Celik, Mehmet Yusuf; Meric, FarukObjective: To assess the probable agents affecting middle ear pressure in intubated patients hospitalized in intensive care units with various diagnoses. Methods: Middle ear pressure of 38 patients hospitalized in intensive care units within our faculty hospital was measured using portable tympanograms and acoustic reflectometry. The mode of the device to which each patient was attached and patients' blood pressure, Glasgow Coma Score, and additional disease parameters other than admission diagnosis were recorded. All data collected were subjected to statistical analysis to determine whether or not they affected middle ear pressure. Results: Septal deviation, survey, and mode of automatic respiratory device emerged as factors affecting middle ear pressure (odds coefficient 4.796, 3.745, 2.557, respectively, with 95% CI). Although aged over 60, additional disease and nasogastric tube also compromised middle ear pressure; the levels involved were not statistically significant. Conclusion: Middle ear pressure in patients hospitalized in intensive care units may change, particularly after the seventh day. This may particularly involve septal deviation, survey, and mode of automatic respiratory device, and tympanograms and reflectometry may be added to the patient-monitoring protocol in terms of changes in middle ear pressure.Öğe Patients With Congenital Choanal Atresia Treated by Transnasal Endoscopic Surgery(Lippincott Williams & Wilkins, 2014) Kinis, Vefa; Ozbay, Musa; Akdag, Mehmet; Cetin, Muzeyyen; Gul, Aylin; Yilmaz, Beyhan; Sengul, EnginCongenital choanal atresia (CCA) is defined as a congenital failure in the development of communication between the nasal cavity and nasopharynx in newborns. It is the most common congenital anomaly of nose. Most of the patients presented with unilateral CCA. Neonates with bilateral CCA have severe respiratory distress after birth. Airway control with orotracheal intubation should be done immediately to save the life of neonate with bilateral CCA. After airway control, surgery should be performed as soon as possible. The aim of surgery is to create a patent nasal passage and to prevent restenosis with minimal morbidity. Transnasal endoscopic surgery of CCA has become the most popular treatment method. The retrospective review of 33 patients with CCA was presented in this study. The patients who were diagnosed at the neonate period and operated on in 6 months after birth were grouped as I (neonate). The patients who were diagnosed 6 months after birth were grouped as II (child-young adult). All patients were treated by transnasal endoscopic surgery. Stent were put in all patients to prevent restenosis. Although the restenosis rate was higher in group I (53.8%) than in group II (23.1%), it did not cause a statistically significant difference. Overall success rate of our surgical approach was 61.5%. Despite the surgical developments and many treatment modalities, restenosis is still the most challenging problem in CCA.
