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Öğe Appendicular tuberculosis: review of 155 published cases and a report of two cases(Urban & Vogel, 2010) Akbulut, S.; Yagmur, Y.; Bakir, S.; Sogutcu, N.; Yilmaz, D.; Senol, A.; Bahadir, M. V.This paper provides an overview of the literature on appendicular tuberculosis (ATB) between 1909 and 2010. We present two cases of primary ATB and a literature review of studies on ATB published in English and accessed via the Pubmed and Google Scholar databases. One hundred fifty-five published cases of ATB were reviewed, and two patients with primary ATB, treated and followed in our clinic, were reported. The age range of the patients (62 females, 60 males and 33 with unnoted gender) was between 2 and 60 years, with a mean age of 27.1 +/- A 10.6 years. Of the patients who had applied to hospital, 59 had acute right lower quadrant pain, 46 had recurrent right lower quadrant pain, 19 had generalized pain, and 10 had chronic abdominal symptoms suggestive of subacute intestinal obstruction, while 47 patients were operated on with a diagnosis of acute appendicitis, 24 with recurrent appendicitis, 19 with TB peritonitis, 14 with mass in the right lower quadrant, 13 with subacute intestinal obstruction, and 7 with ATB. While appendectomy was not performed on 4 patients, one or more of the following procedures were done in the other 151 cases: appendectomy, hemicolectomy, ileocecal resection, or cecectomy. Different anti-tubercular treatment regimens with durations varying from 3 weeks to 18 months were applied to 60 patients. During the follow-up period of 3 weeks to 15 years, mortality occurred in 14 patients, sinus in five, and fistula in one patient. Secondary ATB was detected in 86 patients, primary ATB in 50, and no differential diagnosis could be made in 19 cases. Tuberculosis is a systemic disease with localized manifestations; therefore, anti-TB therapy must be initiated in any patient whose pathologic specimen reveals tuberculosis.Öğe Cerebral venous sinus thrombosis: an analyses of 47 patients(Verduci Publisher, 2012) Uzar, E.; Ekici, F.; Acar, A.; Yucel, Y.; Bakir, S.; Tekbas, G.; Oncel, O.OBJECTIVE: Cerebral venous sinus thrombosis (CVST) is an extremely rare disease and its early treatment is important for decreasing the morbidity and mortality. In present study, it was investigated to clinical and etiological factors, localization features, treatment, and prognosis of patients with CVST. PATIENTS AND METHODS: The study group included CVST cases who were followed up between January 2008 and June 2010. Demographical, clinical, radiological, etiological and prognostic characteristics of 47 patients with CVST were retrospectively investigated. RESULTS: Presentation complaints of the patients were as follows in order: acute and/or subacute headache (80.8%), impaired consciousness (25.5%), ear complaints (21.3%), paresis (19.1%) and epileptic seizures (14.9%). Chronic daily headache without any signs of neurological deficit was found in 10.6% of cases. Neurologic examinations of 40.4% of the CSVT patients were found to be normal. The most frequently found etiological factors were as follows: MTHFR gene mutation (25.5%), local infections due to chronic otitis complications (21.3%), puerperium (17%), pregnancy (12.8%), lupus anticoagulant positivity (12.8%). The sigmoid sinus was found to be involved in 35 patients (74.5%), the transverse sinus in 29 (61.7%) and superior sagittal sinus in 21 (44.7%). Impaired consciousness (p = 0.046), hemorrhagic infarct (p = 0.017), acute onset (p = 0.026), and presence of hemiparesis (p = 0.019) were found to be associated with increased mortality. CONCLUSIONS: New onset sub-acute or chronic headache may be the only neurologic complaint of CVST patients. Early diagnosis and anticoagulant treatment may decrease mortality and/or morbidity rates related with CVST in these patients.Öğe Complications of chronic suppurative otitis media: a retrospective review(Springer, 2013) Yorgancilar, E.; Yildirim, M.; Gun, R.; Bakir, S.; Tekin, R.; Gocmez, C.; Meric, F.The purpose of this study was to review our patients with complications of chronic suppurative otitis media (CSOM) and compare with literature. This retrospective study was performed over 10 years in our tertiary referral university hospital. During this period 4,630 patients with CSOM were admitted to the department and 906 patients underwent a surgery. From the records of the 4,630 patients, 121 patients (2.6%) with complications were identified. Of the 906 CSOM patients that underwent a surgery, 511 had cholesteatoma, and 395 had granulation and/or polyp tissue. Ninety-four of 511 (18.4%) patients with cholesteatoma and 27 of 395 (6.8%) patients with granulation and/or polyp tissue had a complication. Of the 121 complicated CSOM patients, 57 extracranial (47.1%) and 37 intracranial (30.6%). Multiple combined complications were occurred in 27 (22.3%) patients. The mastoid abscess was the commonest extracranial complication (28.3%); it was followed by labyrinthitis (9%), facial nerve paralysis (8.4%), and Bezold's abscess (1.3%). The most common intracranial complication was lateral sinus thrombophlebitis (19.5%), followed by perisigmoid sinus abscess (13.5%), meningitis (9%), brain abscess (6.5%), and extradural abscess (4.5%). Most frequent intraoperative finding of complicated CSOM patients was cholesteatoma, with the exception of patients with facial nerve paralysis. There was no mortality in any of our patients. The additional morbidities were recorded in 25 patients (20.6%). In this study, we emphasize the importance of an accurate and early diagnosis, followed by adequate surgical therapy and a multidisciplinary approach.Öğe Determination of trigeminocardiac reflex during rhinoplasty(Churchill Livingstone, 2012) Yorgancilar, E.; Gun, R.; Yildirim, M.; Bakir, S.; Akkus, Z.; Topcu, I.In most rhinoplasty procedures, osteotomies are usually required. The osteotomy areas are innervated by sensory branches of the trigeminal nerve. The trigeminocardiac reflex (TCR) is clinically defined as the sudden onset of parasympathetic activity during stimulation of the trigeminal nerve. When an osteotomy is performed or external pressure is applied over the nasal bone, the infraorbital nerve may send signals via this nerve. The aim of this prospective study is to determine the blood pressure changes and occurrence of TCR during rhinoplasty. one hundred and eight patients were enrolled into the study. Lidocaine and adrenaline combination (LAC) was injected only into the left lateral osteotomy sites. All patients underwent median, right-side, then left-side lateral osteotomies and nasal pyramid infracture. The haemodynamic changes were recorded. A 10% or more decrease in the heart rate from baseline was considered a TCR. TCR was detected in nine patients following lateral osteotomies and nasal pyramid infracture procedures (8.3%). The authors determined that LAC injection prior to osteotomy did not prevent TCR. Manipulation at or near the infraorbital nerve during rhinoplasty may cause TCR, even if local anaesthetic infiltration is used.Öğe Effects of lidocaine and adrenaline combination on postoperative edema and ecchymosis in rhinoplasty(Churchill Livingstone, 2011) Gun, R.; Yorgancilar, E.; Yildirim, M.; Bakir, S.; Topcu, I.; Akkus, Z.Nasal osteotomies are the most important cause of periorbital edema and ecchymosis. Injection of lidocaine and adrenaline is recommended to reduce bleeding. Whilst the lidocaine and adrenaline combination (LAC) is claimed to reduce postoperative ecchymosis and edema, this effect remains to be proven conclusively. This study, on 48 patients, was designed to investigate the effects of LAC injection on postoperative edema/ecchymosis in rhinoplasty. LAC was applied at a random side prior to the lateral osteotomy. The opposite side was used as a control. The relationship between edema/ecchymosis and the degree of LAC on the injected and uninjected sides was evaluated on the first, third and seventh day, postoperatively. The relationships between edema and ecchymosis with operation time and intraoperative systolic blood pressure were also evaluated. Bleeding was reduced on the side treated with LAC (p = 0.050). The degrees of edema/ecchymosis increased with increases in the duration of operation and the systolic blood pressure on the first postoperative day for the LAC-applied side (p < 0.05). This correlation was not observed on the opposite side (p > 0.05). Application of LAC reduces bleeding during rhinoplasty and pain control postoperatively but reduced edema and ecchymosis should not be expected following LAC application.Öğe Phosphodiesterase-5 inhibitors may facilitate bone defect recovery(Verduci Publisher, 2011) Yaman, F.; Atilgan, S.; Gunes, N.; Agacayak, S.; Gunay, A.; Ucan, M. C.; Bakir, S.Background and Objectives: Bone healing is still one of the most important problems of the oral and maxillofacial surgery procedures. This study was designed to evaluate the effect of sildenafil citrate (which is used for erectile dysfunction) on bone defect healing in an experimental animal model. Materials and Methods: A total of 42 male Wistar-albino rats were randomly assigned to the control group (n=21) or the study group (n=21). The control group was fed on a standard laboratory diet until 12 h before surgery, whereas the study group received Sildenafil citrate via orogastric tube 10 mg/kg once a day for 30 days. Under anaesthesia, a 3x3x2 mm depth defect was made on tibia of each rat. 7 animals from each group were euthanised on postoperative days 7,15 and 30. Bone samples were taken for examination, histologically on day 7, by 3D dental tomography on day 15, and for bone strength resistance on day 30. Results: Statistically significant differences were determined between the groups from the inflammatory and repair phase, with the healing process being more advanced in the Sildenafil group. Conclusions: Sildenafil citrate can be used as a supporting factor to accelerate the healing process of bone. In future comprehensive studies will need to demonstrate the Sildenafil citrate affect on bone defect healing.Öğe A rare mass in the neck region: Primary hydatid cyst(Galenos Yayincilik, 2012) Gul, A.; Bakir, S.; Ozbay, M.; Kinis, V.; Aguloglu, B.; Avci, Y.Hydatid disease is a common parasitic infestation caused by the parasite Echinococcus granulosus. It is a serious health problem most frequently encountered in rural areas where domestic livestock-raising is common. Humans can be infected accidentally through oral ingestion of tapeworm eggs with contaminated water, food, and green vegetables or direct contact with host. It affects both animals and humans. Complete surgical excision is the gold standard treatment for hydatid cyst. Postoperative medical treatment with antihelminthic drugs (benzimidazole derivatives) are frequently combined with surgical treatment to prevent recurrence of disease and high-risk contamination. Although hydatid cysts usually involve in liver and lungs, less frequently may occur in any area of the body. A hydatid cyst occurrence in the head and neck area is extremely rare. So this disease does not usually come to mind. Therefore in this case, we wish to draw attention to possibility of the hydatid disease in the neck. For this reason, we present an unusual case of primary hydatid cyst located in the neck region in a 42-year-old male patient, who engaged in livestock.Öğe The reconstruction of thyroid cartilage defect due to penetrating laryngeal trauma using a autogenous septal cartilage graft(Galenos Yayincilik, 2011) Yorgancilar, E.; Yildirim, M.; Gun, R.; Bakir, S.; Topcu, I.Laryngeal trauma is a rare but potentially lethal injuries. Depending on the amount of force and the degree of ossification of the larynx, this may result in a variety of injury patterns. These injuries may range from simple cartilaginous fracture of thyroid cartilage with cartilaginous displacement, cartilaginous defect, endolaryngeal disruption, or laryngotracheal separation. The clinician should have a high suspicion for laryngeal injury in any patient who has neck trauma. When evaluating the patient with suspected laryngeal trauma, the stability of the airway must first be established. Management of laryngeal trauma may include medical or surgical treatment. In surgical treatment, correction of loss of skeletal support may be performed with alloplastic stents, miniplate and screw fixation and autogenous cartilage grafts. In this report we presented a case of thyroid cartilage defect due to penetrating laryngeal trauma who reconstructed by autogenous septal cartilage graft.Öğe Relationship between hearing loss and sexual dysfunction(Cambridge Univ Press, 2013) Bakir, S.; Penbegul, N.; Gun, R.; Yorgancilar, E.; Kinis, V.; Ozbay, M.; Atar, M.Objective: Deafness may be one of the factors that leads to a change in sexual function. This study aimed to assess sexual function, in particular erectile dysfunction, in male patients with hearing loss. Materials and methods: We studied two groups: (1) adult men with acquired, bilateral, sensorineural hearing loss, and (2) healthy, adult, married men demonstrated to have normal hearing levels, as the control group. Sexual function was assessed using the International Index of Erectile Functions questionnaire, and quality of life using the 36-Item Short-Form Health Survey. Results: There was a statistically significant difference between the groups regarding the International Index of Erectile Functions questionnaire results (p < 0.001), both for each of the five questionnaire domain scores and for the total score. Conclusion: Our results indicate that men with mild or moderate sensorineural hearing loss have poorer sexual health.Öğe Scar Endometriosis in the Abdominal Wall: a Predictable Condition for Experienced Surgeons(Acta Medical Belgica, 2010) Akbulut, S.; Sevinc, M. Mahsuni; Bakir, S.; Cakabay, B.; Sezgin, A.Purpose : Endometriosis in surgical scars develops in 0.1% of those women who undergo Caesarean section or other obstetric surgery. Herein we analyse and discuss the clinico-pathological characteristics of 15 patients with scar endometriosis in the abdominal wall. Methods : Fifteen cases of scar endometriosis in the abdominal wall that were treated surgically in our department between 2003 and 2009 were examined retrospectively. Age, parity, complaint, medical or surgical history, pre/postoperative hormonotherapy, size of the mass, surgical procedure, follow-up and disease recurrence were analysed. Results : This retrospective study included 15 patients presenting with 17 postoperative abdominal wall masses. The mean age of the patients was 32.1 +/- 6.0 years (range, 23-48). Eleven of the patients had a painful mass that became bigger before menstruation, two had palpable masses only, and two were hospitalised because of a mass with persistent pain. The locations of the masses were as follows : eight were close to the right side and three were close to the left side; two were in the middle of the Pfanenstiel incision and two were in trocar tracts. The patients' surgical histories included Caesarean. section in thirteen, bilateral laparoscopic ovarian cyst excision in one, and laparoscopic appendectomy in one. Conclusions : if a patient presents with incision pain and a palpable mass after gynaecologic surgery, an incisional endometrioma should be considered. Surgical excision and hormone therapy are effective treatment approaches in these patients.Öğe Temporal bone erosion in patients with chronic suppurative otitis media(Royal Belgian Soc Ear, Nose, Throat, Head & Neck Surgery, 2013) Yorgancilar, E.; Akkus, Z.; Gun, R.; Yildirim, M.; Bakir, S.; Kinis, V.; Meric, F.Temporal bone erosion in patients with chronic suppurative otitis media. Objectives: To analyse temporal bone erosion sites (including scutum, labyrinth, facial canal, mastoid tegmen, posterior fossa dural plate and sigmoid sinus plate) in patients with chronic suppurative otitis media (CSOM). Methodology: Retrospective case review in a tertiary referral centre. Medical records were reviewed from 905 patients (121 complicated; 784 non-complicated) who received a mastoidectomy as a minimum intervention for the treatment of CS OM. Results: All types of temporal bone erosion were found to be more frequent in patients with complicated CSOM. Erosion in the scutum, mastoid tegmen, posterior fossa dural plate and labyrinth was observed significantly more frequently in complicated-CSOM patients with a cholesteatoma. Granulation/polyp tissue invaded the sigmoid sinus and facial canal at a rate similar to cholesteatoma. Conclusions: Our study demonstrates that bone erosion is more frequent in complicated-CSOM patients. Temporal bone erosion can be seen in both cholesteatomatous and non-cholesteatomatous CSOM patients. Granulation/polyp tissue was as important as cholesteatoma in the erosion of the facial canal and sigmoid sinus plate.
