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    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, Faruk
    Objective: 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.
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    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, Engin
    Congenital 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.
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    Rare Head and Neck Trauma due to Construction Nail: Case Report
    (Aves, 2014) Aguloglu, Bulent; Gul, Aylin; Ozbay, Musa; Ozkurt, Fazil Emre; Cetin, Muzeyyen; Topcu, Ismail
    Introduction: Oropharyngeal penetrating trauma is encountered more often in children under the age of 5 due to lack of their selfprotection. Case Report: In this paper, a 2-year-old girl who had penetrating oropharyngeal trauma after falling on a construction nail was presented. As a consequence of the physical examination and radiological examination applied to the patient, it was seen that the foreign body reached the clivus in the base of the skull, through the nasopharynx, passing by the hard and soft palate junction. In the status of the patient, who was operated on, no additional clinical aspects or neurological or lack of visual activity was observed in the post-operative period. As there was no complication during the follow-ups, the patient was discharged with recommendations. Conclusion: Oropharyngeal penetrating trauma should be careful in terms of mortality and morbidity due to the proximity to vital organs.