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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 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 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.