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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 Formaldehyde on Respiratory Mucosa in Rats(Soc Chilena Anatomia, 2012) Yorgancilar, E.; Deveci, E.; Deveci, S.Formaldehyde inhalation, are known to be nasal mucosa irritating feature. This study we are examined the effects histopathologic of formaldehyde inhalation on rats by using light microscopy. 16 adult wistar albino rats were used in this study. 8 rats were in control group and 8 rats were in experiment group. Experiment group was exposed to 10 ppm formaldhyde 8hours/day, 5days/week for 8 week. Nasal mucosa was removed and placed in 10% formaline. Sections were stained with Hematoxylene-Eosine and observed under light microscopy. The lining epithelium of respiratory mucosa showed a loss of ciliated cells with metaplasia of goblet cells and hyperplasia of squamous cells.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 EFFECTS OF MANGANESE ETHYLENE-BIS-DITHIOCARBAMATE (MANEB) ON RAT NASAL RESPIRATORY MUCOSA(Carbone Editore, 2013) Deveci, E.; Yorgancilar, E.; Ekinci, C.; Koparal, M.; Akkus, Z.; Yavuz, D.Maneb (Mn-ethylene(bis)dithiocarbamate is a dithiocarbamate pesticides. It is a fungicide pesticide used in the control of mildew disease on certain crops. In general, dithiocarbamates are considered chemicals of low toxicity for humans. However, the effects of maneb in humans are diverse. It has some effects to humans via absorption through skin and respiratory system. The nasal mucosa is the first part of the airways in contact with the environment and toxic agents. The aim of this study was todetermine the histopathological effects of numb on nasal mucosa. In experimental group, the maneb was administered with inhalation to 10 male Wistar-Albino rats for five days a week. The control group (n=10) received distilled water with spray at the same time period. The experiment was terminated after three weeks. In each case, sections of the nosewere taken. In experimental group,microscopic examination of nasal respiratory mucosa revealed; Hypertrophy of epithelial cells and goblet cells, increasing of mucus secretion, decreasing in sizes of cilia and flattening of the cells near the basement membrane and apoptotic cells in the degenerated respiratory epithelial cells, detected a mild inflammatory reaction and a vascular dilatation in the connective tissue. All changes were statistically significant. In control group of 10 rats no significant histopathologic lesions were found. As a result, our study, maneb is potentially toxic agent to respiratory mucosa.Öğe Effects of N-acetyl-cysteine and acetylsalicylic acid on the tonsil bacterial biofilm tissues by light and electron microscopy(Verduci Publisher, 2014) Bulut, F.; Meric, F.; Yorgancilar, E.; Nergiz, Y.; Akkus, M.; Nergiz, S.; Nasir, Y.OBJECTIVE: The present study aimed to investigate the effects of the bacterial biofilm formation on the tonsil surface exposed N-acetyl-cysteine (NAC) and acetylsalicylic acid (ASA) of patients undergoing tonsillectomy by light and electron microscopy. The general process of biofilm formation comprises adhesion of free-living or planktonic bacteria to a surface, which subsequently develop into microcolonies and form a biofilm. Based on studies that have shown the presence of biofilms in common sites of chronic infections, it has become clear that bacteria may persist on mucosal surfaces through formation of biofilms. PATIENTS AND METHODS: Ten patients between 4 and 39 years of age (mean, 11.9 +/- 11.2 years). In all cases, periodic acide Schiff (PAS) staining was found to be an accurate predictor of the presence or absence of biofilm using light microscopy as a control standard. Therapeutic doses of NAC and ASA were identificated as the effective on the tonsil bacterial biofilm using light and electron microscopy. RESULTS: Biofilm formation was detected on all samples. Tonsils removed from patients with ASA-10 had showed higher-grade inhibitory effect at the biofilm formation than the other group (p <= 0.0001). The correlation was found between drug dose and decrease at the biofilm formation. CONCLUSIONS: In chronic or recurrent tonsillitis patients, decrease on the tonsils surface biofilm formation may be associated with ASA dose. Whether effect on the tonsils surface biofilm formation of other agent have a role is not known.Öğe The need for mentoplasty following rhinoplasty(Royal Belgian Soc Ear, Nose, Throat, Head & Neck Surgery, 2014) Ozkurt, F. E.; Akdag, M.; Yorgancilar, E.; Baylan, M. YildirimObjective: Rhinoplasty is the most common facial plastic surgery procedure. The appearance of the face must be considered as a whole to achieve the best results, but assessment of the chin is often overlooked. The aim of this paper was to determine the need for mentoplasty after rhinoplasty. Methods: Adobe Photoshop CS6 (Adobe Systems, San Jose, CA) was used to analyze 200 consecutive rhinoplasty patients, 170 of whom were included in this study. We used Silver and Agarwal's method for assessment of the chin. Results: A total of 170 profile photographs were analyzed. Of these patients, 58.2% (n=99) had normal chins, 40% (n=68) had small chins (microgenia), and 1.8% (n=3) had over-projection. There were no statistically significant differences between men and women. Conclusion: Chin projection is an important component of facial euphony. Approximately half of the rhinoplasty patients we assessed would also benefit from mentoplasty. Surgeons that perform rhinoplasty should discuss mentoplasty with their patients to achieve the best results.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 Schwannoma of the nasal tip: case report and short review of literature(Galenos Yayincilik, 2009) Yildirim, M.; Yorgancilar, E.; Bulut, F.; Meric, F.; Topcu, I.A case of nasal tip Schwannoma is presented in this paper. Schwannoma is usually a benign neoplasm which is composed of Schwann cells. A 14-year-old boy had suffered from progressive swelling of the nasal tip over 4 months. Computed tomography showed a large soft tissue density in the nasal tip. The mass was resected using an external rhinoplasty approach, and the pathologic diagnosis was Schwannoma. Here, we present this case and discuss the clinical and pathological aspects of Schwannoma arising in the nasal tip.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.
