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Öğe Acute invasive fungal rhinosinusitis: Survival analysis and the prognostic indicators(Ocean Side Publications Inc, 2015) Gode, Sercan; Turhal, Goksel; Ozturk, Kerem; Aysel, Abdulhalim; Midilli, Rasit; Karci, BulentBackground: Acute invasive fungal rhinosinusitis (AIFR) is a highly mortal, progressive fungal infection of the paranasal sinuses and surrounding structures that is almost always seen in patients who are immunocompromised. Despite the use of newer antifungal treatments and early diagnosis, the prognosis of AIFR does not improve significantly. Due to the higher incidence of patients who are immunocompromised and have more complex disease, AIFR is a growing medical issue in tertiary medical centers. Objective: The aim of this study was to present the outcomes and analyze the prognostic indicators of patients with AIFR who underwent surgery. Methods: Between October 2009 and November 2014, 37 patients who underwent surgery for AIFR at a tertiary care university hospital were included in the study. Overall survival and disease-specific mortality and survival rates were calculated to estimate survival function. The impact of age, sex, underlying disease, extent of AIFR, applied medical treatment, and causative species (mucormycosis, aspergillosis) were also taken into consideration. Also, the effect of a variety of laboratory parameters, such as hemoglobin, leukocyte, neutrophil, lymphocyte, platelet, and C-reactive protein (CRP) levels, to survival were evaluated. Results: The median follow-up time was 58 days (interquartile range = 304). Overall and disease-specific mortality rates were 64.9 and 51.4%, respectively. Fever was the most common symptom (86.5%), along with nasal obstruction and/or fullness (48.6%) and epistaxis (48.6%). Age and sex did not have a significant impact on survival (p > 0.05). Palate involvement was significantly associated with mortality (p < 0.05). According to the results of Cox, regression analysis for disease-specific mortality rate, leukocyte and neutrophil counts as well as CRP levels had a significant effect on survival function (p < 0.05). Conclusions: Palatal involvement was associated with a higher mortality in our study. Also, leukocyte counts, neutrophile counts, and CRP values had a significant impact on survival function. The reversal of the underlying disease and immunosuppression is as important as the medical and surgical treatment.Öğe Anatomic variations of sphenopalatine artery and minimally invasive surgical cauterization procedure(Ocean Side Publications Inc, 2009) Midilli, Rasit; Orhan, Mustafa; Saylam, Canan Y.; Akyildiz, Serdar; Gode, Sercan; Karci, BulentBackground: Sphenopalatine artery (SPA) ligation or cauterization stands to be one of the most common management options of refractory epistaxis. Ramification pattern of SPA as it passes through sphenopalatine foramen (SPF) has not been clearly established. The aim of this study is to investigate situations in which middle meatal approach may fail due to anatomic variations of SPA and to define a minimally invasive surgical cauterization procedure. Anatomic variations of SPA were determined by microdissection of 20 adult sagittally cross-sectioned head specimens. Methods: Branching characteristics of SPA and its anatomic relations were evaluated and anatomic variations were noted. Results: SPA was generally (80%) forming branches within SPF before entering into the nasal cavity. In 20% of the specimens, SPF was located superior to the horizontal lamella of the middle turbinate, and accessory foramen was present in 10%. In 10% of the cases, the posterior lateral nasal branch was situated as two branches in a deep sulcus in the middle meatus. Conclusion: The ramification pattern of SPA can not be fully exposed without resection of the posterior part of the middle turbinate via the middle meatal approach. Two-step procedures are advocated in reducing failure rates. Previously defined two-step procedures are relatively invasive. A less invasive procedure is defined based on the variations of SPA and SPF. (Am J Rhinol Allergy 23, e38-e41, 2009; doi: 10.2500/ajra.2009.23.3403)Öğe Anatomic variations of sphenopalatine artery and minimally invasive surgical cauterization procedure(Ocean Side Publications Inc, 2009) Midilli, Rasit; Orhan, Mustafa; Saylam, Canan Y.; Akyildiz, Serdar; Gode, Sercan; Karci, BulentBackground: Sphenopalatine artery (SPA) ligation or cauterization stands to be one of the most common management options of refractory epistaxis. Ramification pattern of SPA as it passes through sphenopalatine foramen (SPF) has not been clearly established. The aim of this study is to investigate situations in which middle meatal approach may fail due to anatomic variations of SPA and to define a minimally invasive surgical cauterization procedure. Anatomic variations of SPA were determined by microdissection of 20 adult sagittally cross-sectioned head specimens. Methods: Branching characteristics of SPA and its anatomic relations were evaluated and anatomic variations were noted. Results: SPA was generally (80%) forming branches within SPF before entering into the nasal cavity. In 20% of the specimens, SPF was located superior to the horizontal lamella of the middle turbinate, and accessory foramen was present in 10%. In 10% of the cases, the posterior lateral nasal branch was situated as two branches in a deep sulcus in the middle meatus. Conclusion: The ramification pattern of SPA can not be fully exposed without resection of the posterior part of the middle turbinate via the middle meatal approach. Two-step procedures are advocated in reducing failure rates. Previously defined two-step procedures are relatively invasive. A less invasive procedure is defined based on the variations of SPA and SPF. (Am J Rhinol Allergy 23, e38-e41, 2009; doi: 10.2500/ajra.2009.23.3403)Öğe Assessing the rhinoplasty outcome: inter-rater variability of aesthetic perception in the light of objective facial analysis(Springer, 2015) Ozturk, Kerem; Gode, Sercan; Karahan, Ceyda; Midilli, RasitThe aim of this study was to assess the success of rhinoplasty by evaluating the inter-rater variability in the light of primary indication as functional or cosmetic. Subjective aesthetic perception was compared with objective facial analysis. 45 rhinoplasty patients were included in the study. 25 had cosmetic plus functional reasons with septal deviation (group 1) and 20 had pure cosmetic reasons without septal deviation (group 2). Preoperatively and 6 months postoperatively, four individuals (patient, surgeon, 2 independent surgeons) rated the aesthetic appearance of the nose with visual analogue scale. Facial photogrammetric analysis was applied. The patient's aesthetic perception score was significantly correlated with the two independent surgeons (p < 0.05) whereas not with the primary surgeons. Regarding the objective parameters, patient's aesthetic perception was significantly correlated with the dorsal alignment in both groups (p < 0.05). General satisfaction score was significantly correlated with the nasal breathing as well as with the aesthetic perception scores in both groups. This correlation was higher for aesthetic perception in group 1 and nasal breathing in group 2. Inter-rater variability of outcome perception was higher in cosmetic patients. Nasal dorsal alignment was the only objective parameter which was correlated with the patient's perception. Patient's perception of outcome has better represented the objective photogrammetric analysis rather than the primary surgeons. An interesting finding was the more significant correlation of general satisfaction with aesthetic perception in the functional group whereas nasal breathing in the cosmetic group.Öğe Assessment of Different Middle Vault Reconstruction Techniques in Rhinoplasty from Multiple Patient-Reported Outcome Measures(Thieme Medical Publ Inc, 2022) Sahin, Fetih Furkan; Apaydin, Fazil; Gode, SercanIt is important to assess the patient satisfaction with shape and function by patient-reported outcome measures (PROMs) following structural or dorsal preservation rhinoplasty (DPR) techniques on the middle nasal vault. To analyze the results of different middle vault rhinoplasty techniques with multiple PROMs and compare their differences according to the findings of PROMs. Four different techniques were performed for the middle vault: spreader graft, L-strut graft, DPR with high strip (DPRwHS), DPR with low strip. The outcomes were evaluated preoperatively, 2 and 12 months postoperatively with the following PROMs: Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcomes Evaluation, and Standardized Cosmesis and Health Nasal Outcomes Survey. This study included 129 patients. All techniques provided significant improvements in all PROMs ( p < 0.001), except DPRwHS in NOSE. Between postoperative short- and longer-term, no significant differences were observed in DPR groups ( p > 0.05), unlike structural techniques. In this comparative study of different middle nasal vault rhinoplasty techniques, we did not detect a difference in the improvement of the patient-reported outcomes of DPR techniques from as early as 2 months to 1 year postoperative.Öğe Blood Supply of the Inferior Turbinate and Its Clinical Applications(Wiley, 2010) Orhan, Mustafa; Midilli, Rasit; Gode, Sercan; Saylam, Canan Y.; Karci, BulentOne of the most effective treatments of inferior turbinate (IT) hypertrophy is surgical reduction. Bleeding from the IT branch of the posterior lateral nasal artery (ITB) may interfere with the outcome of IT surgery. The aim of this study is to define the anatomic localization of the ITB and its variations and to investigate its clinical importance. Anatomic relations of the ITB were determined by microdissecting 20 adult, sagittally cross-sectioned head specimens. Branching characteristics of the ITB and its anatomical relations were evaluated. The most consistent two markers to define the ITB on the lateral nasal wall were the posterior attachment of the IT (PAIT) and the posterior attachment of the middle turbinate (PAMT). Mean horizontal distances of the ITB from the PAIT and the PAMT were 7.2 mm +/- 2.8 mm (2.5-11.8 mm) and 8.2 mm +/- 2.8 mm (4-14.6 mm), respectively. ITB was the only major artery that supplied the IT in 85% of the specimens, and, in 15%, there was more than one artery. ITB was located lateral to the IT in 95% and medial to the IT in 5%. The ITB coursed on the lateral nasal wall, vertically between the middle and ITs and always anterior to the PAIT. All the variations of blood supply to the IT were within a one square centimeter area, similar to 1-cm anterior to the PAIT. Successful cauterization of this particular area may be an alternative cauterization site in IT surgery. Clin. Anat. 23:770-776, 2010. (C) 2010 Wiley-Liss, Inc.Öğe Butterfly cartilage tympanoplasty: an alternative new technique instead of conventional surgery method(Springer, 2017) Kaya, Isa; Benzer, Murat; Gode, Sercan; Bilgen, Cem; Kirazli, TayfunButterfly graft inlay tympanoplasty is a well-established technique for the repair of small- and medium-sized perforations. There are some difficulties with application of conventional butterfly technique and it affects our success rate of graft healing. With some modifications of graft preparation we can make better success rates. The aim of this study was to present the new renovation of conventional method, describe about what kind of changes we made and its technical facilities about the procedure. The study design is a prospective case series. This study was carried out on 18 patients who underwent inlay butterfly cartilage tympanoplasty with the new technique for anterior and inferior perforations at an otolaryngology department of a tertiary medical center between November 2015 and August 2016. Patients were followed with otoscopy and audiometry, and graft healing's success. Anatomic closure at 6th month after tympanoplasty was found in all 18 patients. There was no incidence of cartilage graft rejection or displacement. Preoperative mean PTA was 27.7 dB, which improved 6 months after surgery to 10.5 dB (the average value of hearing thresholds at 0.5, 1, 2 and 4 kHz). Butterfly cartilage tympanoplasty technique is safe and efficient in terms of both anatomical closure of the defect and improvement in hearing. We believe with this new technique, we facilitate this procedure in addition to the improvement of patients' comfort and decrease the morbidity of the procedure.Öğe Cavernous Sinus and Parasellar Region: An Endoscopic Endonasal Anatomic Cadaver Dissection(Lippincott Williams & Wilkins, 2018) Erdogan, Umut; Turhal, Goksel; Kaya, Isa; Biceroglu, Huseyin; Midilli, Rasit; Gode, Sercan; Karci, BulentThe aim of this study was to investigate the neurovascular structures of the cavernous sinus with the endonasal endoscopic transpterygoid approach on fresh human cadavers. Additionally, the course of internal carotid artery (ICA) and relevant anatomy was thoroughly investigated to refine the anatomical landmarks, exposure difficulties, potential complications, and limitations using the endonasal endoscopic technique. This study was carried out at an otolaryngology department of a tertiary medical center between June 2014 and June 2015. The surgical dissection was performed on 10 fresh human cadaver specimens using paranasal sinus and skull base endoscopic instruments. Cavernous sinuses and parasellar area were explored via an endoscopic endonasal transpterygoid approach. Dehiscence was present in 5 (25%) cavernous ICAs. Projection of the cavernous ICA on the whole lateral sphenoid wall was prominent in 6 (%30) sphenoid sinuses. Anterior curve was prominent in 12 (60%) cavernous ICAs, whereas posterior was prominent in 7 (35%). Mean distance between the lateral wall of eustachian tube orifice and petrous ICA was 19.50 +/- 1.05 mm (range 18-22 mm). Cranial nerves of the cavernous sinus showed no variation. Control of the ICA is critical during the endonasal endoscopic approach to the cavernous sinus and skull base. The vidian nerve is a reliable and important landmark to the petrous ICA in the transpterygoid approach. Dissection of the eustachian tube and its relation to the ICA has to be kept in mind during nasopharyngeal surgery.Öğe Clinical Experience with Secondary Endoscopic Reconstruction of Clival Defects with Extracranial Pericranial Flaps(Thieme Medical Publ Inc, 2019) Gode, Sercan; Lieber, Stefan; Nakassa, Ana Carolina Igami; Wang, Eric W.; Fernandez-Miranda, Juan C.; Gardner, Paul A.; Snyderman, Carl H.Objectives The aim of this study is to report the clinical outcome of extracranial pericranial flaps (ePCF) used for reconstruction of clival dural defects following failure of primary repair. Design Retrospective review of skull base database. Setting Academic medical center. Participants Patients undergoing reconstruction of clival defects with ePCF following endoscopic endonasal surgery (EES). Main outcome measures Postoperative cerebrospinal fluid (CSF) leak, meningitis, and flap necrosis. Results Seven patients (five males and two females) who underwent ePCF reconstruction for clival defects following EES were included. All patients (ages 8-64 years) had a postoperative CSF leak due to a failed primary clival reconstruction (five had one, one had two, and one had three failed CSF leak repairs prior to ePCF reconstruction). Nasoseptal and inferior turbinate (lateral nasal wall) flaps were not available for secondary reconstruction due to prior surgeries. The immediate success rate of ePCF for the reconstruction of clival defects in patients with multiple flap failures was 58%. Two patients developed CSF leaks that were successfully repaired endoscopically with the addition of free tissue grafts; one patient had partial flap necrosis that required debridement; none required an additional vascularized flap. Width of the defect, length of the defect, properties of the ePCF, and age did not demonstrate significance ( p >0.05) for adverse outcome. Conclusion An ePCF is a reconstructive option for high-risk, large clival defects when other local and regional vascularized flaps are not available or fail. ePCFs can be used for reconstruction of clival defects in all populations, including pediatric patients.Öğe Comparison between Rescue Flap and Double Flap Technique(Thieme Medical Publ Inc, 2019) Benzer, Murat; Biceroglu, Huseyin; Ates, Murat Samet; Kaya, Isa; Ozgiray, Erkin; Midilli, Rasit; Karci, Bulent; Gode, SercanObjectives Endoscopic techniques in pituitary surgery lead to inevitable mucosal loss of the sphenoethmoidal recess and posterior nasal septum in the nasal cavity. There is no other comparative study between primary reconstruction of septal perforation and secondary healing in the literature. The aim of this study is to evaluate postoperative patient morbidity with or without posterior septal perforation in endonasal pituitary surgery by comparing two commonly used techniques: rescue and double nasoseptal flaps. Design Prospectively randomized study. Setting Tertiary academic center. Participants Sixty patients underwent endoscopic endonasal pituitary surgery. Main Outcomes and Measures Functional results (breathing) using visual analog scale (VAS), sphenoid sinusitis, presence of synechia, perforation in the posterior septum, and crusting in the sphenoethmoidal recess were assessed. Results Pre- and postoperative mean VAS scores were 71.67 +/- 11.47 and 67.67 +/- 9.71 mm in the intact septum group and 77.67 +/- 14.06 and 62.67 +/- 10.48 mm in the posterior septal perforation group. There was a significant difference between pre- and postoperative VAS values in all groups. There was significant worsening in both groups; worsening in VAS values was much higher in the posterior septal perforation group. In the posterior septal perforation group, much more crusting was seen. Conclusions This is the first study to compare the postoperative patient morbidity in endoscopic endonasal pituitary surgery with and without a posterior septal perforation. Reconstruction of the posterior septum along with less mucosal loss yields better postoperative nasal symptom score.Öğe Comparison of anterior and posterior tympanomeatal flap elevations in endoscopic transcanal tympanoplasty(Taylor & Francis Ltd, 2019) Ozturk, Arin; Benzer, Murat; Kaya, Isa; Gode, Sercan; Bilgen, Cem; Kirazli, TayfunBackground: There is not an ideal tympanomeatal flap incision type for transcanal procedures. Aims/Objectives: Comparing the outcomes and feasibility of posteriorly and anteriorly based tympanomeatal flap incisions for anterior perforations in endoscopic transcanal cartilage tympanoplasty. Material and methods: Twenty-six patients who had anterior TM perforation were included. Patients were divided into two groups with randomization. All of the data were prospectively collected. These included demographic data, date of the surgery, mean surgery time, preoperative and postoperative sixth-month pure-tone audiometry (PTA), type of tympanomeatal flap incision and graft healing success. Results: Mean follow up time was 20.69 +/- 5.03 months. Graft healing rate was 100% in both groups. There was no major complication in both of groups. Mean air bone gap level improvement of (dB HL) at all frequencies was 7.69 +/- 2.83 dB HL in group 1 and 7.98 +/- 3.08 dB HL in group 2 respectively. Regarding pre-and postoperative mean air bone gap levels and mean surgery times, there was no significant difference between groups (p>.05). Conclusions and significance: For non-complicated anterior perforations that are less than 50% of TM, endoscopic transcanal cartilage tympanoplasty using anterior tympanomeatal flap elevation procedure was seemed minimally invasive and feasible to perform with successful audiologic and postoperative outcomes.Öğe Does betahistine treatment have additional benefits to vestibular rehabilitation?(Springer, 2010) Karapolat, Hale; Celebisoy, Nese; Kirazli, Yesim; Bilgen, Cem; Eyigor, Sibel; Gode, Sercan; Akyuz, Aycan; Kirazli, TayfunThe aim of this study was to investigate the effect of high-dose betahistine treatment added to vestibular rehabilitation (VR) on the disability, balance and postural stability in patients with unilateral vestibular disorder. The VR group (group 1, n = 24) and the VR + betahistine group (group 2, n = 23) were analyzed retrospectively. All patients were evaluated before and after an 8-week customized VR in terms of disability (Dizziness Handicap Inventory, DHI), dynamic balance [Dynamic Gait Index (DGI)] and postural stability (static posturography). In group 1 and group 2, differences between DHI, DGI and falling index score on static posturography before and after the exercise program were significant (p < 0.05). In addition, a significant difference was detected only in group 2 in the variables evaluated in static posturography-Fourier 4 analysis (p < 0.05). Both VR and betahistine + VR have a positive effect on disability and balance in patients with unilateral vestibular disorder. Betahistine treatment added to VR was effective in increasing postural stability.Öğe Double nasoseptal flap technique for endonasal pituitary surgery(Springer, 2017) Gode, Sercan; Biceroglu, Huseyin; Turhal, Goksel; Erdogan, Umut; Ates, Murat S.; Kaya, Isa; Ozgiray, Erkin; Midilli, Rasit; Karci, BulentEndoscopic endonasal approach has been successfully used for the management of pituitary tumors; however, the loss of septal mucosa especially around sphenoethmoidal recess and posterior nasal septum might be a disadvantage of this technique. The aim of this study is to describe a variation of the endonasal approach, "double nasoseptal flap'' technique in endoscopic transsphenoidal pituitary surgery, and to evaluate its outcomes. The technique depends on fully harvested bigger nasoseptal flap on one side and smaller on the other. Thirty patients were included. Functional results were assessed by preoperative and postoperative first month visual analogue scale (VAS), and morphology was evaluated by achieving intact septum from the sphenoid ostium to the columella. Sphenoid sinusitis, the presence of synechia and crusting in the sphenoethmoidal recess was also assessed. Mean VAS was 71 and 67 mm preoperatively and postoperatively, respectively (p > 0.01). There were no septal perforations, synechia, and sphenoid sinusitis postoperatively. Three patients had (10 %) crusts on sphenoethmoidal recess on first month postoperatively. Double nasoseptal flap technique has advantages, such as wider exposure during surgery; prepared flaps could be used if needed, better morphological and functional outcomes postoperatively. The technique is safe without any perforations and minimal crusting.Öğe The effect of "xanthan gum-based fluid thickener" on hydration, swallowing functions and nutritional status in total maxillectomy patients(Springer, 2018) Sezgin, Baha; Durusoy, Duygu; Demirci, Meltem Sezis; Ozturk, Kerem; Kaya, Isa; Eyigor, Sibel; Gode, SercanPurposeSwallowing functions are affected after total maxillectomy operations and adjuvant chemoradiotherapy. The purpose of our study is to assess the role of xanthan gum based thickening agents on swallowing and hydration of maxillectomy patients on a randomized controlled fashion.Methods12 of the 22 patients diagnosed with maxillary carcinoma and planned to undergo total maxillectomy was identified as study group and 10 of them were identified as control group. The study group used xantham based liquid thickener for liquid foods up to 3 months postoperatively and the control group did not use. Dysphagia-related quality of life, bioimpedance analysis, EAT-10 scores, swallowing functions were evaluated both preoperative and postoperative period.ResultsThe mean age of the study group was 569.87, and 41.6% were women. The mean age of control group was 60 +/- 15.63, and 50% were women. Postoperative EAT-10 scores were statistically significant higher than preoperative scores in both groups (p<0.05). In both of the study and control groups, a statistically significant reduction in dysphagia related quality of life was detected postoperatively (p<0.05). Intracellular water, extracellular water and total body water detected statistically significant higher in study group at postoperative month three.Conclusion Swallowing functions are affected due to total maxillectomy and radiotherapy. With this study, it has been shown that, total maxillectomy and radiotherapy reduce dysphagia-related quality of life. Swallowing dysfunction and dehydration has been shown to affect total maxillectomy patients. Using of xanthan gum-based fluid thickener' helps to maintain intracellular water, extracellular water, and total body water.Öğe The Effect of Endoscopic Endonasal Transsphenoidal Skull Base Surgery on Cochlear Function(Thieme Medical Publ Inc, 2019) Ates, Murat Samet; Benzer, Murat; Kaya, Isa; Biceroglu, Huseyin; Ozgiray, Erkin; Midilli, Rasit; Gode, SercanEndoscopic transsphenoidal skull base surgery (ETSS) has become a standard approach in the treatment of sellar and clival lesions, such as pituitary adenoma and chordoma. Due to the close proximity of the clivus and the sella turcica to the inner ear, it is thought that bone drilling in the surgery may have effects on hearing. the aim of this study was to assess the effect of bone drilling in ETSS procedure on cochlear function. This study was performed on 18 patients who underwent ETSS procedure between December 2016 and May 2017. the study was designed as a prospective study. All of the data were prospectively collected. These included demographic data, date of surgery, type of surgery, preoperative pure-tone audiometry, and preoperative and postoperative distortion product otoacoustic emission (DPOAE) measurements. of the DPOAE measurements of the patients who were operated for pituitary adenoma, there was a statistically significant difference between the signal-to-noise ratio (SNR) measurements at 0.5, 1, 2 and 4 kHz ( p < 0.05). Additionally, there were no significant differences in preoperative and postoperative SNR measurements of six patients who were selected for clivus chordoma. When the preoperative and postoperative tonal audiometric tests of the patients were compared, no statistically significant difference was found ( p > 0.05). in conclusion, it is found that bone drilling in ETSS procedure has a negative effect on cochlear function in the early period. This is the first study to evaluate the degree of noise-induced cochlear damage in patients who were gone under ETSS procedure.Öğe The Effect of Endoscopic Tympanoplasty on Cochlear Function(Korean Soc Otorhinolaryngol, 2018) Kaya, Isa; Turhal, Goksel; Ozturk, Arin; Gode, Sercan; Bilgen, Cem; Kirazli, TayfunObjectives. The aim of this prospective clinical study was to measure the audiologic outcomes of the patients that underwent endoscopic transcanal cartilage tympanoplasty, and to investigate the effects on cochlear function. Methods. Thirty-three patients (33 ears) who were diagnosed with noncomplicated chronic otitis media and underwent endoscopic transcanal cartilage tympanoplasty technique were included. Pre- and postoperative first month distortion product otoacoustic emission (DPOAE) signal-to-noise ratio (SNR), bone conduction hearing levels and air bone gap (ABG) values were measured and total endoscope usage time was noted. Results. Preoperative median SNR measurements at 0.5, 1, 2, and 4 kHz were 6 dB (1-11; interquartile range [IQR], 1), 6 dB (4-20; IQR, 1), 7 dB (3-26; IQR, 5) and 5.50 dB (0-9; IQR, 3), respectively. Postoperative median SNR measurements at 0.5, 1, 2, and 4 kHz were 6 dB (3-9; IQR, 1), 6 dB (2-21; IQR, 3), 7 dB (2-20; IQR, 3), and 6 dB (0-10; IQR, 7), respectively. Regarding the DPOAE measurements, there was no statistically significant difference between the SNR values of all given frequencies (P>0.05). Regarding the pure tone audiometry (PTA) measurements, bone conduction was significantly better at 0.5 and 1 kHz, postoperatively (P<0.05) and there was statistically significant difference at 2 and 4 kHz (P>0.05). Additionally, no statistically significant correlation was found between the SNR and PTA measurements and the endoscope usage time (P>0.05). Conclusion. We suggested that cochlear functions and sensorineural hearing remained stable after endoscopic transcanal cartilage tympanoplasty and cold light source doesn't cause significant adverse effects cochlear functions.Öğe Effect of Injectable Platelet-Rich Fibrin on Diced Cartilage's Viability in Rhinoplasty(Thieme Medical Publ Inc, 2019) Gode, Sercan; Ozturk, Arin; Berber, Veysel; Kismali, ErkanDiced cartilage is one of the most widely used camouflage technique in rhinoplasty. Its variable resorption rate creates issues in postoperative time period. Platelet-rich fibrin is an autologous concentrated blood derivative containing growth factors that accelerate tissue healing. The authors evaluate the effect of injectable platelet-rich fibrin (I-PRF) on the viability of diced cartilage, which has been used for dorsum camouflage in rhinoplasty. Forty patients were randomly divided into two groups based on dorsal camouflage grafts: diced cartilage with I-PRF (study group) and diced cartilage without I-PRF (control group). Cartilage graft thickness was measured by linear superficial tissue ultrasound at the postoperative first week and the third month in both groups. The mean cartilage graft thickness loss between the first-week and third-month ultrasound measurements was 0.58 +/- 0.21mm in the study group and 0.82 +/- 0.35mm in the control group. There was significant volume loss in the control group. I-PRF was successful in reducing the resorption rate of diced cartilage on nasal dorsum by either increasing the viability or keeping its form. Sticky cartilage is an easily applicable and reliable technique that may be used to camouflage dorsal irregularities in rhinoplasty.Öğe The Effect of Mandibulectomy and Mandibulotomy on Cochlear Function(Lippincott Williams & Wilkins, 2016) Gode, Sercan; Kaya, Isa; Turhal, Goksel; Kirazli, Tayfun; Bilgen, Cem; Ogut, Mehmet Fatih; Ozturk, KeremMandibulectomy and mandibulotomy procedures are performed with the oscillating saw and the acoustic energy generated during the osteotomies is transferred to the cochlea via temporomandibular joint and air conduction. The aim of this study was to assess the effect of mandibulectomy and mandibulotomy on cochlear function. This study was carried out on 15 patients who underwent at an otolaryngology department of a tertiary medical center between January 2013 and August 2015. The study was designed as a prospective study. All of the data were prospectively collected. These included demographic data, date of the surgery, type of surgery, preoperative pure-tone audiometry, preoperative and postoperative distortion product otoacoustic emission (DPOAE) measurements. Of the DPOAE measurements, there was a statistically significant difference between the signal-to-noise ratio measurement on the right ear measurement at 4kHz (P<0.05). Additionally, there was a statistically significant correlation between the signal-to-noise ratio measurements and the side of the osteotomy (P<0.05). In conclusion, it is found that mandibulectomy and mandibulotomy procedure has a negative effect on cochlear function in the early period. The DPOAEs were diminished on the osteotomy site in day one postoperatively. Results with a longer follow-up time can yield more information on the prognosis of the cochlear damage.Öğe The Effect of Mild Hypocapnia on Postoperative Ecchymosis in Rhinoplasty(Sage Publications Inc, 2022) Turhal, Goksel; Ozturk, Arin; Berber, Veysel; Sergin, Demet; Gode, SercanPurpose: Ecchymosis and edema are the most common complications in patients following rhinoplasty in the early postoperative period. Vasoconstriction created by hypocarbia may have a positive effect on postoperative ecchymosis. The aim of this study was to evaluate the effect of mild hypocapnia induced in rhinoplasty on the severity of periorbital ecchymosis. Methods: The study was carried out retrospectively in the digital photographs (control group and study group) of 31 participants who underwent open technical rhinoplasty between January and March 2019. During the operation, partial carbon dioxide pressure in the study group was kept in the range of 32 to 38 mmHg and in the control group between 42 and 46 mmHg and this was confirmed by arterial blood gas measurements taken during the operation. Measuring the brightness and shadows of digital photos Digital color meter was used in MacOS X as a computer software. Results: The mean ratio of periorbital ecchymosis to forehead brightness was 0.84 +/- 0.05 in the study group and 0.81 +/- 0.03 in the control group. There was no significant difference between the study and control groups (P > .05). Conclusion: This study investigates the potential role of hypocapnia on postoperative ecchymosis during rhinoplasty. The severity of ecchymosis was less in the patients with induced mild hypocapnia regarding both subjective and objective evaluations, but this difference didn't reach statistical significance compared to the normocapnic control group.Öğe The effect of partial superficial parotidectomy on amplitude, latency and threshold of facial nerve stimulation(Springer, 2016) Ozturk, Kerem; Akyildiz, Serdar; Gode, Sercan; Turhal, Goksel; Gursan, Gulce; Kirazli, TayfunThe aim of this study is to assess the effect of partial superficial parotidectomy and facial nerve dissection to electrophysiologic parameters of intraoperative facial nerve monitoring such as nerve stimulation threshold, stimulus amplitude and latency. Twenty-five patients who underwent partial superficial parotidectomy for benign parotid gland mass were included in the study. After the identification of the facial nerve main trunk, minimum stimulation threshold, latencies and amplitudes of the orbicularis oculi (electrode 1) and orbicularis oris (electrode 2) electrodes at 0.50 milliamperes (mA) were recorded. All of the recordings were repeated after the completion of parotidectomy. Median nerve dissection duration was calculated and size of the tumors was measured during macroscopic pathology. The median minimum nerve stimulation threshold was 0.15 mA [interquartile range (IQR) = 0.05] before and 0.15 mA (IQR = 0.08) after the parotidectomy (p = 0.02). Median nerve dissection duration was 49 min (IQR = 38). Median amplitude and latency in electrode 1 before and after the facial nerve dissection were 322 millivolts (mV) (IQR = 330), 370 mV (IQR = 370) (p = 0.02), 3 milliseconds (ms) (IQR = 1) and 4 ms (IQR = 2) (p = 0.05), respectively. Median amplitude and latency in electrode 2 before and after the facial nerve dissection were 396 mV (IQR = 275), 365 mV (IQR = 836) (p = 0.86), 3 ms (IQR = 1.5) and 4 ms (IQR = 1.5) (p = 0.17), respectively. Minimal nerve stimulation threshold and amplitude of electrode 1 were affected by facial nerve dissection among the electrophysiologic parameters (p = 0.02 and p = 0.02). Of the electrophysiological parameters only the latency of electrode 2 was significantly correlated with tumor size (p = 0.03). Besides, none of the parameters were predictive for a possible postoperative facial nerve dysfunction regarding superficial partial parotidectomy.
