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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 The buccal fat pad flap for the reconstruction of intraoral buccal defects following buccal cancer surgery(Elsevier Science Inc, 2022) Ozturk, Kerem; Turhal, Goksel; Sahin, Fetih FurkanObjective: There are many reconstruction techniques for the repair of the intraoral buccal defects following oncological resections. The pedicled buccal fat pad (BFP) flap can be used for reconstruction of medium-sized buccal defects. The purpose of this study was to investigate the outcomes of the reconstruction with BFP flap following the resection of buccal tumors and risk factors on BFP flap success. Methods: This study was designed as a retrospective case series research. Ten patients with squamous cell carcinoma of the buccal mucosa underwent BFP flap reconstruction following tumor resection. The dimensions of the primary tumor and post-resection defect were calculated. The intraoral operation field was evaluated on the postoperative 7th day and in the postoperative 1 st and 6th months. Postoperative flap status, disease recurrence, risk factors for flap success were assessed. Results: The mean greatest dimension of the post-resection buccal defect was 41.9 +/- 10.3 mm. A partial dehiscence was observed in three patients in the postoperative 7th day. The 6th month-examination revealed no flap complications. The mean greatest dimension of post-resection buccal defect in uncomplicated patients was 42.7 +/- 11.4 mm and in patients with partial dehiscence was 40 +/- 8.6 mm (p = 0.727). There was no significant difference between uncomplicated patients and patients with partial dehiscence according to body mass index (normal vs overweight, p = 0.667). Conclusion: The BFP flap is a reliable reconstruction method in medium sized buccal defects following oncological resection. It has low complication and donor site morbidity rates and also good anatomical and oncological outcomes. (C) 2021 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI. Published by Elsevier Ltd. All rights reserved.Öğe Cartilage Chips in Rhinoplasty(Thieme Medical Publ Inc, 2022) Apaydin, Fazil; Garcia, Rodrigo Fortunato Fernandez-Pellon; Sahin, Fetih Furkan; Rahavi-Ezabadi, SaraObjective This study reveals that the cartilage chips can be a good solution for camouflage and augmentation in rhinoplasty. Methods In this study, 64 patients who had undergone rhinoplasty from 2014 to 2019 were retrospectively studied. The average age was 31. Forty-nine patients had primary and 15 revision rhinoplasties. Cartilage chips were cut into less than 0.5-mm thickness dimensions changing from 2 to 10 mm. They were used to fill deep radix, depressions at the key area, supratip area, around the grafts to prevent their visibility at the tip. In addition, they were used in the fascia for augmentation. The cartilage chips were sculpted from the septal cartilage in 47, rib in 16, and ear cartilage in one case. Results They were applied on the radix in 25, middle vault in 37, supratip area in 32, and on the tip in 12 cases. In 30 cases, cartilage chips were mixed with cartilage dust for better fixation and camouflage. They were placed in the fascia in three cases for dorsal augmentation. Complications were seen in three cases in the form of irregularities. Conclusion Cartilage chips are found to be a powerful solution in terms of camouflage and augmentation.Öğe Comparison of endoscopic and microscopic stapedotomy in the same patients: a prospective randomized controlled trial(Springer, 2024) Kaya, Isa; Sahin, Fetih Furkan; Tanriverdi, Hasan; Eroglu, Suleyman; Kirazli, TayfunPurpose This study aimed to conduct a comparative analysis of audiological and postoperative clinical outcomes between the endoscopic and microscopic stapedotomy approaches. Methods This study employed a randomized, controlled design. Twenty-seven patients with bilateral otosclerosis underwent stapedotomy in both ears, with randomized allocation of the surgical technique (endoscopic vs. microscopic) for the first operated ear. Air-bone gap (ABG) and ABG gain were measured at least 12 months postoperatively. Postoperative outcomes including pain (Visual Analog Scale-VAS), dizziness, early-term (day 1) and late-term (6 months) dysgeusia were evaluated. The Glasgow Benefit Inventory (GBI) assessed health-related quality of life at one month postoperatively, and operative time was measured. Results This study compared endoscopic (n = 27 ears) and microscopic (n = 27 ears) stapedotomy for otosclerosis. Both groups achieved similar hearing improvement with no significant differences in pre-operative and post-operative bone/air conduction thresholds, ABG, and ABG gain (all p > 0.05). The endoscopic stapedotomy group demonstrated reduced postoperative pain (lower VAS scores, p < 0.001), lower early dysgeusia (3.7% vs. 33.3%, p = 0.005), shorter operative time (47.3 vs. 75.4 min, p < 0.001) and improved patient-reported outcomes (higher GBI score, p = 0.014) when compared to microscopic stapedotomy group. No significant differences were observed in postoperative dizziness or late-term dysgeusia between groups. Conclusion This study found similar hearing improvement with both endoscopic and microscopic stapedotomy for otosclerosis. However, the endoscopic approach showed advantages in reduced postoperative pain, early dysgeusia, and operative time, with improved patient-reported quality of life. These findings suggest endoscopic stapedotomy as a valuable alternative to the conventional microscopic approach.Öğe Evaluation of significant gene expression changes in congenital and acquired cholesteatoma(Springer, 2020) Kaya, Isa; Avci, Cigir Biray; Sahin, Fetih Furkan; Ozates, Neslihan Pinar; Sezgin, Baha; Kurt, Cansu Caliskan; Kirazli, TayfunEtiopathogenesis of acquired and congenital cholesteatoma is still unclear. the clinical behavior of adult acquired, pediatric acquired and congenital cholesteatomas show differences. the scope of the this study was to detect thematrix metalloproteinase(MMP),tissue inhibitors of metalloproteinase(TIMP) andepidermal growth factor receptor(EGFR) gene expression changes in cholesteatoma perimatrix and to compare these changes among congenital cholesteatoma, adult acquired cholesteatoma and pediatric acquired cholesteatoma. A total of 16 genes includingMMPs,TIMPs andEGFRwere analyzed in the samples of 32 cholesteatoma tissues. Real-time PCR was used for detection of the gene expression levels. Data analyses were achieved by Delta Delta CT method (Light Cycler 480 Quantification Software) and Statistical Package for Social Sciences (SPSS) version 22.0. the expression levels ofMMP-2,-9,-10,-11,-13,-14,-15,-16andEGFRgenes were significantly higher in acquired cholesteatoma than healthy tissue (p < 0.05). There was a statistically significant decrease (3.34 times more) in the meanTIMP-2gene expression level in acquired cholesteatoma compared to healthy tissue (p < 0.05). There was a significant increase in the mean expression level ofMMP-7gene and a decrease in the mean expression level ofTIMP-1gene (3.12 times more) in congenital cholesteatoma compared to healthy tissue (p < 0.05). This study indicates that increased expression levels of some particularMMPgenes andEGFRgene and decreased expression levels ofTIMPgenes may play an important role in the development of cholesteatoma. Further,MMP-9,MMP-13andMMP-14genes may have a remarkable role in the development of more aggressive cholesteatoma forms. the authors concluded that overexpression ofMMP-9,MMP-13andMMP-14may cause stronger inflammation associated with cholesteatoma.Öğe Histopathology of thermal effects in endoscopic ear surgery: An experimental animal study(Wiley, 2024) Kaya, Isa; Sahin, Fetih Furkan; Uyanikgil, Yigit; Tomruk, Canberk; Sirin, CansinObjectiveThe potential risk of thermal damage in the transcanal endoscopic ear surgery has been a concerning issue. This study aimed to investigate the histopathological effects of heat exposure of different durations in external auditory canal (EAC) skin and facial nerve tissues.MethodsThis study was conducted on 20 rabbits assigned equally to five groups according to the endoscope-transmitted heat exposure duration: Control group (no exposure), 2, 10, 15, and 30 min. At the end of the procedure, EAC skin and the tympanic segment of facial nerve tissue samples were taken surgically and histopathologically examined.ResultsSignificant histopathological thermal damage findings in external auditory canal skin and facial nerve tissues were observed under endoscope-transmitted heat exposure longer than 15 and 10 min, respectively.ConclusionThis study demonstrated that prolonged exposure of the endoscope-transmitted heat can cause histopathological thermal damage in EAC skin and facial nerve on rabbit subjects.Öğe The new cubism graft technique in tympanoplasty: A randomized controlled trial(Wiley, 2021) Kaya, Isa; Sahin, Fetih Furkan; Tanriverdi, Hasan; Kirazli, TayfunObjectives The aim of this prospective, randomized-controlled study is to analyze the outcomes of a new graft technique in tympanoplasty and compare its outcomes with cartilage island graft plus extra perichondrium. Methods A total of 44 patients with noncomplicated chronic otitis media were included in this prospective randomized-controlled clinical trial. Patients were randomly divided into 2 double-layer graft groups: The cartilage island graft + cubism graft (study group) and the cartilage island graft + extra perichondrium (control group). The main outcome measures of the study were the air-bone gap (ABG), ABG gain, and graft status. Results Graft success rate was 100% and 95.5% in the study group and the control group, respectively. There were statistically significant differences in the postoperative first month ABG and ABG gain between study and control groups (P < .05). ABG and ABG gain showed no significant differences in the postoperative sixth month between groups (P > .05). Conclusion This study revealed that both graft techniques have satisfactory functional and morphological results compared to preoperative findings. The use of cubism graft with cartilage island graft has significantly better auditory outcomes in short-term and similar results in long-term compared to double-layered cartilage island graft with extra perichondrium. Cubism graft is a highly promising graft technique with its many advantages. Level of Evidence 1b.Öğe A novel graft-harvesting technique in tympanoplasty: the cubism graft(Springer, 2021) Kaya, Isa; Sahin, Fetih Furkan; Hasan, Tanriverdi O.; Kirazli, TayfunBackground The slicing method that is used for thinning the cartilage graft may cause forming complications in tympanoplasty. Besides, double-layered grafting techniques may be required when graft medialization is observed. Method This article presents a new and controlled graft cartilage thinning and the cubism graft-harvesting technique in tympanoplasty. Conclusion Thanks to this new technique, over-curling and undesirable fractures of the cartilage island graft can be prevented and the obtained cartilaginous dust can be mixed with platelet-rich fibrin to form the cubism graft. This combined cartilage thinning and cubism graft technique provided 100% graft success and an average air-bone gap gain of 16.3 +/- 2.9 dB (10.7-22.3 dB) in our series of 22 patients. in conclusion, 100% graft success, successful tympanic membrane re-epithelialization and significant auditory improvement can be achieved with this method.Öğe The modified asymmetric chondro-perichondrial island graft in type I tympanoplasty: A retrospective analysis of 784 patients(Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2024) Sahin, Fetih Furkan; Kaya, Isa; Ceylan, Hakan; Kirazli, TayfunObjective: This study aimed to assess the efficacy of a novel modified asymmetric chondro-perichondrial island graft in tympanoplasty. The design features a longer anterior segment compared to the posterior segment, addressing limitations of symmetrical grafts. We investigated the impact of this modified graft on hearing improvement and graft success rates in patients undergoing tympanoplasty surgery. Methods: This retrospective study evaluated 784 patients with chronic otitis media who underwent primary type I tympanoplasty with a modified asymmetric chondro-perichondrial island graft technique. Demographics and characteristics of all patients, preoperative location of the perforation, and Pure-Tone Audiometry (PTA) were assessed preoperatively, and graft success and postoperative hearing outcomes were evaluated at the 12-month follow-up. Results: This study evaluated the efficacy of a modified asymmetric chondro-perichondrial island graft in tympanoplasty. In 784 patients, the mean 12-month postoperative Air-Bone Gap (ABG) improvement was 17.3 dB with a 99% graft success rate. Preoperative ABG significantly improved from 24 dB to 6.6 dB postoperatively (p < 0.001). Perforation location did not affect ABG improvement (p = 0.193) but did influence graft success rate (p < 0.001). No sensorineural hearing loss, retraction pockets, or cholesteatoma were observed postoperatively. Conclusion: Tympanoplasty offers a well-established surgical approach for restoring hearing function and preventing recurrent otorrhea. The asymmetric cartilage-perichondrium island graft design has emerged as a promising technique to achieve optimal functional and anatomical outcomes in tympanoplasty. Level of evidence: Level 4.Öğe Transcutaneous Suture Tip Plasty: The Technique and Outcomes(Sage Publications Inc, 2019) Turhal, Goksel; Benzer, Murat; Sahin, Fetih Furkan; Midilli, Rasit; Karci, Bulent; Sahin, Mustafa; Gode, SercanPurpose: Radical resections and invasive techniques have been mostly replaced with more conservative techniques. The aim of this study was to assess the objective and the subjective functional and aesthetic outcomes of transcutaneous suture tip plasty. Methods: A total of 20 patients were included in the study. Patients were treated with transcutaneous suture tip plasty. Functional results were assessed with pre- and postoperative 6-month Sino-Nasal Outcome Test (SNOT-22) and acoustic rhinometry. The pre- and postoperative 6-month mean values of first minimal cross-sectional area (MCA1), second minimal cross-sectional area (MCA2), the distance from the tip of the probe to the first minimal cross-sectional area, the distance from the tip of the probe to the second minimal cross sectional area, nasal volume 1, and nasal volume 2 were measured. Facial analysis was made with the Rhinobase software, designed for facial analysis. Results: The mean pre- and postoperative SNOT-22 scores were 25.55 +/- 6.64 and 15.70 +/- 8.11, respectively (P < .05). The mean pre- and postoperative nasolabial angles were 82.26 degrees +/- 5.69 degrees and 101.47 degrees +/- 7.70 degrees, respectively (P < .05). The mean pre- and postoperative nasofrontal angles were 144.30 degrees +/- 3.81 degrees and 138.25 degrees +/- 3.26 degrees, respectively (P < .05). The mean pre- and postoperative nasal length was 54.22 +/- 4.62 mm and 49.95 +/- 2.75 mm, respectively (P < .05). The mean pre- and postoperative tip projection was 25.77 +/- 3.64 mm and 28.40 +/- 2.97 mm, respectively (P < .05). Only postoperative MCA2 values on the right and left side were significantly different from preoperative MCA2 values (P < .05). None of the remaining postoperative acoustic rhinometry scores significantly differed from preoperative scores. Two patients (10%) required revision at around 1 month after surgery due to suture loosening and breakage. Conclusions: Especially in the era of minimal invasive surgery, transcutaneous suspension tip plasty is promising, with rapid and reliable functional and cosmetic results. Further studies with longer follow-up durations are needed to assess the long-term outcomes of this technique.
