Browsing by Author "Erol, Ozan"

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Age- and Gender-Related Variability in Nasal Tip Support
(2020) Koycu, Alper; Erol, Ozan; Buyuklu, Fuat Adnan; Jafarov, Sabuhi; Berker, Sinem; 0000-0003-1528-0036; 0000-0003-1290-3509; 0000-0002-7302-4199; 31834522; W-5941-2018; AAF-3650-2021; AAI-8044-2021
Background The age at which nasal tip support changes start to occur is unknown. Evaluation of nasal tip support is difficult, especially as the ideal nasal tip support pressure remains elusive. The aim of this study is to determine the nasal tip support pressure alterations relative to age and sex. Objectives The aim of this study is to determine the changers in resistance of the nasal tip support in relation to age and sex. Methods This prospective clinical study was conducted between January and April 2019 at a tertiary health facility. Nasal tip resistances were measured in four different age-groups (20-29, 30-39, 40-64, and > 65 years) with a digital Newton meter. A total of 159 patients with a minimum of 36 patients per group were included in the study. Nasal tip resistance measurements were compared among nasal tip displacement distances of 2, 3, and 4 mm, focusing on age and sex. Results The nasal tip resistance of the 20-29 age-group was significantly higher at 2, 3, and 4 mm nasal tip displacement distances, when compared with the 30-39 and 40-64 age-groups, whereas compared to the > 65 years group, it was significantly higher at 3 and 4 mm nasal tip displacement distances (p < 0.005). Nasal tip resistance of males was found to be significantly higher than that of females, at 3 and 4 mm nasal tip displacement distances (p < 0.001). Conclusions Nasal tip resistance is higher in males and universally decreases significantly after 30 years of age while remaining constant at later ages. Therefore, surgeons should prefer nasal tip resistance increasing techniques in the rhinoplasty operations that are performed on patients even from early years of age, in order to maintain and strengthen the nasal tip resistance.
Comparison of Rapid Absorbable Sutures with Nonabsorbable Sutures in Closing Transcolumellar Incision in Septorhinoplasty: Short-term Outcomes
(2020) Erol, Ozan; Buyuklu, Fuat; Koycu, Alper; Jafarov, Sabuhi; Gultekin, Goknil; Erbek, Selim S.; 0000-0002-7302-4199; 0000-0003-1290-3509; 0000-0003-4825-3499; 0000-0003-1528-0036; 0000-0002-9001-7812; 32700009; AAI-8044-2021; AAF-3650-2021; B-7604-2019; W-5941-2018; AAI-8256-2021
Background Following open rhinoplasty, a postoperative scar at the columellar incision line is a common morbidity. The aim of this study is to compare absorbable and nonabsorbable suture materials which had been used for closing the transcolumellar incision, in the aspect of risk of postoperative infection, wound healing, postoperative columellar scar and patient satisfaction. Method A prospective, randomized, single-blind study was conducted between May 2017 and February 2018. Sixty-four rhinoplasty patients were randomly assigned to absorbable (n = 32) or nonabsorbable (n = 32) groups. The columellar incision was closed with 7 full-thickness skin sutures. Either nonabsorbable 6/0 polypropylene (Group 1) or absorbable 6/0 polyglytone 6211 (Group 2) sutures were placed at the columellar incisions. Polypropylene sutures were removed at the 7th postoperative day. A Mann-WhitneyUtest and Monte Carlo were used for statistical comparison. Photographs of the patients at the postoperative third month (Fig. 2) were evaluated and scored in terms of scarring, pigmentation, notching, level differences in the incision area by two different otorhinolaryngologists who did not know the randomization. Suture removing discomfort was assessed with visual analogue scale scores. A satisfaction survey was filled out by all the patients completing their third month after the operation. Results According to the results of both otorhinolaryngologists, there was no significant difference between the two groups in terms of pigmentation, level difference, notching, overall appearance and total score (p = 0.920,p = 0.498, respectively). The mean score on the Wong-Baker scale was 3.19 +/- 1.67 in group 1. In the Satisfaction Survey, the average score of the group 1 was 6.90 +/- 3.24, while the mean score of the group 2 was 7.062 +/- 2.77. There was no statistically significant difference between the two groups (p = 0.715). Conclusions Suturing inverted V transcolumellar incisions with rapid resorbable sutures caused significantly less discomfort but no difference in scarring compared to nonresorbable sutures as evaluated by patients and observers.
Comparison of the efficacy of two different local anesthetics in inferior turbinate reduction
(2020) Erol, Ozan; Buyuklu, Fuat; 0000-0003-1528-0036; 32942114; W-5941-2018
Purpose: The present study compares the local anesthetic efficacy of EMLA (R) cream and lidocaine injection used in the radiofrequency reduction of the inferior turbinate. Methods: The study included a total of 124 patients with inferior turbinate hypertrophy and who underwent turbinate reduction under local anesthesia. The operations were performed 15 min after a lidocaine injection and 30 min after EMLA cream application. The respondent patients were asked to interpret such situations as intraoperative pain, discomfort during the procedure, choking sensation and difficulty swallowing using the Visual Analogue Scale (VAS). Results: The EMLA cream patients (Group A) were found to have a lower level of discomfort, choking sensation and difficulty swallowing than the lidocaine patients (Group B), while there was no substantial difference in pain between the two groups. Conclusions: It is concluded that EMLA (R) cream is an effective alternative to lidocaine injection during inferior turbinate reduction procedures.
The Effect of Smoking on Septoplasty and Septorhinoplasty Outcomes
(2022) Erol, Ozan; Koycu, Alper; 0000-0003-1290-3509; 34988636; AAF-3650-2021
Background There have been many studies in the literature describing the techniques, the associated comorbidities and the outcomes related to septoplasty and septorhinoplasty, while there have been few studies evaluating the effects of cigarette smoking on septorhinoplasty. The present study evaluates the effect of cigarette smoking on complication and revision rates and compares the functional results of smoking and non-smoking patients. Method The data of 598 patients were retrospectively analyzed, and the age, gender, cigarette smoking status, type of operation, NOSE scores, complications and revision rates were recorded. For the purpose of the study, three different patient groups were defined, being those who had never smoked, those who smoked in the past but had quit and active cigarette smokers. The preoperative and postoperative 6th month Nasal Obstruction Symptom Evaluation (NOSE) Questionnaire scores were compared, and the three groups were compared in terms of complications and the need for revision. Results No differences were identified in the complication rates or revision requirements of the three groups with different cigarette smoking statuses (p=0.17 and p=0.74, respectively). The NOSE scores of the surgery groups and cigarette smoking categories improved significantly after the operation (p=0.01). No difference was identified in the NOSE scores of the groups with different cigarette smoking statuses (p>0.05). Conclusion Active cigarette smoking has no effect on the functional results and rates of complication/revision after septoplasty or septorhinoplasty operation. That said, surgeons should suggest that patients quit smoking preoperatively in order to minimize the general systematic effects of cigarette smoking.
Effect of Suture Type and Suture Distance on Holding Strength in Nasal Septal Laceration Model
(2021) Koycu, Alper; Hizal, Evren; Erol, Ozan; Buyuklu, Adnan Fuat; 0000-0003-1290-3509; 0000-0002-9699-6783; 0000-0002-4209-9403; 33912854; AAF-3650-2021; A-5853-2018
Objective: Septal mucosal-perichondrial flaps can be lacerated during the elevation of the flaps. Appropriate repair of the lacerations is essential to prevent the development of septal perforation during the healing process. We aimed to determine the superior suture type and suture distance to use in repairing the lacerations of nasal septal mucosal-perichondrial flaps. Methods: The study used 128 nasal septal mucosal-perichondrial flaps prepared from sheep heads. Experimentally induced lacerations on the mucosal-perichondrial flaps were sutured with two interrupted sutures using one of four suture materials (4-0/5-0 Polyglactin 910, 4-0/5-0 Polydioxanone) and leaving either 5 mm or 10 mm distance between the sutures. Maximum tissue holding strength (HSmax) was measured for each suture material and suture distance used. Results: Mean HSmax values were higher for Polyglactin 910 sutures (p<0.001) and 10 mm suture distance (p=0.008) when the groups were compared in terms of suture material and suture distance, respectively. There was no statistically significant difference between the mean HSmax values of sutures with 4-0 and 5-0 diameters (p=0.057). Conclusion: Polyglactin 910 suture material with 10 mm space between two adjacent sutures may be more durable than the other suture materials when repairing nasal septal mucosal lacerations.
Evaluation of Nasal Tip Support in Septorhinoplasty
(2019) Erol, Ozan; Buyuklu, Fuat; Koycu, Alper; Bas, Ceren; Erbek, Selim S.; 0000-0002-4209-9403; 0000-0003-1290-3509; 30895358
BackgroundA good understanding of nasal tip support mechanisms is essential for achieving successful and functional rhinoplasty results. The loss of nasal tip support resulting from different maneuvers adopted during rhinoplasty and how this loss is affected by reconstructive applications should be known. This study evaluated and compared changes in nasal tip support perioperatively after different techniques were used during septorhinoplasty.MethodsPatients who underwent primary open rhinoplasty between January 2018 and March 2018 in a tertiary medical center were included in this prospective blind case series. Nasal tip resistance measurements were taken after perioperative maneuvers by creating enough force to achieve 1mm, 2mm and 3mm of displacement at the tip region. Measurements were obtained during six different stages using a Newton meter: preoperatively, after caudal septal resection, after skin flap elevation, after the columellar strut or tongue-in-groove procedure, after tip suturing and postoperatively. Our hypothesis was that during septorhinoplasty, each maneuver used changes the tip support intraoperatively. The predictor variables were the different rhinoplasty techniques used. The outcome variable was nasal tip resistance to compression intraoperatively and immediate postoperatively. Appropriate statistics were computed, and a p<0.05 value was considered significant.ResultsTen of the 15 patients were female, and 5 were male. The patient age ranged from 19 to 40 (mean 24.84.9). The tongue-in-groove technique was applied in 5 of the patients, while columellar strut grafting was performed in 10. The application of columellar strut grafting did not create a significant increase in nasal tip support (p>0.05). An increase in nasal tip support was observed at each stage (85%, 53%, 35%) after application of the tongue-in-groove technique (p<0.05).ConclusionsA novel and reproducible technique for digitally evaluating manual force is presented for determining changes in nasal tip support with different maneuvers applied in living patients undergoing rhinoplasty. No significant difference was noted between the preoperative and postoperative measurements for columellar strut grafting. The tongue-in-groove technique is an important maneuver that has a significant effect on nasal tip support. According to our data, the interdomal and intercrural ligaments, the medial crus-septum connections and the connections between alar cartilage and overlying skin and muscle tissue are important structures for tip support.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
A Rare Cause of Hemifacial Spasm: Papillary Oncocytic Cystadenoma
(2016) Erol, Ozan; Aydin, Erdinc; 0000-0001-6864-7378; 27761290; AAJ-2379-2021
Background: Hemifacial spasm is a sudden, involuntary and synchronous spasm of the facial muscles. The most frequent cause of this condition is compression of the facial nerves due to vascular pathologies. The most commonly used method of treatment is Botulinum toxin injection. However, the gold standard treatment is surgical treatment. Case Report: A 64-year-old male patient with hemifacial spasms, which had occurred due to a rare parotid mass that had been surgically treated, is presented in this case. Conclusion: This case report demonstrates that long-standing parotid gland masses may compress the facial nerves and cause demyelination in the nerve and thus may cause spasms in the facial muscles.
A Rare Complication of Tonsillectomy: Subcutaneous Emphysema
(2016) Aydin, Erdinc; Erol, Ozan; 0000-0001-6864-7378; 29392042; AAJ-2379-2021
Tonsillectomy is one of the surgical procedures that are frequently performed by ear, nose, and throat surgeons. The procedure is associated with many intra-operative and postoperative complications, and the nature of the operation site hampers surgical interventions. Cervicofacial subcutaneous emphysema is characterized by the presence of air within the fascial planes of the head-neck region because of various reasons. It may develop iatrogenically or spontaneously because of trauma. Herein, we report a 4-year-old male patient who presented to our clinic with complaints of frequent tonsillitis and snoring and who developed subcutaneous emphysema involving only the maxillofacial region following tonsillectomy. In addition, treatment strategies have been discussed, taking current literature into account.
A Rare Tumor in the Cervical Sympathetic Trunk: Ganglioneuroblastoma
(2016) Erol, Ozan; Koycu, Alper; Aydin, Erdinc; 0000-0003-1290-3509; 0000-0001-6864-7378; 0000-0002-4209-9403; 27965907; AAF-3650-2021; AAJ-2379-2021
Ganglioneuroblastoma is a rare tumor with moderate malignancy, which is composed of mature ganglion cells and seen in sympathetic ganglia and adrenal medulla. The diagnosis is possible after cytological and immunohistochemical studies following a needle biopsy or surgical excision. There is no consensus regarding the need for chemo-or radiotherapy after surgery. In this case report, clinical behavior and diagnosis and treatment of the rare tumor cervical ganglioneuroblastoma were discussed.
Septorinoplastide nazal tip desteği değişikliklerinin değerlendirilmesi
(Başkent Üniversitesi Tıp Fakültesi, 2018) Erol, Ozan; Büyüklü, Adnan Fuat
Gereç-Yöntem: Bu prospektif ve kör çalışma Şubat 2018-Mart 2018 arasında Başkent Üniversitesi Kulak Burun Boğaz Anabilim Dalı'nda açık teknik estetik rinoplasti uygulanan 15 hasta üzerinde uygulandı. Çalışma öncesinde tüm hastalardan bilgilendirilmiş onam formu alındı. Daha önce opere edilen hastalar ve kaudal septum deviasyonu olan hastalar çalışma dışı bırakıldı. Ameliyatlar tek bir cerrah tarafından yapıldı. Midkolumellar insizyon, flep elevasyonu, kaudal septum rezeksiyonu, tongue in groove tekniği, kolumellar strut grefti, tip müdahaleleri uygulanan hastalar çalışmaya alındı, Kliniğimizde rutin olarak kullandığımız bu teknikler tüm hastalara aynı sıra ile uygulandı. Kaudal strut ve tongue in groove teknikleri cerrah tarafından gerekli görülen hastalara uygulandı. Her bir aşama 1mm, 2mm, 3mm ölçülerinde tip bölgesine kompresyon uygulanarak preoperatif, kaudal septum rezeksiyonu, flep elevasyonu, kolumellar insizyon kapatılmasının hemen ardından erken postoperatif dönemde newtonmetre (SF-50Newton Dijital Dinamometre, EgeRate) ile direnç ölçümü yapıldı. Ölçümler sırasında kolumellanın hemen önüne cetvel konularak kompresyon uygulanırken profilden video ve seri fotoğraflar alındı. Daha sonra bu kayıtlar kör bir araştırmacı tarafından bilgisayar ortamında incelenerek veriler kaybedildi. Bulgular: Hastaların yaşları 19 ile 35 arasında değişmekte olup ortlaması 24 8±4 9 idi. Cinsiyetlerine göre dağılıma bakıldığında; olguların %66 6'sı (n=10) kadın, %33 4’ü (n=5) erkekti. Kaudal septum re ek iyonu onra nda tip direnci anlamlı şekilde düşük saptanmıştır. Tongue in groove tekniğinde diğer tüm manevralarla karşılaştırıldığında tip desteğinde anlamlı olarak bir artış saptandı (p<0.05). Kolumellar strut grefti uygulamasında ameliyat öncesi ve sonrası dönemde tip desteğinde anlamlı bir değişiklik saptanmadı. Ayrıca intradomal bağların diseksiyonu sonrası tip desteği anlamlı olarak azalmış bulunurken, ameliyat sonunda onarım yapıldığında bu desteğin tekrar arttığı saptandı(p<0,05) Sonuç: Bu çalışma, çeşitli rinoplasti manevralarında sonra nazal tip desteğindeki değişimi değerlendirmek ve ölçmek için test ekipmanının kullanımını göstermektedir. Kaudal strut grefti uygulaması tip desteğini artırmamaktadır. Tongue-in-groove tekniği seçilmiş hastalarda kullanılabilen ve nazal tip gücünü en fazla artıran tekniktir. Materials and Method: This prospective and blind study is conducted at, Baskent University School of Medicine, Otorhinolaryngology Department between February 2018- March 2018. 15 patients undergoing open technique aesthetic rhinoplasty are included. Informed consent is obtained from all patients. Patients having history of previous nose surgery and patients with caudal septum deviation are excluded. All procedures are performed by a single surgeon. Patients operated using following techniques are included in this study: midcolumellar incision, flap elevation, caudal septum resection, tongue-in-groove technique, columellar strut grafting and tip intervention. These techniques previously cited are carried out in exact same order for all the patients during surgery. Caudal strut and tongue-in-groove techniques are optionally performed for suitable patients as seen necessary by the surgeon. Measurements are taken in between all the stages, preoperatively; following caudal septum resection; columellar strut grafting; tongue-in-groove (chosen patients only); tip interventions (saturation and grafting) and early postoperative period immediately after closing columellar incision, while applying 1mm, 2mm and 3mm compression forces to tip area. Newtonmeter is used for resistance measurements (SF-50Newton Dijital Dinamometre, EgeRate). Serial photos are taken and video recordings are obtained with a scale placed adjacent to columella during application of compressive forces. Subsequently these recordings are analyzed and data are documented. Results: Mean age for the tudy group wa 24 8±4 9 ranging etween 19and 35. %66.6 (n=10) of the patients were female, %33,4 (n=5) were male. Significant reduction in tip support following caudal septum resection is detected. Significant increase in tip support is observed following tongue-in-groove technique compared to all other maneuvers (p<0.05). There was no significant difference between preoperative and postoperative tip support for columellar strut grafting. Additionally tip support is found to be significantly reduced after dissection of intradomal ligaments which showed improvement with repair (p<0,05). Conclusion: This study shows application of testing equipment for evaluating and measuring nasal tip support following various rhinoplasty maneuvers. Caudal strut grafting revealed no increase in tip support. Tongue-in-groove technique has shown to improve nasal tip support at the utmost compared to other techniques employed.