PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item Throat Symptoms Before and After Septal Surgery in Adults with Nasal Septum Deviation(2023) Jafarov, Sabuhi; Isazade, Artoghrul; Bahcecitapar, Melike; Buyuklu, Adnan Fuat; 35763366Objective To investigate subjective throat symptoms with the Qualities of Sore Throat Index (QuaSTI) in adults with nasal septum deviation. Study Design Prospective study. Setting Baskent University Ankara Hospital. Methods Group 1 included patients with septum deviation. Preoperative data were obtained through evaluation of subjective nasal obstruction with the NOSE (Nasal Obstruction Symptom Evaluation) and throat symptoms with the QuaSTI (group 1a). After 3 months, the same patient group was reevaluated with the NOSE and QuaSTI to obtain postoperative data (group 1b). Group 2 was formed of healthy volunteers with no nasal obstruction. Results The mean +/- SD and median (range) values of the QuaSTI total score were 33.39 +/- 29.50 and 18.5 (0-90) in group 1a, 7.49 +/- 4.31 and 7 (0-18) in group 2, and 7.58 +/- 9.24 and 4.50 (0-49) in group 1b (group 1a vs 2, P < .001; group 1a vs 1b, P < .0001). A significant difference was determined between groups 1a and 2 with respect to the QuaSTI sensory score (26.58 +/- 23.54 and 18 [0-73] vs 6.51 +/- 3.58 and 7 [0-15], P < .001, respectively) and between groups 1a and 1b for the QuaSTI functional score (6.03 +/- 6.62 and 3 [0-20] vs 1.50 +/- 2.47 and 0.50 [0-13], P = .004). No significant difference was found between groups 1a and 2 in terms of the QuaSTI emotional score (P = .126). Conclusion Various persistent sensory and functional throat symptoms can be seen in patients experiencing nasal obstruction associated with septum deviation, and the majority of these symptoms recover after septal surgery.Item Respiratory problems and associated factors following endoscopic balloon dilatation procedure in children with acquired subglottic stenosis(2022) Tuzuner, Arzu; Bas, Ceren; Jafarov, Sabuhi; Bahcecitapar, Melike; Aydin, Erdinc; 0000-0002-7302-4199; 35037169; AAI-8044-2021Objectives Endoscopic balloon dilatation (EBD) offers a safe and non-invasive surgical option for the treatment of subglottic stenosis. Patient selection is important to achieve good results and to detect which patients are more prone to the development of complications. The aim of this study was to determine predictors of postoperative problems and early complications in primary EBD surgeries. Methods A retrospective analysis was made of patients with acquired subglottic stenosis who were operated on with the EBD technique between January 2010 and December 2019 in the Otolaryngology-Head and Neck Surgery Department of Baskent University Hospital. Demographic data including the age and sex of the patients were collected together with etiology, presence of chromosomal or craniofacial anomaly (C/CA), duration of prolonged intubation (DPI), and extubation dilatation timeframe (EDT). Intra and postoperative follow-up data were recorded of the need for intubation or tracheotomy, development of desaturation, and grade and type of stenosis. Results The male to female ratio was 2:1. The patients comprised 42 males and 22 females with a mean age of 296.52 +/- 551.93 days. The cause of prolonged intubation was surgery for congenital heart disease in 50 (78.1%) patients and prematurity in 14 (21.9%). The type of lesion was acute granulation in 44 (72.1%) and chronic granulation in 17 (27.9%) patients. C/CA was determined in 13 patients, the mean grade of stenosis was 76.33 +/- 15.21%, mean DPI was 25.25 +/- 35.49 days, and mean EDT was calculated as 78.23 +/- 373.82 days. Desaturation following endoscopic balloon dilatation developed in 26 (40.6%), orotracheal intubation was required in 10 (15.6%), tracheotomy in 10 (15.6%), and cardiopulmonary arrest occurred in 4 (6.25%). Prematurity, a longer duration of preoperative intubation, longer time from extubation to dilatation, older age, and higher grade of stenosis were determined as factors associated with postoperative early respiratory complications. Conclusion EBD indication should be carefully considered in children with acquired subglottic stenosis. To achieve better results and minimise complications, EBD should be performed without delay.Item Effects of Combined Visible and Infrared Light Rhinophototherapy in Patients With Allergic Rhinitis(2023) Koycu, Alper; Bas, Ceren; Musabak, Ugur H.; Erbek, Selim Sermed; Koca, Huseyin Samet; Babakurban, Seda Turkoglu; Bahcecitapar, Melike; https://orcid.org/0000-0003-1290-3509; 36266929; AAF-3650-2021Background Intranasal phototherapy offers an alternative treatment method for patients with allergic rhinitis who cannot benefit from intranasal corticosteroids and oral antihistamines. Different wavelengths have been tried with promising results. Objective In this present study, we aimed to investigate the effects of visible light-infrared light phototherapy on clinical improvements together with its cytologic effects in patients with allergic rhinitis. Methods Patients with confirmed allergic rhinitis were given a 4-week course of intranasal phototherapy treatment. Weekly symptom questionnaires were applied to monitor clinical effects. Nasal lavage specimens were obtained before the start and at the completion of the 4-week therapy. Fluorescence-activated cell sorting analyses of CD16(+), CD24(+), and CD 45(+) cells were performed. Statistical analyses are performed of weekly changes in symptoms and cell counts. Results CD45(+)CD16(high)CD24(+) neutrophil count in nasal lavages decreased significantly whereas CD45(+)CD16(dim/-)CD24(+) eosinophil counts significantly increased and CD45(+) granulocyte counts remained unchanged. Symptom scores including nasal itching, nasal discharge, nasal obstruction, sneezing, eye itching, throat itching, and ear itching all statistically decreased compared to baseline at the end of 4 weeks. Conclusion Four-week course of intranasal phototherapy with visible and infrared light leads to clinical improvement in allergic rhinitis patients.Item Evaluation of Oropharyngeal Dysphagia in Elderly Patients with Pharyngeal Aberrant Internal Carotid Artery Using the Eating Assessment Tool-10 (EAT-10)(2021) Jafarov, Sabuhi; Isazade, Artoghrul; Koycu, Alper; Beyazpinar, Gulfem; Bahcecitapar, Melike; Tuzuner, Arzu; 0000-0001-9735-3504; 0000-0002-8467-0225; 0000-0003-1290-3509; 0000-0001-9735-3504; 34226957; AAI-8044-2021; AAJ-1829-2021; AAF-3650-2021; AAJ-2487-2021Pharyngeal aberrant internal carotid artery (PAICA) has been reported to be a cause of oropharyngeal dysphagia (OD) in case reports. However, as there have been no clinical studies, the relationship between PAICA and OD is not clear. The aim of this study was to investigate the perception of OD in elderly PAICA patients using the Eating Assessment Tool-10 (EAT-10). A study group (Group 1) was formed of patients diagnosed with PAICA from the visualization of a pulsatile mass in the pharynx in flexible fiberoptic endoscopic examination and carotid magnetic resonance angiography tests, and a control group (Group 2) was formed of age-matched healthy volunteers. The study group was subdivided as patients with unilateral PAICA (Group 1a) and patients with bilateral PAICA (Group 1b). The Turkish version of the EAT-10 was applied to all the participants. Total EAT-10 points of >= 3 were accepted as abnormal. Normal (< 3) and abnormal (>= 3) total EAT-10 points were determined in 88.9% (24/27) and 11.1% (3/27), respectively, of the control group, in 55.2% (16/29) and 44.8% (13/29) of Group 1, in 70.6% (12/17) and 29.4% (5/17) of Group 1a, and in 33.3% (4/12) and 66.7% (8/12) of Group 1b. A statistically significant difference was determined between the control group and Group 1 and Group 1b in respect of abnormal (>= 3) EAT-10 total points (p = 0.007, p = 0.001, respectively). No statistically significant difference was determined between the control group and Group 1a (p = 0.227). Problems (EAT point >= 1) in item 4 (swallowing solids takes extra effort) were experienced by 13 (44.8%) patients in Group 1, 9 (75%) patients in Group 1b, and 5 (18.5%) subjects in the control group (p < 0.05). These results demonstrated that unilateral PAICA does not significantly affect swallowing, whereas bilateral PAICA created a significant negative effect. These patients experience more problems when swallowing solid food.Item Diagnosed in operating room with hypertension: a widespread but unseen affliction(2020) Balci, Eda; Demir, Asli; Bahcecitapar, Melike; Karadeniz, Umit; 32187036Objective The present study aims to describe a widely held misconception in the literature concerning preoperative hypertension diagnosis. The blood pressure elevation occurring in the operative room is seen commonly even in subjects considered hitherto fully normotensive. As these patients have a condition which - similar to White Coat Hypertension (WCH) - indicates the presence of hypertension, and thus necessitates more frequent intraoperative checks. Methods We have named a condition 'Diagnosed in Operating Room (DIOR) with Hypertension', following the preoperative stage at which it is detected. Result Our observational study evaluated 718 elective noncardiac surgery adult patients, finding 28% of them (n = 204) to be 'DIOR-tensive' and thus at risk for suboptimal intraoperative care. Conclusion In addition to recommending a modification to the domain's best practices, we provide a preliminary description of DIOR hypertension patient identifying characteristics (older, higher body weight and BMI, and higher rates of chronic obstructive pulmonary disease, hypothyroidism and obesity), so that DIOR hypertension patients may be more readily identified, and that future research may build on the findings, and that the operating team may remain generally aware that this problem can occur and be dealt with regardless of the patient's medical history.Item Device-related epistaxis risk: continuous-flow left ventricular assist device-supported patients(2020) Koycu, Alper; Vural, Omer; Bahcecitapar, Melike; Jafarov, Sabuhi; Beyazpinar, Gulfem; Beyazpinar, Deniz Sarp; 0000-0003-1290-3509; 0000-0001-7157-0850; 0000-0003-4324-9458; 0000-0002-7302-4199; 32556786; AAF-3650-2021; AAJ-1454-2021; AAI-9939-2021; AAI-8044-2021Background The aim of this study was to analyze the effect of device-dependent factors on epistaxis episodes comparing patients supported with a continuous-flow left ventricular assist device (CF-LVAD) to patients under the same antithrombotic therapy. Methods Patients who underwent CF-LVAD between 2012 and 2018 were reviewed retrospectively from the institutionally adopted electronic database. Patients who underwent mitral valve replacement (MVR) surgery receiving the same anticoagulant and antiaggregant therapy were included as a control group. Demographics, epistaxis episodes, and nonepistaxis bleeding between the two groups were compared. Results A total of 179 patients met the inclusion criteria (61 patients CF-LVAD group, 118 patients MVR group). The median (range) follow-up periods for the study (CF-LVAD) and control (MVR) groups were 370 (2819) and 545.70 (2356) days, respectively. There was a significant difference for frequency of bleeding episodes per month between CF-LVAD and MVR groups (p = 0.003 < 0.05). The most common site of bleeding was the anterior septum in both groups (90.9% for the CF-MVR group and 100% for the MVR group). While 14 patients (23%) had nonepistaxis bleeding in the CF-LVAD group, only two patients (1.7%) had nonepistaxis bleeding in the MVR group. There were significant differences in nonepistaxis bleeding rates between the CF-LVAD and MVR groups (chi(2)=19.79,p < 0.001). Conclusion Both epistaxis and nonepistaxis bleeding rates were higher in the CF-LVAD group than in the MVR group. This suggests that the use of CF-LVAD support could directly increase the risk of hemorrhagic complications.Item An Overlooked Landmark for the Crooked Nose: Eyebrow Position(2020) Gultekin, Goknil; Koycu, Alper; Buyuklu, Fuat; Bahcecitapar, Melike; 0000-0003-1290-3509; 0000-0002-9001-7812; 0000-0003-1528-0036; 32458043; AAF-3650-2021; AAI-8256-2021; W-5941-2018Background Rhinoplasty is one of the most unforgiving operations in facial plastic surgery. The correction of nasal deviation in an asymmetrical face can be challenging because known facial landmarks may mislead the surgeon. Eyebrows trimmed asymmetrically in an effort to create a more symmetrical facial appearance may be overlooked by surgeons. Objective To define the relationship between the eyebrow position and external nasal deviation in patients with a crooked nose. Design, Setting, and Participants Analysis was made of the preoperative and 6-month postoperative life-size photographs of female rhinoplasty patients who had been referred to the senior author's clinic between May 2014 and June 2019. The anthropometric landmarks on the life-size photographs were identifed. The most medial points of the eyebrows and most deviated part of the nose were marked and the distance from the mid-canthal point was measured. Main Outcomes and Measure The direction and amount of eyebrow shift were compared with the direction and amount of nasal deviation. Results Of the total 94 female rhinoplasty patients with at least one level external nasal deviation, 67 (71.2%) had ipsilateral eyebrow shift with external nasal deviation. The preoperative external nasal deviation amount was 1.81 +/- 1.21 mm and preoperative eyebrow shift was 1.18 +/- 1.06 mm (rS = 0.429,p < 0.001). The postoperative nasal deviation was 0.79 +/- 0.92 mm, and the eyebrow shift was 0.54 +/- 0.62 mm (rS = 0.570,p < 0.001). Conclusion and Relevance Patients may tend to trim their eyebrows towards the side of the external nasal deviation. After centralization of the crooked nose with rhinoplasty, asymmetric eyebrow shaping tendencies of the patients were also seen to bItem Upright positioning-related reverse nystagmus in posterior canal benign paroxysmal positional vertigo and its effect on prognosis(2020) Jafarov, Sabuhi; Hizal, Evren; Bahcecitapar, Melike; Ozluoglu, Levent N.; 0000-0002-2150-0237; 0000-0002-9699-6783; 0000-0002-7302-4199; 32597824; AAI-8020-2021; A-5853-2018; AAI-8044-2021BACKGROUND: Positional nystagmus elicited by the Dix-Hallpike maneuver often reverses its direction as the patient is re-seated from the provoking head hanging position. The incidence of reverse nystagmus and its association with prognosis in posterior canal benign paroxysmal positional vertigo (pcBPPV) is not clear. OBJECTIVE: To determine the incidence of upright positioning-related reverse nystagmus and its association with the success of canalith repositioning (Epley) maneuver (CRM) treatment in pcBPPV. METHODS: The records of patients that had been tested with video-nystagmography in a tertiary care center, between October 2016 and March 2019, were reviewed. Data were obtained from detailed analysis of video recordings of 321 patients with typical pcBPPV. RESULTS: Reverse nystagmus was determined in 85% of the patients with pcBPPV. The number of CRMs required for treatment was lower in patients with reverse nystagmus (1.32 +/- 0.68) compared to patients without reverse nystagmus (1.81 +/- 0.98) (p < 0.001). There was not a statistically significant relationship between reverse nystagmus and recurrence (p = 0.623). CONCLUSIONS: The absence of reverse nystagmus on upright positioning during the Dix-Hallpike test predicts poor success for the CRM, as repetitive repositioning maneuvers might be required to achieve successful treatment in pcBPPV.