PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item 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-8256-2021Background 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.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 Comparison of the efficacy of two different local anesthetics in inferior turbinate reduction(2020) Erol, Ozan; Buyuklu, Fuat; 0000-0003-1528-0036; 32942114; W-5941-2018Purpose: 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.Item 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; 30895358BackgroundA 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.