PubMed İndeksli Yayınlar Koleksiyonu
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Item The Effect of Smoking on Septoplasty and Septorhinoplasty Outcomes(2022) Erol, Ozan; Koycu, Alper; 0000-0003-1290-3509; 34988636; AAF-3650-2021Background 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.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 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-5853-2018Objective: 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.Item 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-8044-2021Background 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.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 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 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.Item Lingual Tonsil Hypertrophy in Patients With Allergic Rhinitis(2019) Coban, Kubra; Koycu, Alper; Aydin, Erdinc; 0000-0003-1290-3509; 31522521Background Lingual tonsils, part of the Waldeyers' Ring, are located in base of the tongue. They are commonly observed in childhood, due to increased immunological activity. Several factors such as laryngopharyngeal reflux, younger age, smoking, and obesity are associated with hypertrophy of lingual tonsils (LTH) in adulthood. However, the relation between allergic rhinitis and LTH is not clearly highlightened in the literature so far. Objective To investigate the role of allergic rhinitis in the development of LTH. Methods Adult patients who were diagnosed with allergic rhinitis were included in the study group. The control group consisted of age- and sex-match healthy volunteers. Complete otorhinolaryngology examination including fiberoptic endoscopic evaluation was performed to both groups. Blood samples were obtained for total immunglobulin E levels, and skin prick tests were performed to both groups. Patients with allergy complaints and positive skin prick tests were included in the study group, while healthy volunteers with negative skin prick tests were enrolled in the control group. The grading for LTH was achieved by a physician who was blind to the study. Results The incidence of LTH was significantly higher in the study group when compared to the control group (P = .001). Similarly, the incidence of grade 3 LTH was significantly higher in the study group compared to the controls (P = .002). Conclusion According to our results, LTH is more frequently observed in patients with allergic rhinitis. Grade 3 representing larger LTH is more commonly seen in patients with allergic rhinitis.