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Öğe Anesthesia Management in Patients With Choanal Atresia(Lippincott Williams & Wilkins, 2016) Yildirim, Zeynep Baysal; Akdag, Mehmet; Celik, Feyzi; Baysal, ElifBackground:In this study, the anaesthetic management of newborn and infant patients who underwent surgery for choanal atresia between 2009 and 2016 is discussed in the light of recently published literature.Methods:The diagnoses, demographic data, anaesthetic risk and duration, additional anomalies, airway management, and complications that arose in 41 patients with choanal atresia who were operated on between 2009 and 2016 were evaluated retrospectively by examining their medical and anaesthesia records.Results:The patients were divided into 2 groups: Group Ibilateral choanal atresia and Group IIunilateral choanal atresia. Of the 41 patients included in the study, 24 (58.53%) were in the bilateral group, and 17 (41.46%) were in the unilateral group. Fifteen (34.1%) of the patients were male, and 26 (59.1%) of the patients were female. The mean age of the 24 patients in Group I was 25.86 days (3-72), and the mean age of the 17 patients in Group II was 171.08 days (81-365). Additional congenital anomalies were present in 13 of the patients in the bilateral choanal atresia group and 3 of the patients in the unilateral choanal atresia group.Seven patients from Groups I and 2 patients from Group II were determined to have difficult airways. The laryngoscopic images from these patients were classified as grades 3 and 4 according to the Cormack-Lehane classification system. When the durations of anesthesia in the groups were compared, the duration of anesthesia in Group I was found to be significantly longer (Table 3). Anesthesia-related complications were observed in 9 patients (37.5%) from the bilateral choanal atresia group and in 4 patients (2.3%) from the unilateral atresia group. Steroids were used as prophylactics in these patients.Conclusions:Congenital anomalies and their associated risks, as well as intubation and ventilation problems and the complications that might arise, must be considered in addition to anesthetic management when repairing choanal atresia in newborn and infant patients.Öğe Evaluation of the treatment results of laryngeal carcinoma: our experience over 10 years(Tubitak Scientific & Technological Research Council Turkey, 2012) Karatas, Erkan; Baysal, Elif; Durucu, Cengiz; Baglam, Tekin; Bayazit, Yildirim Ahmet; Kanlikama, MuzafferAim: To retrospectively analyze the treatment results for laryngeal carcinoma and to find the impact of the clinical parameters on the survival of the patients. Materials and methods: The medical records of 150 consecutive patients, operated on for laryngeal squamous cell carcinoma between 1991 and 2009, were reviewed. Tumor localization, TNM stages, treatment modalities, radiotherapy, second primary tumors, and tumor recurrence were recorded, and the survival data were obtained. Results: Neck metastasis was rare (3.6%) in T1 and T2 glottic tumors, while there was a significant increase in the rate of N+ neck (35%) in T3 and T4 glottic tumors (P < 0.05). N+ neck was encountered in 28% of the early and 33% of the late-stage supraglottic cancers (P > 0.05). There was a significant relation between survival and tumor recurrence (P < 0.05), whereas the other clinical parameters were not associated with survival (P > 0.05). The risk for death of the disease increased by 63.3% when tumor recurrence occurred (odds ratio = 6.3573). Conclusion: Aggressive treatment of the primary tumor and neck may eliminate the impact of advanced tumor stage on survival. Local and regional recurrence and second primary diagnosis are the most important factors involved in survival in laryngeal carcinoma.Öğe Intra- and postoperative electrically evoked stapedius reflex thresholds in children with cochlear implants(Elsevier Ireland Ltd, 2012) Baysal, Elif; Karatas, Erkan; Deniz, Murat; Baglam, Tekin; Durucu, Cengiz; Karatas, Zeynel Abidin; Mumbuc, SemihObjectives: The aim of this study was to investigate whether there is a significant correlation between intra- and postoperative electrically evoked stapedius reflex thresholds (eSRTs) in children with cochlear implants. Methods: Sixty-five pediatric cochlear implant users were included in this study. All patients had congenital prelingual hearing loss. The round window approach was used in all patients. The eSRTs were intraoperatively measured using the 1st, 3rd, 6th and 12th electrodes of the cochlear implant. The measurements taken during the first fitting of the device were taken again one month after surgery. We used paired-sample t-tests to determine the correlation between intra- and postoperative eSRTs. Results: The eSRT analysis revealed a statistically significant difference between the intra- and postoperative thresholds. A correlation analysis did not reveal any correlation between intra- and postoperative eSRTs. Conclusion: Intraoperative eSRT measurements were unable to predict early postoperative eSRTs. (C) 2012 Elsevier Ireland Ltd. All rights reserved.Öğe Intraoperative electrically evoked stapedius reflex thresholds in children undergone cochlear implantation: Round window and cochleostomy approaches(Elsevier Ireland Ltd, 2011) Karatas, Erkan; Aud, Murat Deniz; Baglam, Tekin; Durucu, Cengiz; Baysal, Elif; Kanlikama, MuzafferObjectives: To study the best electrically stimulation in cochlear implant surgery with round window (RW) and Promontory cochleostomy approaches with electrically evoked stapedius reflex thresholds (ESRT) intraoperatively. Methods: Thirty-nine children underwent CI surgery were included for this study. The surgical procedures consisted of RW and Promontory cochleostomy. ESRT for each 1st, 3rd, 6th and 12th electrodes (E) were determined. Statistical evaluation was done for the comparison of the thresholds and duration times for both groups. Results: The duration times of ESRT for E1, E3, E6 and E12 electrodes was shorter in RW group compared with the Promontory group (p < 0.05). The statistical evaluation of ESRT measurements of E1, E3, E6 found p < 0.001 and E12 electrode p < 0.05 in RW group. ESRT measurements were recorded at lower threshold in the RW group compared with the Promontory group. Conclusion: The duration of electrically stimulation thresholds were shorter in RW group. ESRT measurements were recorded at lower threshold in the RW group compared with the Promontory group. RW insertion offers best electrically stimulation relative to electrode insertion via a promontory cochleostomy. (C) 2011 Elsevier Ireland Ltd. All rights reserved.Öğe Oxidative stress in otosclerosis(Taylor & Francis Ltd, 2017) Baysal, Elif; Gulsen, Secaattin; Aytac, Ismail; Celenk, Fatih; Ensari, Nuray; Taysi, Seyithan; Binici, HabibObjectives: Otosclerosis is a disease involving abnormal bone turnover in the human otic capsule that results in hearing loss. Several hypotheses have been suggested for the etiopathogenesis of otosclerosis; however, its etiology remains unclear. Methods: This study evaluated the correlation between otosclerosis and levels of paraoxonase-1 (PON1), arylesterase, total antioxidant status, total oxidant status (TOS), oxidative stress index (OSI), total sulfhydryl (-SH) groups, lipid hydroperoxide, and ceruloplasmin in the serum of otosclerosis patients and healthy subjects with respect to oxidative stress. Results: In our study, TOS and OSI levels were higher in the otosclerosis patients than in the controls. The PON1 levels showed that oxidative stress was severe, and as a result, antioxidants were consumed and depleted. Discussion: When an imbalance between oxygen free radical production and antioxidative defense mechanisms occurs, reactive oxygen species levels may increase, which in turn may damage cells and tissues through the peroxidation of phospholipid membrane structures. The body initially responds with increased antioxidant production, but if the oxidative stress is severe, decreased antioxidant levels may result. This study reports expression levels of oxidative stress species in otosclerosis patients.Öğe Radioprotective effect of thymoquinone on salivary gland of rats exposed to total cranial irradiation(Wiley, 2017) Akyuz, Mehmet; Taysi, Seyithan; Baysal, Elif; Demir, Elif; Alkis, Hilal; Akan, Muslum; Binici, HabipBackground: The purpose of this study was to investigate the radioprotective effects of thymoquinone against radiation-induced damage in the salivary glands of rats exposed to total cranial gamma irradiation. Methods: Thirty-two Sprague-Dawley rats were divided into 4 groups to test the radioprotective effectiveness of thymoquinone by intraperitoneal injection. An appropriate control group was also studied. Biochemical parameters in liver tissue of rats were determined by spectrophotometer. Results: Glutathione peroxidase (GSH-Px), glutathione-S-transferase (GST), total (enzymatic plus nonenzymatic) superoxide scavenger activity (TSSA), nonenzymatic superoxide scavenger activity (NSSA), and superoxide dismutase (SOD) activities were significantly decreased, whereas xanthine oxidase, nitric oxide synthase activities, malondialdehyde, nitric oxide, and peroxynitrite levels were significantly increased in the irradiation group when compared to the control and sham control groups. Conclusion: Results showed that thymoquinone reduces oxidative and nitrosative stress parameters and has antioxidant effects and a free radical scavenging activity.Öğe Surgical intervention for traumatic facial paralysis: an analysis of 15 patients(2016) Baysal, Elif; Gülşen, Secaattin; Aytaç, İsmail; Çıkrıkçı, Serkan; Gönüldaş, Burhanettin; Durucu, Cengiz; Durucu, Cengiz; Mumbuç, Lütfi Semih; Kanlıkama, MuzafferAbstract: Amaç: Bu çalışmanın amacı fasiyal sinir dekompresyonu yapılan hastaları analiz etmektir. Yöntem: 2005 Ocak - 2015 Ocak tarihleri arasında cerrahi geçiren15 hastanın verileri geriye dönük incelendi. Bütün hastalar yüksek rezolüsyonlu temporal tomografi, House-Brackmann derecelendirmesistemi, elektrodiagnostik testler elektromiyografi ya da elektronörografi) ile değerlendirilmiştir. Bulgular: Çalışmaya yaş ortalaması 20.56 (aralık: 2-59) yıl olan 8 kadın ve 7 erkek hasta katılmıştır. Hastaların tümüne transmastoid yolla fasiyal dekompresyon uygulanmıştır. Sonuç: Transmastoid yaklaşım fasiyal sinir birinci dirseği ve digastricridge arasında hasar olanlarda uygun olmaktadır. Postoperatif elektromiyografi bulgularındaki orbikularis okuli kasındaki amplitüd artışıklinik iyileşme öncesinde sinirdeki iyileşmenin anlamlı indikatörüolarak bulunmuşturÖğe Tinnituslu hastalarda trimetazidin hidroklorür kullanımı sonrasında odyolojik testlerin ve VAS skorlarının karşılaştırılması(2012) Çevik, Cengiz; Bağlam, Tekin; Şengül, Engin; Akbay, Ercan; Baysal, Elif; Karataş, Erkan; Kılıç, Ali; Kanlıkama, MuzafferÖz: Amaç: Tinnitusun patofizyolojisi tam olarak anlaşılamamış olmakla birlikte işitsel sistemdeki anatomik ve/veya fonksiyonel bir değişim sonucu ortaya çıktığı düşünülmektedir. Bu çalışmada Tinnituslu hastalarda trimetazidin hidroklorür kullanımı sonrasında odyolojik testlerin ve vizüel analog skala (VAS) bulgularının karşılaştırılması amaçlanmıştır. Gereç ve yöntem: Bu çalışmaya polikliniğimize tinnitus şikayeti ile başvuran 12 kadın ve 28 erkek olmak üzere toplam 40 hasta dahil edildi. Tedavide 3 ay boyunca düzenli olarak trimetazidin hidroklorür kullanan olgulara ait demografik ve tıbbi özellikler ve tinnitusun değerlendirmeleri kayıt edilmiştir. Hastaların dosyalarından hem tedavi öncesi ve hem de tedavi sonrası saf ses odyogram, tinnitus frekansı ve şiddeti, minimal maskeleme, rezidüel inhibisyon değerleri ve VAS anket formlarındaki değerler de ayrıca değerlendirilmiştir. Bulgular: Yapılan istatistiksel analiz sonucu ilaç kullanımı sonrasında hastaların VAS testindeki tinnitus şiddeti, tinnitus sıklığı, tinnitustan rahatsızlık derecesi ve tinnitusa bağlı dikkat eksikliği şikayetlerinde anlamlı olarak azalma tespit edildi (p=0.000). Hastaların odyolojik testlerinden tinnitus frekansı (p=0.250), tinnitus siddeti (p=0.057), minimal maskeleme seviyesi (p=0.213) ve rezidüel inhibisyon değerlerinde ise ilaç kullanımı sonrasında istatistiksel olarak anlamlı bir değişiklik tespit edilemedi. Sonuç: Üç aylık trimetazidin tedavisinin tinnituslu hastaların şikayetlerinde azalmaya neden olduğu ve odyolojik test sonuçlarında istatistiksel olarak anlamlı bir değişikliğe neden olmadığı görüldü.Öğe Treatment of Congenital Choanal Atresia via Transnasal Endoscopic Method(Lippincott Williams & Wilkins, 2017) Gulsen, Secaattin; Baysal, Elif; Celenk, Fatih; Aytac, Ismail; Durucu, Cengiz; Kanlikama, Muzaffer; Mumbuc, SemihObjectives: Congenital choanal atresia (CCA) is a very rare abnormality of the nose, but in the case of bilateral presence, it becomes a life-threatening malformation. Various surgical treatment options, such as transpalatal, transseptal, and open rhinoplasty techniques, as well as the transnasal approach, have been defined for the repair of CCA. In this study, the authors intended to evaluate the outcomes of transnasal endoscopic surgery for CCA, and stent implementation's impact on surgical success. Methods: Patients who were admitted to the Otorhinolaryngology Department of Gaziantep University and patients who had not undergone CCA surgery before were included in the study. Patients who underwent transnasal endoscopic choanal atresia surgery (TECAS) were advised to have regular nasal endoscopic examinations performed at check-ups; after a 6-month follow-up period, surgical results were evaluated concerning whether stenosis had occurred or not. Results: Of the 48 patients who underwent TECAS after a minimum 6-month follow-up period, 34 of patients revealed no stenosis, so the overall surgical success rate was 70.8%. Fourteen (29.2%) patients who underwent TECAS developed stenosis and required revision surgery. Conclusions: Transnasal endoscopic choanal atresia surgery is the most preferred approach for CCA repair and has many advantages, such as excellent vision, shorter operative time, minimal bleeding, and minimum complication. Despite advances in endovision systems and surgical instruments, stenosis is the most challenging problem after TECAS, so new treatment strategies should be developed to prevent stenosis.
