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Öğe Approaches to twisted noses and results of treatment(2002) Ozturan O.; Miman M.C.; Yigit B.; Cokkeser Y.; Kizilay A.; Aktaş D.OBJECTIVES: The aim of this study was to address the multiplicity of surgical techniques and pitfalls in the treatment of twisted noses. PATIENTS AND METHODS: Fifty-nine patients (43 males, 16 females; mean age 27 years; range 17 to 47 years) with vertical axis deviation of the nose were surgically treated. Thirty patients had C-type and 29 patients had I-type twisted noses. Deviation angles were measured before nd at least six months after the operation. Correction of deviations was graded according to the ideal angular values and the two groups were compared. RESULTS: Significant correction was achieved in both types of twisted noses (p < 0.01). The results of the I-twisted noses were significantly closer to the ideal angles compared to those of the C-twisted noses (p < 0.05). Three patients underwent revision surgery. CONCLUSION: To correct functional and aesthetic problems in twisted noses, an external approach can be employed to straighten the nose by releasing, mobilizing, aligning and reinforcing the nasal anatomic structures. Cartilage grafts may be used to camouflage persistent deformities. C-twisted noses require more experience in, and familiarization with, a large number of surgical techniques.Öğe Audio-vestibular evaluation in patients with Behçet's syndrome(2001) Evereklioglu C.; Cokkeser Y.; Doganay S.; Er H.; Kizilay A.A prospective controlled clinical study was carried out at the Department of Ophthalmology and ENT, Inönü University Medical Faculty, Turgut Ozal Medical Center, Research Hospital, to evaluate the audiovestibular involvement in patients with Behçet's syndrome compared with controls. Twenty-five consecutive patients with Behçet's syndrome (mean age ± SD, 34.96 ± 8.50) and 20 age- and sex-matched healthy volunteers (hospital staff) as control subjects (mean age ± SD, 34.45 ± 9.16) were included in this study. Behçet's patients were divided into two groups according to the number of criteria, complete (all four major criteria) and incomplete (three major criteria without ocular involvement). The groups were compared with each other or controls regarding inner ear involvement. Audiometric pure-tone thresholds at 125 to 8000 Hz were obtained in all subjects in both groups, and pure tone average (PTA) hearing thresholds were calculated for the middle, high and low frequencies. In addition, short increment sensitivity index (SISI), tone decay and BERA examinations were performed in all Behçet's patients. Sensorineural hearing loss (SNHL) was present in six of 25 patients with Behçet's syndrome. Two Behçet's patients had unilateral total SNHL, two had bilateral moderate level SNHL, one had bilateral low-frequency SNHL and one bilateral high frequency SNHL. In two, BERA, and in five SISI, examination disclosed inner ear involvement. In control subjects, the past medical history was normal and there was no consistent audio-vestibular complaint. Their PTA thresholds were all in the normal range. Otoscopic examination findings were normal, with intact, mobile tympanic membranes in both groups. The present study showed that audio-vestibular involvement is not infrequent in Behçet's syndrome compared with age- and sex-matched healthy controls, and it is under-estimated. All Behçet's patients should regularly be followed by an otolaryngologists and be given information about the possibility of inner ear involvement. According to our results, hearing loss occurs more often in older patients and also in the complete form of Behçet's syndrome.Öğe Dural bone defects and encephalocele associated with chronic otitis media or its surgery(2002) Kizilay A.; Aladag I.; Cokkeser Y.; Ozturan O.OBJECTIVES: We investigated the incidence of dural bone defects and encephalocele following radical mastoidectomy or open cavity tympanoplasty. PATIENTS AND METHODS: We retrospectively evaluated 190 operations of 182 patients (97 males, 85 females; mean age 30.6 years; range 9 to 70 years) who underwent radical mastoidectomy (n=89) or open cavity tympanoplasty (n=101). Follow-up examinations included otomicroscopy. Patients with documented dural bone defects on examination or operation records were further evaluated by axial and coronal computed tomography scans of the temporal bone. Those with suspected encephalocele were studied by magnetic resonance imaging. RESULTS: Dural bone defects were detected in 17 patients perioperatively. Of these, 14 defects were associated with chronic otitis media. Three iatrogenic bone defects were induced during obliteration of lateral sinus thrombosis. The mastoid tegmen was the most common site of defects (41%) and the most common etiologic factor was cholesteatoma (84%). Encephalocele was detected in one patient in whom radical mastoidectomy with lateral sinus obliteration was performed due to lateral sinus thrombophlebitis. Encephalomalasia was found nearby the defect area in two patients. CONCLUSION: Dural bone defects associated with chronic otitis media are not rare, the most common cause being cholesteatoma. Repair of dural lacerations requires watertight closure to prevent the occurrence of encephalocele.Öğe The effect of endoscopic sinus surgery on quality of life(2003) Akarçay M.; Kizilay A.; Miman M.C.; Cokkeser Y.; Ozturan O.OBJECTIVES: We assessed the effects of endoscopic sinus surgery on quality of life of patients with nasal polyposis or chronic sinusitis. PATIENTS AND METHODS: Thirty patients (5 females, 25 males; mean age 36 years; range 17 to 58 years) who underwent endoscopic sinus surgery were prospectively evaluated. The diagnoses were nasal polyposis in 15 patients and chronic sinusitis in 15 patients. Primary and revision operations were performed in 23 patients and seven patients, respectively. The quality of life was evaluated before and six months after surgery with the use of the Chronic Sinusitis Survey (CSS), and Medical Outcomes Study Short Form-12 (SF-12). Prior to administration, the two questionnaires were translated and adapted to Turkish. Computed tomography (CT) findings were scored before and six months after surgery according to the Lund-Mackay system. The results of the surveys were compared with CT scores. RESULTS: The postoperative SF-12 and CSS scores of all the patients improved significantly. Computed tomography scores were not found in correlation with improvements in the SF-12 and CSS scores. CONCLUSION: Endoscopic sinus surgery results in significant improvement in the quality of life of patients with nasal polyposis and chronic sinusitis, which may not be reflected by CT scores.Öğe Flexible bronchoscopy. Is atropine necessary for premedication?(Sociedade Portuguesa de Pneumologia, 2001) Hasanoglu H.C.; Gokirmak M.; Yldirim Z.; Koksal N.; Cokkeser Y.[No abstract available]Öğe Flexible bronchoscopy: Is atropine necessary for premedication?(2001) Hasanoglu H.C.; Gokirmak M.; Yildirim Z.; Koksal N.; Cokkeser Y.To investigate whether atropine is necessary for premedication of flexible bronchoscopy (FFB), 93 patients who underwent bronchoscopy for different indications were randomly separated into two groups. Subjects in the first group were premedicated only with 10 mg of intramuscular (IM) diazepam, whereas the second group was given 10 mg of IM diazepam and 0.5 mg of IM atropine. Blood pressures and pulse rates were recorded before, during, and after FFBs. Blood glucose levels were measured before and after the procedures. Amounts of bronchial secretion and complications related to the procedure were recorded during and after FFBs. The blood pressures were found higher in both groups during the bronchoscopies, whereas only the diastolic blood pressures were significantly higher when compared with the values before FFBs in the atropine-treated group. There was no intergroup difference when increase in blood pressures was compared. The pulse rates were found increased during and after FFBs in both groups (P < 0.05), and the increase in Group II was significantly more when compared with Group I (P < 0.05). Blood glucose levels were measured significantly higher after bronchoscopy when compared with those before the procedure (P < 0.05); however, the increase showed no statistical difference between the groups. Complication rates and amounts of bronchial secretion were similar in both groups of patients. Routine application of atropine for premedication of FFB was found to have no advantages. Instead, it might have some potential disadvantages such as hyperglycemia and tachyarrhythmias in patients with diabetes mellitus and cardiac diseases, respectively.Öğe Polyurethane stent obstruction as a cause of recurrent epiphora: Case report(Centauro SRL, 2006) Doganay S.; Sarac K.; Miman M.C.; Karadag N.; Cokkeser Y.A Song's nasolacrimal duct stent was placed in a patient with epiphora due to primary nasolacrimal duct obstruction and the stent was kept for 32 months. Mitomycin C 0.02% eye drops four times a day were prescribed for four weeks following polyurethane stent placement procedure. No epiphora-related complaints occurred for thirty months after then the epiphora started. Nasolacrimal stent was removed from nasal cavity endoscopially and the tissues within the extruded stent were examined histopathologically. The patient's complaints were relieved following stent removal. Dacryocystogram revealed normal passage and a filling defect within the lacrimal sac. Macroscopic evaluation of the stent revealed a firm mass in the stent mushroom, causing complete obstruction. Pathological examination of the mass revealed chronic inflammation, increased connective tissue and vascular proliferation. N asolacrimal polyurethane stents can be removed easily by nasal approach. Nasolacrimal passage may be left open temporarily after stent removal. The use of Mitomycin C drop is a novel approach in nasolacrimal stent placement cases. However, when the long-term results of endoscopic and external dacryocystorhinostomy are considered, further research is needed on the biocompatibility of stent material.Öğe A sporadic case with fraser syndrome with cleft lip and palate(2001) Evereklioglu C.; Er H.; Cokkeser Y.; Bayramlar H.; Mutus M.[No abstract available]
