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    A comparison of general versus regional anesthesia in patients over 100 years old: A retrospective cohort study
    (2021) Akbas, Sedat; Ozkan, Ahmet Selim; Korkmaz, Mehmet Hakan
    Aim: As the life expectancy maintains to rise, the number of centenarians applied for surgery is increasing. Functional and anatomical changes in elderly patients may cause postoperative morbidity and mortality. The aim of this retrospective cohort study is to analyze and compare general and regional anesthesia in centenarians underwent different surgeries. Material and Methods: Patients aged over 100 years (American Society of Anesthesiology scores of II–IV) were included in our study. The centenarians were divided into two study groups: general anesthesia (Group GA, n=20) and regional anesthesia (Group RA, n=18). The demographic characteristics, procedure, and hospital data were evaluated. Results: There were no significant differences betveen two groups with regards to gender, height, weight, body mass index, ASA scores, perioperative colloid and crystalloid fluid consumptions. Duration of anesthesia and procedure in Group RA was shorter than that in Group GA. The requirement for invasive arterial monitorization, central venous catheterisation, and nasogastric tube in Group GA was higher than that in Group RA. Postoperative delirium was similar in both groups. Heart rate, mean arterial pressure, and peripheral oxygen saturation were similar. In-hospitality mortality was 26.3% in the entire group of centenarians. Conclusions: This study examined the role of different anesthetic methods in extremely elderly patients over 100 years old during different surgeries. Anesthetic agent preferences, long duration of anesthesia and surgery, and hemodynamic instability can cause serious complications. We therefore conclude that careful considerations are required in extremely elderly patients.
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    Effects of endoscopic endonasal sinus surgery on nasal flora in patients with chronic rhinosinusitis with nasal polyps
    (2019) Ulusoy, Bulent; Ersoy Callioglu, Elif; Muderris, Tuba; Bozdemir, Kazim; Oguzhan, Tolga; Kutluhan, Ahmet; Acikgoz, Ziya Cibali; Korkmaz, Mehmet Hakan
    Aim: This study aimed to evaluate the alterations in the nasal flora in patients who underwent endoscopic endonasal surgery for chronic rhinosinusitis with nasal polyps (CRSwNP). Material and Methods: This prospective study included 30 patients diagnosed with CRSwNP who were resistant to medical treatment and recommended for surgery. The nasal cavity was sampled two times, first preoperatively on the day of operation and postoperatively in the 4th week. Patients were divided into two groups according to their culture results, including normal flora bacteria and potential pathogen production. Results: In the preoperative swab samples, 3 (11.1%) patients had no bacterial growth, 16 (59.3%) patients had a normal flora, and potential pathogens were detected in 8 (29.6%) patients. However, postoperatively, 3 (11.1%) patients had no bacterial growth, 13 (48.1%) patients had a normal flora, and potential pathogens were detected in 11 (40.7%) patients during the postoperative period. No significant difference was found between preoperative and postoperative culture results in terms of the number of patients with normal flora, potential pathogens, and no bacterial growth (p=0.676). The most common microorganism in the normal flora group preoperative and postoperative period was coagulase-negative Staphylococcus (77.8%, 51.9%, respectively), and the most common microorganism in the potential pathogen group was Staphylococcus aureus (18.5% and 25.9%, respectively). Comparing preoperative and postoperative culture results according to isolated potential pathogen microorganism types, no statistically significant difference was observed for any microorganism in the potential pathogen group (p>0.05).Conclusion: As a result, no correlation between nasal polyps’ surgery and potential pathogens was detected. Keywords: Chronic rhinosinusitis; culture; nasal polyps; flora; potential pathogens; bacteria; Staphylococcus aureus; coagulase; transnasal endoscopic surgery; pseodomanas.
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    Is chirp more effective than click and tone-burst during oVEMP test?
    (2020) Bas, Banu; Keseroglu, Kemal; Er, Serap; Ozdek, Ali; Korkmaz, Mehmet Hakan
    Aim: We aimed to show the effectivity of chirp stimulus and to compare with tone-burst and click stimulus during ocular VEMP (oVEMP) and also to exhibit same stimulation response pattern in utricle as seen in cochlea. Material and Methods: A total of 85 healthy volunteers without any vestibular and otologic disease history were enrolled in this study. Three different types of air conduction stimuli (tone-burst, click and chirp) were used for the oVEMP test. N1, P1 latencies, N1P1 amplitudes and asymmetry ratios were investigated for each stimulus type according to age subgroups and sex.Results: The ratio of presence of oVEMP response was found to be 94.1%, 82.1% and 98.8% with tone-burst, click and chirp stimuli respectively. The latencies were significantly shorter in chirp stimulus with respect to others in both ears. The amplitudes were also significantly larger in chirp stimulus with respect to other in both ears. According to analysis of N1P1 asymmetry ratios, N1 and P1 latency asymmetry, there were no statistically significant difference in these values within each stimulus types.Conclusion: oVEMP is more practical, easier, faster and less invasive method. oVEMP results with chirp stimulus have shorter latency and higher amplitude and more clear waveform morphology with higher ratio of response when compared to click and tone-burst stimulus. As a result, chirp is a reliable and suitable stimulus type for oVEMP analysis. In the light of these unique results with chirp stimulus, utricular hair cells may have similar frequency specific tonotopic organization as seen in cochlea.
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    The relation between idiopathic subjective tinnitus and risk factors for venous and arterial thrombosis
    (2019) Ulusoy, Bulent; Kale, Hayati; Serifler, Serkan; Bozdemir, Kazim; Korkmaz, Mehmet Hakan
    Aim: The aim of this study was to investigate the relationship between tinnitus and the factors that cause the tendency to thrombosis in terms of gender.Material and Methods: Fifty-five consecutive patients who admitted to our clinic with the complaint of idiopathic subjective tinnitus were included in this study. Routine ENT (ear nose throat) examinations and pure tone audiometry test were performed. Prothrombin time (PT), partial thromboplastin time (PTT), total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, Triglycerides, antithrombin III (AT III), protein C, protein S, homocysteine, antiphospholipid and anticardiolipin antibodies were examined in blood samples of patients. Temporal bone magnetic resonance imaging (MRI) was performed all patients. The results of the patients were compared in terms of gender and age groups (40 age).Results: The study was completed with 47 patients. Twenty-four of the patients were female and 23 were male. Both genders groups were similar in terms of age and pure tone average. Antiphospholipid and anticardiyolipin antibodies (IgG and IgM) were found as negative in all patients. Homocysteine levels were found to be statistically significantly higher in males than females (p=0.015; respectively 13.38±5.98 µmol/L and 9.87±3.11 µmol/L). AT III and Protein S levels were lower in males than females although this difference was not statistically significant (respectively p=0.07 and p=0.08)Conclusion: In this study, an association was shown between hyperhomocysteinemia and tinnitus, especially in males. Keywords: Tinnitus; tinnitus of vascular origin; thrombosis; gender role.