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Öğe Cartilage tympanoplasty with island technique: A comparison with the temporalis muscle fascia technique(2009) Tayyar Kalcioglu M.; Firat Y.; Selimoglu E.Objective; To evaluate hearing results and failures of tympanoplasty techniques with either island cartilage or temporaiis muscle fascia. Materials & Methods; Retrospective evaluation of selected cases operated by the same surgery team between 2000 and 2008. A total of 307 patients with a tympanic membrane perforation or retraction due to chronic otitis media were treated surgically with tympanoplasty with or without mastoidectomy. From these 96 cases who had primary repair of tympanic membrane perforation or retraction with intact ossicular chain and normal middle ear were included into the study. Tympanic membrane perforation was reconstructed by using fascia in 36 while cartilage island graft was used in 60 patients. Temporalis muscle fascia was preferred for simple perforations while cartilage was used in more difficult cases such as retractions or total or subtotal perforations. Preoperative and postoperative pure-tone average air-bone gaps were compared at 250, 500, 1000, 2000 and 4000 Hz frequencies. Postoperative failures were compared. Results; Main outcomes of both techniques were similar for hearing results and prevalence of failures. Closure of air-bone gaps after surgery were 14.98, 12.5, 9.67. 8.67, and 7.01 dB for cartilage group and 15.42, 11.67, 8.34, 7.36, and 8.61 dB for fascia group respectively. The differences were not statistically significant. Graft survival rates were 86.1% in the fascia group and 95% in the cartilage group. Conclusion; Both techniques show similar functional and hearing results. Cartilage tympanoplasty with island technique may be chosen according to patient's condition like atelectatic ear, adhesive otitis and retraction pockets, totally or sub totally perforation of tympanic membrane or revision tympanoplasty. Copyright 2005 © The Mediterranean Society of Otology and Audiology.Öğe Comparison of clinical differences between patients with allergic rhinitis and nonallergic rhinitis(Medquest Communications LLC, 2013) Akarcay M.; Miman M.C.; Erdem T.; Oncel S.; Ozturan O.; Selimoglu E.We conducted a retrospective study to investigate the clinical differences between subtypes of rhinitis patients. Our findings were based on a detailed history and nasal examination. The study population was made up of 910 patients who had at least two rhinitis symptoms. These patients were categorized into one of three rhinitis groups: nonallergic rhinitis (NAR), seasonal allergic rhinitis (SAR), and perennial allergic rhinitis (PAR); there were 212 patients (23.3%) in the NAR group, 473 (52.0%) in the SAR group, and 225 (24.7%) in the PAR group. In addition to demographic data, we compiled information on the season when each patient presented, specific symptoms and their triggers, parental history, associated allergic diseases (e.g., skin, lung, and eye allergies), and nasal examination findings. The SAR patients represented the youngest of the three groups. Most SAR patients presented in spring and summer, and this group had the highest incidence of eye itchiness, pharyngeal itchiness, eye redness, and palatal itchiness. In terms of triggering factors, a visit to a green area was significantly more common in the SAR patients, while detergent odor, sudden temperature change, and cold air were significantly more common in the NAR patients. On nasal examination, a pale nasal mucosa was significantly more common in the NAR group. In clinical practice, it is crucial to differentiate between allergic and nonallergic rhinitis. We conclude that relevant information from the history can predict allergic rhinitis. Future studies of prevalence should take into consideration the important findings of our study, including the significance of age and the seasonality of exacerbation of rhinitis symptoms.Öğe Dexmedetomidine: A novel anesthetic agent for middle ear surgery(2007) Firat Y.; Selimoglu E.Proper selection of anesthetic technique is important in otologic surgical procedures. In the middle ear microsurgery an anesthetic agent must provide bloodless, good surgical field visibility for safe tympanic membrane reconstruction, safe ossicular reconstruction with respect to the basic anatomic structure of the middle ear. Additionally, no alteration of intratympanic pressure is acceptable during the anesthetic act and after its discontinuation. Consequently, postoperative nausea and vomiting should be minimal after tympanoplasty operations for the stability of tympanic graft and ossicles. Therefore, the anesthesiologist must use a technique that provides a sufficiently deep level of anesthesia with minimal intraoperative movement, rapid emergence, good hemodynamic control and tympanometric stability. Currently, many inhaler and intravenous (IV) anesthesia could be preferred for otologic surgical procedures and they offer ideal intraoperative conditions. Dexmedetomidine is a novel analgesic agent that helps this inhaler or IV anesthesia at preoperative state, postoperative period and during surgery especially for hemodynamic stability. In this article, pharmacocinetic properties of dexmedetomidine were described, its advantages for patients undergoing surgery,related patents and its role in otologic surgery were discussed. © 2007 Bentham Science Publishers Ltd.
