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    The impact of the frozen section analysis on surgical strategy in nodular thyroid diseases
    (2021) Cicek, Mehmet Turan; Gunduz, Emrah; Bayindir, Tuba; Gunduz, Sumeyye; Gokce, Hasan; Toplu, Yuksel
    In this retrospective cross-sectional study we aimed to investigate of the impact of frozen section analysis (FSA) on the surgical strategy in nodular thyroid diseases. The patients who underwent thyroidectomy (n=293) were analyzed retrospectively and 138 of 293 who had intraoperative FSA results included to the study. All these patients (n=138) also had fine needle aspiration biopsy (FNAB). The patients (n=138) were divided to 5 groups; Group 1 (n=32), Group 2 (n=22), Group 3 (n=12), Group 4 (n=17) and Group 5 (n=55). Twelve of these patients who were reported as “follicular neoplasia” in FSA were excluded from the study. According to the results of FSA (n=126), 48 patients were reported as malignant, whereas 78 patients were benign. The permanent sectional pathological examination (n=126), 57 patients were reported as malignant and 69 were benign. The sensitivity of FSA was found 78.9% and the specificity was found 95.6%, respectively. Also, FSA affected the surgical strategy correctly in 111 (88.1%) and incorrectly in 15 patients (11.9%). As a conclusion of this study we found that frozen section analysis significantly affects the surgical strategy especially in patients whose surgical strategy cannot be determined by FNAB.
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    Nasolacrimal duct obstruction with obstructive nasal deformity; is synchronous nasal surgery necessary?
    (2021) Toplu, Yuksel; Bayindir, Tuba; Balbaba, Mehmet; Kalcioglu, Mahmut Tayyar; Sapmaz, Emrah; Karatas, Erkan
    The aim of this study was to evaluate the necessity of the simultaneous additional nasal surgery to increase success rate of the endoscopic dacryocystorhinostomy operation, in the patients with nasolacrimal duct obstruction and obstructive nasal deformity. One hundred and thirty patients with nasolacrimal duct obstruction and obstructive nasal deformity (59 were female and 71 male, age ranged between 31 and 82 years, mean=60.3 years) were included in this study. Patients with nasolacrimal duct obstruction were divided into two main groups (group A and B) and six subgroups (A1, A2, A3 and B1, B2, B3) according to the presence of obstructive nasal deformity and applied operation techniques. The success and complications rates of this groups were evaluated. The success rates of endoscopic dacryocystorhinostomy in the additional nasal surgery performed group (Group A) were not statistically significant higher than the group without additional nasal surgery (Group B). Complications rate of group A (26.08%) were statistically significant higher than group B (9.8%). In patients with complications, the average success rate of endoscopic dacryocystorhinostomy surgery (70.8%) was statistically significant lower than in patients with no complications (88.6%), respectively. Additional nasal surgery has no statistically significant effect on the success of the endoscopic dacryocystorhinostomy surgery. Developing complications was statistically affect the success rate of endoscopic dacryocystorhinostomy surgery. Due to these reasons, contrary to the general idea, we believe that, to increase the success rate of the endoscopic dacryocystorhinostomy surgery, additional nasal surgery is unnecessary in patients with nasolacrimal duct obstruction and obstructive nasal deformity.
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    PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome in children; surgical versus medical treatment?
    (2021) Toplu, Yuksel; Bayindir, Tuba; Tekin, Mehmet; Kalcioglu, Mahmut Tayyar
    PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical lymphadenopathy) syndrome usually presents in childhood and one of the most common periodic fever syndromes. The syndrome is self-limitted, characterized by periodic fevers at regular intervals and standard clinical features of pharyngitis, aphtous ulcers and cervical lympadenitis. The diagnosis is based upon clinical criteria with the exclusion of other recurrent fever causes. The treatment of PFAPA syndrome is divided two parts; to control of the acute attacks and to decrease the frequency of the attacks. In this retrospective study we aimed to compare the indications and efficiency of medical versus surgical treatment in children with PFAPA syndrome. Forty-five children with PFAPA syndrome whom treated with surgical or medical options were included and divided into two groups. The recovery rates before and after treatments were statistically analyzed. In both groups symptomatic improvement were seen. In surgical and medical treatment groups, complete clinical recovery was found 80% and 74%, respectively. Besides, statistically significant reduction in frequency (p<0.05) and duration (p<0.05) of recurrences in the incomplete clinical recovery cases were seen. Similar to literature our results support that both medical and surgical treatment are effective treatment methods. Surgery is a preferable treatment option especially in patients who do not response to medical treatment. The optimal strategy for management is depend on response to treatments.