8 research outputs found
Assessment of Approaches of Otorhinolaryngologists in Facial Plastic and Nasal Surgery: A Survey Study
No full textObjective: To assess approaches and experiences of otorhinolaryngologists in facial plastic and nasal surgery. Methods: In total, 234 surgeons (191 males and 43 females; average age, 37.22 +/- 8.4 years; age range, 26-63 years) were included. All participants were given a questionnaire comprising 22 multiple choice and closed-ended questions. All responses to the questionnaires were analyzed. Results: Of 234 participants, 42 (17.9%) were residents and 192 (82.1%) were specialists in otorhinolaryngology. The most challenging cases in rhinoplasty were crooked nose (33.8%), ideal nasal dorsum (18.8%), revision cases (13.2%), and skin deformities (11.1%). The photodocumentation rate by surgeons before and after procedures of facial plastic surgery was 86.3%, whereas the intraoperative photodocumentation rate by surgeons was 47%. The most common facial plastic surgery procedures other than rhinoplasty were otoplasty (68.4%), filler-Botox-fat injections (20.5%), and mentoplasty (18.4%). Conclusion: This survey study is quite important because it assesses approaches of otorhinolaryngologists in facial plastic surgery. Although this study provides more valuable data for determining the current status, further studies with larger number of surgeons are required
Results of the Endoscopic Anterior Skull Base Cerebrospinal Fluid Rhinorrhea Repair Without a Rigid Graft: A Retrospective Analysis
No full textWegener'S Granulomatosis Presenting With An Isolated Paranasal Sinus Involvement In A Child
No full textWegener's granulomatosis which is rarely seen in children is an idiopathic necrotizing granulomatous vasculitis, affecting primarily paranasal sinuses, nasopharynx, lungs, kidneys and joints. In this article, we report a very rare case of eight-year-old boy presenting with Wegener's granulomatosis of paranasal sinuses without lung, kidney and any other organ involvement. We discuss the diagnosis, treatment and the differential diagnosis of paranasal sinus involvement in Wegener's granulomatosis in the light of literature data.WoSScopu
Endonasal Choanal Atresia Repair; Evaluating the Surgical Results of 58 Cases
No full textBackground. Choanal atresia is the most common congenital nasal anomaly, with an incidence of 1:5000-1:8000 live births. Atresia can be seen as membraneous, bony or mixed type. When it is bilateral, it is accepted life-threatening, therefore bilateral atresia necessitates immediate intervention. Diagnosis is confirmed by endoscopic examination and computed tomography. The absolute treatment is surgical, and different approaches have been proposed. Methods. Herein, we describe our 15-year experience in the treatment of 58 patients of congenital choanal atresia with transnasal endoscopic approach, and we compare the efficacy of placement of an intranasal stent and applying mitomycin while endoscopic microsurgical repair. Results. The study included 41 female patients (71%) and 17 male patients (29%) with congenital CA. The mean age was 3 years ranging from 10 days to 16 years. The atretic plate was bilateral in 24 patients (41%) and unilateral in 34 (59%). The most common atresia type was the mixed type with 29 patients (50%). A total of 17 patients (29%) required postoperative revision(s). Postoperative revisions were more frequent among patients with bilateral CA (50%), and with mixed CA (31%). Stenting was used additionally by surgical correction for 10 patients. After stenting, fibrosis and restenosis was seen in 7 patients (79%). Mitomycin C was applied peroperatively in 8 patients. Restenosis after mitomycin application was seen in 4 patients (50%). Conclusions. By our experience, endoscopic microsurgical repair of atresia proved to be an effective and safe procedure, results compared with adjuvant treatment modalities like stent or mitomycin C use, was not better. Restenosis was the major problem seen after surgical correction
The Oblique Split Method A Novel Technique For Carving Costal Cartilage Grafts
No full textImportance: Autogenous rib cartilage is widely used in the septorhinoplasty cases with major structural grafting requirements. However, there is a risk of warping over time. Objective: To introduce a novel method for carving costal cartilage grafts to obtain straight grafts of varying thicknesses and to eliminate the risk of warping. Design: Between 2007 and 2011, a total of 43 consecutive patients underwent septorhinoplasty using autogenous costal cartilage grafts carved by the oblique split method (OSM). Setting: The Ankara Training and Research Referral Hospital, Ankara, Turkey. Participants: The study included 43 patients with saddle nose deformity and revisional rhinoplasty with a depleted source. All patients were followed-up for a period ranging from 12 to 37 months (mean, 19.2 months) after surgery. Interventions: All patients underwent open or closed septorhinoplasty. Autogenous costal cartilage was carved with the OSM to obtain grafts suitable for use as columellar strut, dorsal onlay, L-strut, lateral crural strut, caudal extension, and tip or speader grafts in selected cases. Main Outcome Measures: Patients were evaluated by inspection, palpation, and photographic documentation before surgery. Inspection, palpation, and photographic documentation were carried out every 6 months and 12 months after surgery and once a year thereafter. Results: Patient satisfaction in terms of form and function was achieved in 41 patients (95%). Two patients required reoperation for further tip projection (n=1) and alar batten graft displacement (n=1). No complication was observed as a result of graft warping, resorption, or fracture. Conclusions and Relevance: The OSM provides straight costal cartilage grafts of varying thicknesses without the risk of warping. Because they strictly preserve their straight form, the grafts may safely be modified into rectangular shape or carved asymmetrically and/or have their edges beveled. Current data from this study suggest that the OSM offers a flexible and reliable reconstructive option for the rhinoplasty surgeon.WoSScopu
Obstrüktif uyku apneli ve horlayan erişkin erkek hastaların dentofasiyal özelliklerinin değerlendirilmesi
No full text<p><strong>ÖZET </strong></p> <p><strong>Amaç:</strong> Bu çalışmanın amacı obstrüktif uyku apne sendromu (OUAS) olan erişkin erkek hastaların kraniofasiyal morfolojik özellikleri değerlendirmektir.</p> <p><strong>Gereç ve Yöntem</strong>: Çalışmada 80 erkek hastanın (60 OUAS, 20 horlama hastası) lateral sefalogramları değerlendirildi. Bireyler Grup 1: horlama (AHİ&lt;5); Grup 2: hafif OUAS (5£ AHİ&lt;15); Grup 3: orta OUAS(15£ AHİ&lt;30) ; Grup 4: şiddetli OUAS (AHİ<strong> </strong>³30) olarak değerlendirildi. Sefalogramlar üzerinde hyoid, dil kökü ve yumuşak damak konumu, kranioservikal postür ve havayolu genişliğini belirleyen ölçümler yapıldı. Gruplar arasındaki farklar normal dağılım gösteren değişkenlerde tek yönlü varyans analizi ve Duncan testiyle, normal dağılım göstermeyen değişkenlerde Kruskal Wallis testi ve Bonferroni düzeltmesi uygulanarak Mann Whitney U testiyle yapıldı.</p> <p><strong>Bulgular:</strong> Gruplar karşılaştırıldığında hyoid pozisyonu, yumuşak damak konumu, kranioservikal postür ve havayolu genişliğini gösteren ölçümlerde istatistiksel anlamlılık gösteren bir fark bulunmadı (p&gt;0.05). Dil kökü konumunu gösteren PNS-V (mm) değeri şiddetli OUAS grubu ile diğer gruplar arasında istatistiksel olarak anlamlı fark gösterdi (p&lt;0.05). Dil kökü ile ilgili diğer ölçümlerde ise gruplar arasında anlamlı fark bulunmadı (p&gt;0.05).</p> <p><strong>Sonuçlar: </strong>İncelenen popülasyonda şiddetli OUAS grubunda dil kökünün daha aşağıda konumlandığı belirlenmiş, diğer kraniofasiyal değişkenlerde gruplar arasında fark görülmemiştir.</p> <p><strong>Anahtar kelimeler:</strong> Obstrüktif uyku apnesi sendromu, horlama, sefalometri, kraniofasiyal.</p> <p><strong> </strong></p> <p><strong> </strong></p> <p><strong>ABSTRACT</strong></p> <p><strong>Objectives: </strong>The aim of this study was to evaluate the craniofacial morphology of adult male patients with obstructive sleep apnea syndrome (OSAS).</p> <p><strong>Materials and Methods:</strong> Cephalograms of 80 male patients (60 OSAS, 20 snoring) were evaluated. Subjects were grouped as, Group 1: snoring (AHI&lt;5); Group 2: mild OSA (5£ AHI&lt;15); Group 3: moderate OSA (15£ AHI&lt;30) ; Group 4: severe OSA (AHI ³30). Measurements were made to evaluate hyoid bone position, tongue base and soft palate, craniocervical extension and the airway width. Statistical significance was determined with one-way ANOVA and Duncan test for variables showing normal distribution. Kruskal Wallis test and Mann Whitney U test with Bonferroni correction were used to evaluate the variables that were not normally distibuted.</p> <p><strong>Results:</strong> No significant differences were found in hyoid bone position, soft palate position, craniocervical extension and the airway width (p&gt;0.05). PNS-V (mm), was significantly different between severe OSA group and the other groups (p&lt;0.05). The other measurements on tongue base showed no difference between groups (p&gt;0.05).</p> <p><strong>Conclusions:</strong> In this study population, the tongue base was more inferiorly positioned in the severe OSA group whereas the other craniofacial variables showed no difference between groups.</p> <strong>Key words: </strong>Obstructive sleep apnea syndrome, snoring, cephalometry, craniofacial
Complications of endoscopic surgery of the pituitary adenomas: analysis of 570 patients and review of the literature
No full textEndoscopic transsphenoidal surgery is emerging as a minimally invasive and maximally effective procedure for pituitary adenomas. In this report we analyzed the complications in 624 procedures of endonasal transsphenoidal endoscopic surgery in the treatment of 570 patients with pituitary adenomas. The leading author (MB) operated pituitary adenomas via pure endoscopic endonasal transsphenoidal surgery between January 2006 and August 2011 at the Hacettepe University, Department of Neurosurgery in Ankara. Complications were assessed in 624 surgical procedures under five groups; rhinological, CSF leaks, infection, vascular and endocrinologic complications. We observed a total of 76 complications (12.1%). Rhinological complications occurred in 8 patients (1.3%): 4 epistaxis (0.6%) and 4 hyposmia (0.6%). Postoperative CSF leaks occurred in 8 patients (1.3%), and infectious complications occurred in 8 patients: 3 cases of sphenoidal sinusitis (0.4%), 5 cases of meningitis (0.8%). Only 1 case of internal carotid aneurysm rupture during the opening of sellar floor (0.16%) was observed. Endocrinologic complications occurred in 51 (8.1%) patients: Anterior pituitary deficiency in 12 (1.9%), transient diabetes insipidus (DI) in 29 (4.6%), permanent DI in 3 (0.4%) and inappropriate antidiuretic hormone secretion syndrome occurred in 7 (1.1%). There was no mortality directly related to the surgical procedure. The complication rates observed in our study suggests that the endoscopic pituitary surgery is at least as safe as microscopic transphenoidal surgery. These rates were obtained with due experience and well-coordinated teamwork. To further improve these rates, new technological developments will be helpful
