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Öğe Anesthesia mumps resulting in temporary facial nerve paralysis after the auditory brainstem implantation in a 3-year-old child(Elsevier Ireland Ltd, 2014) Ozdek, Ali; Bayir, Omer; Isik, Murat Eray; Tatar, Emel Cadalli; Saylam, Guleser; Korkmaz, HakanAn acute transient sialadenitis of the major salivary glands in the early postoperative period is called 'anesthesia mumps'. It has been reported in different surgical procedures especially in neurosurgical procedures. Anesthesia mumps develops very fast after the extubation period but it usually regresses with no sequelae within a few hours. However, sometimes serious complication can occur such as respiratory distress. In this report, we present a 3-year-old girl with an anesthesia mumps and facial palsy occurring after successful auditory brainstem implantation and we discuss the cause and the management of this rare complication in this report. (C) 2013 Elsevier Ireland Ltd. All rights reserved.Öğe Biofilms in chronic rhinosinusitis with polyps: is eradication possible?(Springer, 2014) Korkmaz, Hakan; Ocal, Bulent; Tatar, Emel Cadalli; Tatar, Ilkan; Ozdek, Ali; Saylam, Guleser; Celik, Hakan HamdiThe objective of the study was to reveal if mometasone furoate nasal spray as monotherapy or combined with long-term oral clarithromycin have influence on biofilms in chronic rhinosinusitis with polyps. The study is a randomized controlled trial in a tertiary referral hospital. Thirty-four patients with chronic rhinosinusitis completed the study. In the first group, 19 patients received mometasone furoate nasal spray 200 mu g once daily for 8 weeks. In the second group, 15 patients received oral clarithromycin 500 mg twice daily for 2 weeks and continued once daily 250 mg tablet for subsequent 6 weeks, plus mometasone furoate. Scanning electron microscopy was the primary outcome measure. Secondary outcome measures included computerized tomography and sinonasal outcome test-20 items. Mucosal biofilms were detected in 23 of 34 (68 %) patients on pretreatment polyp samples. After the treatment, biofilms disappeared in 1 of 11 patients in the first group, whereas the eradication of biofilms was evident in 6 of 12 (50 %) patients in the second group. Tomography scores improved in eight patients of each group (42.1 and 53.4 %, respectively). The comparison of improvements did not reveal significant difference between the groups. The overall symptom scores improved compared to the baseline levels. The mean changes of -8.8421 and -11.4000 in the first and second group, respectively, were not statistically different. Adding long-term low-dose oral macrolides to nasal steroids was effective in the eradication of biofilm. However, we were not able to demonstrate that combined therapy was superior in terms of the improvement in tomography and symptom scores.Öğe Comparing Traditional Cold Knife Tonsillectomy with a New Technique Plasma Knife Tonsillectomy(Galenos Yayincilik, 2013) Ozler, Gul Soylu; Tatar, Emel Cadalli; Saylam, Guleser; Ozdek, Ali; Korkmaz, HakanObjective: The aim of this study is to compare traditional cold knife tonsillectomy and plasma knife tonsillectomy. Methods: In this study, 15 patients underwent cold knife tonsillectomy, 15 patients underwent plasma knife tonsillectomy. The patients were then followed up in the postoperative days. Results: The operation time and intraoperative blood loss in cold knife tonsillectomy group was significantly greater than the plasma knife group (p<0.001). The mean pain scores in the plasma knife group was significantly higher than the dissection group (p=0.006). Pain scores in each follow up time for each group was not statistically significant (p>0.05). Postoperative compli-cations were similar for both groups (p=0.224). There was no significant correlation of complications and age (p=0.921). Operation time of the patients who had complications was not different from the patients who did not have complications (p=0.086). Pain scores in every follow up time for both groups was not significantly different (p>0.005). Conclusion: According to this data, plasma knife tonsillectomy was not found superior to cold knife tonsillectomy in the postoperative pain and complications but had positive effects on operation time and blood loss.Öğe Does AHI Value Enough for Evaluating the Obstructive Sleep Apnea Severity?(Springer India, 2015) Dundar, Yusuf; Saylam, Guleser; Tatar, Emel Cadalh; Ozdek, Ali; Korkmaz, Hakan; Firat, Hikmet; Ardic, SadikObstructive sleep apnea/hypopnea syndrome (OSAHS) is an important and more common public health problem with increasing incidence. Polysomonography (PSG) is the gold standard test in OSAHS diagnosis. Apnea-hypopnea index (AHI) is the main parameter of PSG, which is correlated with OSAHS severity. The main complaint of OSAHS patients is daytime sleepiness and the Epworth Sleepiness Scale (ESS) used for evaluation of disease severity. The correlation of AHI with daytime sleepiness and ESS is well known. But there are many patients, which have uncorrelated daytime sleepiness with AHI. This data calls this hypothesis; Are there any other parameters which may affect daytime sleepiness. 648 patients with complaining of snoring and apnea were evaluated by polysomnography and anthropometric measurements. The cut-off value of ESS was accepted 10 as an indicator of severe daytime sleepiness. Patients were divided to groups with the aim of homogenization, according to AHI values. The patients with similar AHI values were analyzed according to their ESS scores. BMI and neck circumference were elevated in daytime sleepiness patients. The nocturnal hypoxemia markers; apnea number/index, maximum duration of apnea, at least SO2 concentration, duration of SO2 less than 90 % were much effected in the group of daytime sleepiness. Beside the fact that our research, AHI is not enough for predicting the daytime sleepiness; anthropometric measurements and the nocturnal hypoxemia markers should be evaluated.Öğe The evaluation of inflammatory process, endothelial dysfunction and oxidative stress in sleep apnea(Deomed Publ, Istanbul, 2014) Dundar, Yusuf; Tatar, Emel Cadalli; Saylam, Guleser; Korkmaz, Hakan; Selcuk, Omer Tarik; Ozdek, Ali; Ardic, SadikObjective: To investigate the correlation of inflammatory process, endothelial dysfunction and oxidative stress with obstructive sleep apnea (OSA). Methods: In our prospective cross-sectional clinical study in a tertiary referral hospital, we evaluated 63 patients with newly diagnosed OSA and 9 simple snorers. Each patient was evaluated in terms of additional systemic diseases and laboratory tests. In addition to routine blood analysis; oxidative stress markers (leptine, RBP), vascular endothelial markers (ICAM-I, VCAM-I) and inflammatory markers (Crp, IL-6, TNF-alpha, isoprostane) were analyzed. Polysomnography test was performed and study population was divided into four groups depending on their AHI values. The levels of markers were analyzed and compared between the four groups. Results: There was a weak correlation between the isoprostane levels and mean apnea duration and also a mild correlation to the maximum apnea duration. A weak correlation was detected between leptine and VCAM levels to age and also a weak negative correlation was detected between CRP levels to age. The leptin levels were found to be mildly correlated to BMI and abdominal circumference. The ICAM levels were found to have a weak correlation to BMI and abdominal circumference. Conclusion: Our results indicate a correlation between sleep apnea and oxidative stress. These results may help to explain the association of comorbid diseases with OSAS. Further investigators should aim to explain key steps of inflammatory response in sleep apnea.Öğe Interscapular Pharyngocutaneous Fistula: An Extreme Complication of Cervical Stabilization Surgery(Turkish Neurosurgical Soc, 2013) Korkmaz, Hakan; Saylam, Guleser; Bayir, Omer; Cadalli Tatar, Emel; Ozdek, AliPharyngeal and esophageal perforations are rare during cervical spine surgery but can cause significant morbidity. Pharyngeal or eosephageal perforations can occur by several mechanisms and the management of pharyngeal or eosephageal perforation's treatment may become difficult. We report a 41-year-old paraplegic man with an interscapular pharyngocutaneous fistula secondary to cervical vertebral surgery. The diagnosis of posterior fistula was delayed for several months as it was an extremely rare complication. We explored the anterior neck and repaired the perforation on the right pyriform sinus primarily. The fistula tract on the back of the patient was completely healed and the patient started oral feeding in the second week after surgery.Öğe Is there any correlation between the results of skin-prick test and the severity of symptoms in allergic rhinitis?(Ocean Side Publications Inc, 2012) Tatar, Emel Cadalli; Surenoglu, Unzile Akpinar; Saylam, Guleser; Isik, Eray; Ozdek, Ali; Korkmaz, HakanBackground: This study was designed to determine whether there is any correlation between results of the skin-prick test and the severity of symptoms in allergic rhinitis. Methods: We retrospectively evaluated 150 patients with persistent or intermittent allergic rhinitis confirmed by positive skin tests and scaled from 1 to 4 according to the size of the wheal. The symptoms including sneezing, nasal obstruction, rhinorrhea, and nasal itching were ranked according to their severity (0 for no symptoms, 1 for mild, 2 for moderate, and 3 for severe). We investigated the correlation between the skin tests' positivity and symptoms score, rhinoconjunctivitis quality-of-life questionnaire (RQLQ), and visual analog scale (VAS) scores. Results: Of the 150 patients, 98 had persistent and 52 had intermittent allergic rhinitis. Some patients had multiple allergen sensitivity. Each skin test group was compared with respect to symptom scores, RQLQ, or VAS scores. There was no statistically significant correlation between the size of the wheal and symptoms score, RQLQ, or VAS scores. There was also no correlation between the type of allergen and symptoms score. Conclusion: The skin-prick test can be applied to support the diagnosis of allergic rhinitis, but one can not predict the severity of illness by stratifying the size of the skin-prick test result. (Am J Rhinol Allergy 26, e37-e39, 2012; doi: 10.2500/ajra.2012.26.3750)Öğe A life-saving approach to trachea-innominate artery fistula: endovascular stent(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Korkmaz, Hakan; Yildirim, Utku Mahir; Dundar, Yusuf; Tatar, Emel Cadalli; Saylam, Guleser; Ozdek, AliTracheo-innominate artery fistula is a devastating complication of tracheal operations. It is most commonly seen after tracheotomy and mostly in the postoperative 7th to 14th days. Despite all radical therapeutic interventions, survival rate of this emergency condition is very poor. In this article, we report a 24-year-old male case with trachea-innominate artery fistula after endotracheal titanium stent removal. This complication was successfully managed with an endovascular stent. Sternotomy and innominate artery ligation is the main emergency procedure, however, endovascular stent deployment can be an alternative procedure in hemodynamically stable patients with better results.Öğe Permanent central diabetes insipidus as a complication of sphenoid sinus mucocele(W B Saunders Co-Elsevier Inc, 2014) Saylam, Guleser; Bayir, Omer; Girgin, Derya; Arslan, Muyesser Sayki; Tatar, Emel Cadalli; Ozdek, Ali; Delibasi, TuncayAlthough mucocele is a benign lesion, its unavoidable expansions may result in irreversible damages in adjacent organs. In spheno-ethmoid mucoceles which are extremely rare, this condition may cause more severe problems. Central diabetes insipidus, developed secondary to sphenoid sinus mucocele, was detected in a 54-year-old male patient, who underwent endoscopic sinus surgery 2 times due to nasal polyposis. Endoscopic sphenoid mucocele marsupialization was performed to the patient, but despite partial regression in the 1-year follow up, complete recovery was not observed. (C) 2014 Elsevier Inc. All rights reserved.Öğe Postviral Vagal Neuropathy: What Is the Role of Laryngeal Electromyography in Improving Diagnostic Accuracy?(Mosby-Elsevier, 2015) Tatar, Emel Cadalli; Ocal, Bulent; Korkmaz, Hakan; Unlu, Ece; Surenoglu, Unzile Akpinar; Saylam, Guleser; Ozdek, AliObjectives. To investigate the convenience of laryngeal electromyography (EMG) findings in patients with chronic cough thought to be postviral vagal neuropathy (PVVN) with the clinical symptoms. Study Design. Prospective cohort study. Methods. We applied PVVN questionnaire and chronic cough quality of life (QoL) questionnaire, which is for determining the effect of chronic cough on the QoL, to 20 chronic cough applicants who has no explanatory cause in differential diagnosis. We also carried out videolaryngostroboscopy (VLS) and laryngeal needle EMG in these patients. Results. The mean duration of persisting cough was 1.875 months (SD +/- 0.825). The overall mean symptom score of chronic cough questionnaire was 58.80 (SD +/- 9.89). There was a significant positive correlation between total EMG score and chronic cough score (Spearman r, 0.489, P < 0.05). The correlation between VLS findings and either chronic cough scores or EMG scores did not reach statistical significance. Conclusions. Cranial nerves might be affected by inflammatory processes as occur in the PVVN, which must be considered in the etiology of chronic cough. We showed that the laryngeal EMG can be used as an appropriate diagnostic tool for these patients.Öğe Prevalence of Biofilms and Their Response to Medical Treatment in Chronic Rhinosinusitis without Polyps(Sage Publications Ltd, 2012) Tatar, Emel Cadalli; Tatar, Ilkan; Ocal, Bulent; Korkmaz, Hakan; Saylam, Guleser; Ozdek, Ali; Celik, Hakan HamdiObjective. The aim of this study was to investigate the prevalence of biofilms and the effects of medical treatment modalities in chronic rhinosinusitis (CRS) patients without nasal polyps. Study Design. Randomized controlled trial. Settings. Tertiary referral hospital. Subjects and Methods. The authors randomly divided 32 adult patients with CRS without nasal polyps into 2 groups. In the first group (n = 16), oral clarithromycin was administered 500 mg/bid for 2 weeks and then 250 mg/d for the following 6 weeks. In the second group (n = 16), an 8-week course of 200-mcg/d topical mometasone furoate was added to the clarithromycin regimen, identical to the first group. The pre-and posttreatment nasal tissue samples were evaluated by scanning electron microscopy for biofilm prevalence and graded from 0 to 3 according to density and extension. Results. Biofilms were detected in 24 of 32 patients (75%) before the treatment (grades 1-3). Biofilms were detected in 14 of 32 patients (43.8%) after the treatment (grades 12). When each group was evaluated independently, there was a significant improvement after the treatment in both groups I and II. When the biofilm grades of group I were compared to those of group II, there was no significant difference both in the pre-and posttreatment evaluation. Conclusion. The prevalence of biofilms in CRS without polyps was 75% in our study. Regression of biofilms to 43% was observed under medical treatment. Adding nasal steroids to macrolides gave no further benefit.
