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Öğe Anti-inflammatory effects of hyperbaric oxygen on irradiated laryngeal tissues(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2018) Aricigil, Mitat; Dundar, Mehmet Akif; Yucel, Abitter; Arbag, Hamdi; Arslan, Abdullah; Aktan, Meryem; Findik, SidikaIntroduction: To manage the complications of irradiation of head and neck tissue is a challenging issue for the otolaryngologist. Definitive treatment of these complications is still controversial. Recently, hyperbaric oxygen therapy is promising option for these complications. Objective: In this study, we used biochemical and histopathological methods to investigate the efficacy of hyperbaric oxygen against the inflammatory effects of radiotherapy in blood and laryngeal tissues when radiotherapy and hyperbaric oxygen are administered on the same day. Methods: Thirty-two Wistar Albino rats were divided into four groups. The control group was given no treatment, the hyperbaric oxygen group was given only hyperbaric oxygen therapy, the radiotherapy group was given only radiotherapy, and the radiotherapy plus hyperbaric oxygen group was given both treatments on the same day. Results: Histopathological and biochemical evaluations of specimens were performed. Serum tumor necrosis factor-alpha, interleukin-1 beta, and tissue inflammation levels were significantly higher in the radiotherapy group than in the radiotherapy plus hyperbaric oxygen group, whereas interteukin-10 was higher in the radiotherapy plus hyperbaric oxygen group. Conclusion: When radiotherapy and hyperbaric oxygen are administered on the same day, inflammatory cytokines and tissue inflammation can be reduced in an early period of radiation injury. (C) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Öğe Computed Tomography Analysis of Nasal Anatomy in Dorsal Preservation Rhinoplasty(Oxford Univ Press Inc, 2022) Eravci, Fakih Cihat; Ozer, Halil; Arbag, Hamdi; Eryilmaz, Mehmet Akif; Aricigil, Mitat; Dundar, Mehmet AkifBackground Subdorsal septal resection and radix osteotomy are distinctive surgical steps in preservation rhinoplasty. Objectives The aim of this study was to evaluate the nasal bone thickness, the level of the septal bony-cartilaginous junction (K area), and the distances of the frontal sinus and skull base from the transverse osteotomy line in the Turkish population by means of conventional computed tomography (CT). Methods A retrospective evaluation was made of 203 consecutive preoperative paranasal CT scans of patients (classified in terms of age and gender) who had undergone rhinoplasty surgery between January 2020 and June 2021. The nasal bone thickness at the medial canthus level, and the distances between the transverse osteotomy line and the K area, the frontal sinus, and the cribriform plate were measured. Results The mean measurements were similar in terms of age groups (P = 0.402, P = 0.542, P = 0.134 and P = 0.276 for ages 18-30, 30-40, 40-50, and >50 years, respectively). The mean nasal bone thickness and the distance between the transverse osteotomy line and the K area showed statistical significance (P = 0.001 and P = 0.001, respectively). In both genders, the mean distances between the transverse osteotomy line and the frontal sinus and the cribriform plate were similar (P = 0.921 and P = 0.280, respectively). The nasal bone was thinner and the K area position more cephalic in females. Conclusions CT plays an important role in preoperative planning. The need for resection of the ethmoid perpendicular bone may be greater in males when lowering the dorsal hump, and hence they may be more prone to skull base complications. It is therefore necessary to be more careful in the surgical stage of subdorsal septal excision in males.Öğe Confirmation of anatomical proximities in endoscopic sinus surgery with computer tomography: A cadaveric study(Bayrakol Medical Publisher, 2023) Erdem, Rukiye Ozcelik; Dundar, Mehmet Akif; Aricigil, Mitat; Arbag, HamdiAim: The aim of this study was to investigate the confirmation of anatomical proximities between endoscopic sinus surgery with computer tomography. Material and Methods: This study was done on 5 fresh frozen cadaver heads between May 2017 to June 2018. High-resolution computed tomography (HRCT) was taken before the operations. Firstly uncinectomy was done. Then all stages of functional endoscopic sinus surgery (FESS), which contains anteriorposterior ethmoidectomy, dissection of the sphenoid sinus and frontal recess, and maxillary sinusotomy were performed from anterior to posterior. Distances between each other landmarks and distances to the nasal vestibule were measured during the surgery. All measurements taken during dissection were measured on the coronal, axial, and sagittal section HRCT. Dissection data were compared with radiological data. Results: As a result of comparing the radiological data and dissection data, there was no significant difference between the data obtained from the sagittal section and the dissection data. A significant difference (P=0.03) was found between the dissection and radiological evaluation in the coronal section except for the measurements of SO-UT (p=0.853) and MP-SA (p=0.972), and in the axial section except for the measurements of the SO-C (p=0.579) and MP-SA (p=1). Discussion: Measurements obtained in the paranasal sinus CT can be used during FESS. While the data obtained in the sagittal section are suitable for the operation plan and can be used directly, the coronal and axial section are not.Öğe Dysphagia and Airway Obstruction Due to Large Cervical Osteophyte in a Patient With Ankylosing Spondylitis(Lippincott Williams & Wilkins, 2014) Varsak, Yasin Kursad; Eryilmaz, Mehmet Akif; Arbag, HamdiAnterior cervical osteophytes are excessive bony formation of cervical vertebra bodies. They are common but rarely symptomatic lesions mostly seen in geriatric population. Large anterior cervical osteophytes may cause symptoms such as dysphagia, dyspnea, dysphonia, and odynophagia. They have been attributed to multiple etiologies including diffuse idiopathic skeletal hyperostosis, following trauma, cervical spondylitis, and infectious spondylitis. However, symptomatic large anterior cervical osteophyte with ankylosing spondylitis is extremely rare. Surgical excision is the main treatment for symptomatic cases. We report a case of a 53-year-old man with airway obstruction and dysphagia due to large cervical osteophyte who has a history of ankylosing spondylitis, and we also addressed the etiological factors and management of large symptomatic cervical osteophytes.Öğe The Effect of Rhinoplasty Dissection Planes (Sub-SMAS, Subperichondrial, and Subperiosteal) on the Viability of Diced Cartilage Grafts in a Rabbit Model(Oxford Univ Press Inc, 2023) Eravci, Fakih Cihat; Kaplan, Omer; Oltulu, Pembe; Arbag, Hamdi; Eryilmaz, Mehmet Akif; Aricigil, Mithat; Dundar, Mehmet AkifBackground Dorsal preservation surgeries in which the subperichondral and subperiosteal planes are used to elevate the soft tissue envelope of the nose have become increasingly widespread because they can reduce postoperative edema and promote faster healing. However, the effects of surgical dissection planes on the viability of cartilage grafts are not known. Objective The aim of this study was to determine, in a rabbit model, the viability of diced cartilage grafts in different rhinoplasty dissection planes (sub-superficial musculoaponeurotic system [SMAS], subperichondral, subperiosteal). Methods Diced cartilage samples were placed in the sub-SMAS, subperichondrial, and subperiosteal planes, and after 90 days, histopathologic analysis was performed. Cartilage graft viability was evaluated based on the loss of chondrocyte nuclei in the lacuna, the presence of peripheral chondrocyte proliferation, and the loss of matrix metachromasia in the chondroid matrix. Results The median [interquartile range] percentages of live chondrocyte nucleus viability in the sub-SMAS, subperichondrial, and subperiosteal groups were 67.5% [18.75%] (range, 60%-80%), 35% [17.5%] (range, 20%-45%), and 20% [30.0%] (range, 10%-45%), respectively; and the percentages of peripheral chondrocyte proliferation were 80.0% [22.5%] (range, 60%-90%), 30% [28.75%] (range, 15%-60%), and 20% [28.75%] (range, 5%-60%), respectively. There was strong statistical significance in both parameters (P = .001). Intergroup examination revealed a difference between the sub-SMAS and the other surgical planes (P = .001 for both parameters). A smaller loss of chondrocyte matrix was observed in the sub-SMAS group compared with the other 2 groups, which supports the findings of cartilage viability (P = .006). Conclusions Elevating the soft tissue envelope of the nose in the sub-SMAS surgical plane preserves the viability of cartilage grafts better than subperichondrial and subperiosteal elevation.Öğe Effectiveness of Spreader Graft Versus Autospreader Flap in Reducing Nasal Air Resistance(Lippincott Williams & Wilkins, 2023) Cemiloglu, Muhammed; Aricigil, Mitat; Bayrakci, Erdem; Acar, Guelay; Arbag, HamdiObjective:The authors aimed to compare the functional outcomes of 2 different techniques, spreader graft and autospreader flap, by using them for nasal valve surgery in cadavers using acoustic rhinometry (AR).Method:Ten frozen cadavers who underwent nasal valve surgery between May 2017 and August 2018 were randomly divided into 2 groups. Spreader grafts were applied to 10 nasal valve regions in 1 group, while the autospreader flap method was used on the other 10 nasal valve regions. The effectiveness of the surgical techniques was evaluated utilizing AR.Result:We objectively evaluated the effect of surgery on nasal air resistance by comparing the preoperative and postoperative AR values (MCA1, MCA2, volume) in both the spreader graft and the autospreader flap groups. In addition, the differences in nasal potency gain after the application of both techniques were compared and the superiority of the 2 surgeries in terms of functional gains was evaluated. A statistically significant difference was observed in preoperative and postoperative MCA1, MCA2, and volume values in both the techniques and sides. The authors found more significant nasal valve opening for the spreader graft technique using acoustic rhinometric values when compared with the autospreader flap technique.Conclusions:In both methods, the air resistance was observed to decrease objectively in the nasal valve region. Autospreader flaps increase the nasal valve angle without the need for additional cartilage tissue, and it could be an alternative to spreader grafts.Öğe The effects of local and intraperitoneal zinc treatments on maxillofacial fracture healing in rabbits(Churchill Livingstone, 2020) Azgin, Isa; Arbag, Hamdi; Eryilmaz, Mehmet Akif; Celik, Zeliha EsinObjective: This study aimed to determine whether administration of topical and intraperitoneal zinc for maxillofacial fractures has any impact on the bone healing process. Material and method: Thirty-two New Zealand rabbits were randomly assigned to four groups of eight each. The first group was the control group; fracture lines were fixed using titanium microplates and no medication was administered. The second group received fixations using zinc-coated titanium microplates. A single dose of 3 mg/kg zinc was administered intraperitoneally to the third group following fixations with titanium microplates. A single dose of 3 mg/kg zinc was administered intraperitoneally to the fourth group following fixations with zinc-coated titanium microplates. Zinc coating on to the titanium microplates was achieved using the physical vapor deposition technique. A fracture line was created in the nasal bones of all subjects and fixed with five-hole flat microplates and three 5-mm micro screws. All work groups were sacrificed at the end of the sixth week. Results: Histological examination showed that the number of osteoblasts were significantly higher in zinc-coated group (Group 2) than zinc uncoated, control group (Group 1), (415.6 +/- 46.7 vs 366.3 +/- 11.8) (p < 0.001). It was observed that intraperitoneal zinc treatment alone (Group 3) did not significantly increase in the osteoblast count compared to zinc un-coated group (Group 1), (390.6 +/- 83.2 vs 366.3 +/- 11.8), (p = 0.341). The immunoreactivity scores for IGF-1 were significantly higher in the zinccoated group compared to control group (Group 2 vs 1), (9.3 +/- 2.8 vs 3.7 +/- 1.9) (p < 0.05). It was observed that intraperitoneal zinc treatment did not cause a significant difference in the aspect of IGF-1 for zinc-coated groups (Group 2 vs 4) (9.3 +/- 2.8 vs 9.6 +/- 2.2) (p = 0.791). The difference in the immunoreactivity score among whole groups for TGF-beta was not statistically significant (Group 1 vs 2, 3.2 +/- 1.7 vs 4.4 2.3, p = 0.256; Group 1 vs 3, 3.2 1.7 vs 3.8 2.8, p = 0.524; Group 1 vs 4, 3.2 1.7 vs 2.8 1.3, p = 0.717; Group 2 vs 3, 4.4 2.3, vs 3.8 2.8, p = 0.610; Group 2 vs 4, 4.4 2.3, vs 2.8 + 1.3, p = 0.124; Group 3 vs 4, 3.8 2.8, vs 2.8 + 1.3, p = 0.311). Conclusion: The local use of titanium microplates coated with zinc by PVD technique was found effective for fracture healing. Zinc coating of titanium microplates used in fracture treatment can accelerate fracture healing. It may be concluded that clinical studies should be performed now in order to explore if comparable results can be achieved in humans. (C) 2020 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.Öğe Giant Trichilemmal Cyst of the Submental Region(Lippincott Williams & Wilkins, 2014) Dundar, Mehmet Akif; Varsak, Yasin Kursad; Kozacioglu, Sumeyye; Arbag, Hamdi[Abstract Not Availabe]Öğe Is there a relationship between causative microorganisms and hearing loss in neonatal sepsis?(Wiley, 2021) Yilmaz, Fatma Hilal; Emiroglu, Nuriye; Oflaz, Mehmet Burhan; Yucel, Mehmet; Kececi, Ramazan; Arbag, Hamdi; Altunhan, HuseyinBackground The aim of the present study was to determine the possible relationship between cultured microorganisms and hearing loss in infants admitted to the neonatal intensive care unit (NICU) who could not pass a standard hearing test. Method The medical records of infants treated at the NICU were retrospectively evaluated. The patients were first divided into two groups, and group 1 was divided into two subgroups: Group 1 included patients with hearing loss accompanied by proven sepsis caused by either gram-negative (group 1A) or gram-positive (group 1B) bacteria, and group 2 included patients with clinical sepsis. The groups were compared with potential risk factors related to hearing loss. Results Between January 2014 and January 2019, the cases of 3,800 infants admitted to the NICU were reviewed. Of 3,548 living babies, the Auditory Brainstem Response (ABR) test showed that 35 infants (0.98%) were diagnosed with hearing loss. In 12 infants with hearing loss, microbial growth in the blood cultures was detected, whereas in the remaining 23, the blood cultures were negative. Of the cases with microbial growth, five were gram negative and seven were gram positive. In the comparison of groups 1A, 1B, and 2, there were statistically significant differences in terms of risk factors such as low birth weight (p = .048), neonatal hospitalization time (p = .001), free oxygen support (p = .001), intraventricular bleeding (p = .001), loop diuretic use (p = .001), and blood transfusion (p = .048). Conclusion The relationship between hearing loss and microorganisms causing sepsis could not be determined in this research.Öğe Low-Grade Fibromyxoid Sarcoma of Superior Turbinate in a Pediatric Patient(Lippincott Williams & Wilkins, 2015) Varsak, Yasin Kursad; Arbag, Hamdi; Yesildemir, Huri Sultan; Esen, Hasan[Abstract Not Availabe]Öğe Minimally Invasive Endoscopic Retrosigmoid Approach to the Cerebellopontine Angle Using a Novel Surgical Instrument: A Cadaveric Study(Aves, 2018) Aricigil, Mitat; Arbag, Hamdi; Dundar, Mehmet Akif; Aziz, Suhayb Kuria; Yilmaz, Mehmet TugrulOBJECTIVES: In this study, we aimed to describe how endoscopes show the neural and vascular structures at the cerebellopontine angle (CPA) through a minimal craniotomy in a well-described anatomic point in the retrosigmoid legion and at the same time, evaluate the endoscopic anatomic exposure and maneuverability. We planned to use the new surgical instrument (endoscope cannula), which we designed on fresh frozen cadavers to simulate a real surgical procedure. MATERIALS and METHODS:The surgical procedure was planned to be performed on 20 sides of 10 fresh cadaver heads. The distance between the aster ion and mastoid process was determined, and the midpoint was then marked. From this midpoint, a craniotomy 2 cm in size was posteriorly made. The endoscope cannula together with 0 degrees or 30 degrees endoscopes was inserted to capture the panoramic views of the neurovascular structures in CPA. Endoscopic anatomic exposure and maneuverability wee evaluated using 0 degrees and 30 degrees endoscopes with/without the endoscope cannula. RESULTS: The surgeon could easily use both hands during the surgical simulation, and maneuverability was seen to increase in CPA with the use of the endoscope cannula. CONCLUSION:The surgeon can work actively with both hands when the endoscopes and the endoscope cannula are used together. We believe that owing to this, the surgeon's maneuverability would increase and a more effective minimally invasive endoscopic retrosigmoid surgery would ensue.Öğe Pott's Puffy tumor: The role of ultrasound, computed tomography and magnetic resonance imaging in diagnosis(Modestum Ltd, 2017) Kalkan, Havva; Eryilmaz, M. Akif; Kiresi, Demet; Arbag, Hamdi; Yesildag, AhmetPott's Puffy tumor is a rare disorder which is charactarized by frontal osteomyelitis and subperiosteal abscess as a complication of sinusitis. Nowadays we have forgotten this entity under the broad spectrum antibiotherapies for sinijsitis. We reported an adolescent with chronic sinusitis suffered from forehead swelling and headache. He was performed ultrasound, computed tomography, magnetic resonans imaging for accurate diagnosis. Early diagnosis with appropriate imaging is necessary in order to avoid more severe complications, such as subdural empyema, septic thrombosis of the dural sinuses. Emergency physicians should remember Pott's puffy tumor in differential diagnosis in patients presenting with forehead swelling and headache. Imaging modalities have an important role for the right diagnosis and guidance of the surgery. The thing that make this report special is the ultrasonographic images that are so rare reported in the literature. To our knowledge there are two reports which emphasized the sonographic findings of this entity.Öğe Prenatal Diagnosis and Intrapartum Management of Congenital Ranula(Georg Thieme Verlag Kg, 2018) Ercan, Fedi; Sarikaya, Muslum; Toprak, Erzat; Findik, Sidika; Arbag, Hamdi; Acar, AliA foetal sublingual cystic lesion was diagnosed by routine prenatal ultrasonography at 27 weeks of gestation. Foetal growth and amniotic fluid volume were normal. An ex utero intrapartum treatment (EXIT) procedure was performed, and the cyst was aspirated to allow breathing during planned Caesarean section. The cyst was totally excised when the newborn was 60 days old, and histopathological examination revealed a mucous cyst of the mouth floor.Öğe Reconstruction of the Orbit With a Temporalis Muscle Flap After Orbital Exenteration(Korean Soc Otorhinolaryngol, 2015) Uyar, Yavuz; Kumral, Tolgar Lutfi; Yildinm, Guven; Kuzdere, Mustafa; Arbag, Hamdi; Jorayev, Chary; Kilic, Mehmet VefaObjectives. This study presents the role of the temporalis muscle flap in primary reconstruction after orbital exenteration. Methods. A retrospective nonrandomized study of orbital exenterations performed between 1990 and 2010 for malignant tumors of the skin, paranasal sinus, and nasal cavity is presented. Results. The study included 13 patients (nine men, four women; age range, 30-82 years) with paranasal sinus, nasal cavity, or skin carcinomas. Primary reconstruction of the cavity was performed in all patients after orbital exenteration. No visible defects in the muscle flap donor site were present. Local recurrences were readily followed up with nasal endoscopy, whereas radiology helped to diagnose intracranial involvement in three patients. Two patients died of systemic metastases and five died for other reasons Conclusion. The temporalis muscle flap is readily used to close the defect after orbital exenteration, and does not prevent the detection of recurrence.Öğe Single seventh day debridement compared to frequent debridement after endoscopic sinus surgery: a randomized controlled trial(Springer, 2016) Varsak, Yasin Kursad; Yuca, Koksal; Eryilmaz, Mehmet Akif; Arbag, HamdiThe aim of this study was to evaluate the postoperative debridement frequency following endoscopic sinus surgery. Individual randomized controlled trial. Sixty-two adult patients with a diagnosis of chronic rhino sinusitis (CRS) with nasal polyps (NP) and CRS without NP meeting the inclusion criteria were enrolled in this prospective study. The patients were randomized equally to frequent debridement (FD; at postoperative weeks 1, 2 and 4) or to a single debridement (SD; at postoperative week 1) after surgery. The outcomes were assessed with visual analog scale (VAS) for nine main symptoms concerning patient discomfort within the first 4 weeks, with the modified Lund-Kennedy endoscopic score (MLKES) at weeks 4 and 24 and with the sino-nasal outcome test-20 (SNOT-20) at week 24. Thirty-seven of the patients were male, and twenty-five were female. The mean age was 36.1 +/- 13.5 in FD group and 39.2 +/- 14.7 in SD group. In the SD group, the VAS scores at postoperative week four showed significantly less discomfort at visits (p = 0.004) and less negative effects on their work (p = 0.013). There was no statistically significant difference between the two groups in the week 4 and 24 MLKES and in the week 24 SNOT-20 scores (p > 0.05). The endoscopic findings did not show significant differences between the groups. Our data indicate that FD causes more discomfort at the required visits, more facial pain and more negative effects on patients' work; this method is not superior to postoperative single seventh day debridement in terms of the 24-week quality of life and endoscopic scores.
