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Öğe Can post-adenotonsillectomy morbidity be reduced by intravenous 24 h hydration in pediatric patients following adenotonsillectomy?(Elsevier Ireland Ltd, 2004) Egeli, Erol; Harputluoğlu, Uğur; Öztürk, Özcan; Oğhan, Fatih; Koçak, SuzanObjective: To determine the benefit of 24h intravenous hydration for pediatric postoperative adenotonsillectomy patients. Study design: A prospective, randomized controlled clinical study. Methods: The study is consisting of two groups of pediatric patients following adenotonsillectomy performed in a university hospital. One group received 24 h IV hydration at hospital white the other did not have IV hydration. Chi-square and two-tailed unpaired Student's ttests were used to compare the two independent groups. P < 0.05 was accepted as statistically significant. Results: Although the postoperative parameters such as nausea, fever, vomiting, odor, bleeding, otalgia and trismus were not statistically different between the two groups based on chi-square analysis (P > 0.05), a significant pain-relieving effect was seen in hydration group after the second day (P < 0.05). There were no complications associated with intravenous hydration. Conclusion: Results of the current study suggest that 24 h IV hydration can reduce postoperative pain in late postoperative period following adenotonsillectomy in children but does not offer much advantage over without IV hydration therapy based on a number of other parameters. Furthermore, it seems to be cost effective, safe and easy and even these are encouraging for further studies in the future. (C) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Does pregnancy-associated plasma protein A have a role in allergic rhinitis?(Ocean Side Publications Inc, 2008) Güçlü, Ender; Coşkun, Abdurrahman; Tokmak, Abdurrahman; Duran, Sadık; Öztürk, Özcan; Akkan, Nermin; Egeli, ErolBackground: Pregnancy-associated plasma protein A (PAPP-A), also known as insulin-like growth factor binding protein 4 protease, is postulated to be a new inflammatory marker in various clinical situations such as cardiovascular events, dialysis, renal transplantation, and asthma. PAPP-A also is produced in high concentrations by trophoblasts during pregnancy. Methods: We evaluated PAPP-A levels in allergic rhinitis patients and compared these with levels in healthy subjects. Thirty-one newly diagnosed allergic rhinitis patients and 29 healthy controls were included in the study. Serum PAPP-A, IgE, urea, creatinine, aspartate aminotransferase, creatine kinase (CK), CK-MB isoenzyme, total cholesterol, and triglyceride levels were determined. Results: The serum PAPP-A level was significantly higher (p = 0.013) in the allergic rhinitis group (6.1 +/- 2.9 mU/L) than in the control group (4.5 +/- 1.7 mU/L). The PAPP-A level in patients with allergic rhinitis and asthma (6.1 +/- 2.3 mU/L) was not significantly different (p = 0.959) from that in patients with allergic rhinitis alone (6.1 +/- 3.3 mU/L). The serum PAPP-A level in allergic rhinitis patients who had turbinate hypertrophy (6.9 +/- 2.2 mU/L) had a tendency to be higher than that in patients who had no turbinate hypertrophy (5.5 +/- 3.2 mU/L); however, this difference was not statistically significant (p = 0.151). Conclusion: Increased PAPP-A activity may be involved in the inflammation and tissue remodelling that occurs in allergic rhinitis.Öğe Does topical lidocaine with adrenaline have an effect on morbidity in pediatric tonsillectomy?(2005) Egeli, Erol; Harputluoğlu, Uğur; Oğhan, Fatih; Demiraran, Yavuz; Güçlü, Ender; Öztürk, ÖzcanObjective: To evaluate the efficacy of lidocaine with adrenaline on post-operative morbidity in pediatric patients after tonsillectomy. Study Design: A double blind prospective randomized controlled clinical study. Methods: The study is consisting of two groups of pediatric patients following tonsillectomy performed in a university hospital. One group received lidocaine with adrenaline soaked swabs packed in their tonsillar fossae while the control group received saline-soaked swabs. Chi-square and two-tailed unpaired Student's t-tests were used to compare the two independent groups. p < 0.05 was accepted as statistically significant. Results: No significant pain-relieving effect was seen in the lidocaine with adrenaline group (p > 0.05) and also the other post-operative parameters such as nausea, fever, vomiting, odor, bleeding, otalgia and trismus were not statistically different between the two groups based on chi-square analysis (p > 0.05). There were no complications associated with lidocaine and adrenaline. Conclusion: We suggest that application of topical lidocaine with adrenaline seems to be a safe and easy medication for local anesthetic use. However, in our study, lidocaine with adrenaline offered no advantage over placebo in the control of post-operative pain and other morbidity related factors following pediatric tonsillectomy. We therefore do not recommend topical application of lidocaine with adrenaline for reducing morbidity in pediatric tonsil surgery. © 2005 Elsevier Ireland Ltd. All rights reserved.Öğe Ear examination findings at the Yeditepe School for the Deaf(Elsevier Sci Ireland Ltd, 2003) Egeli, Erol; Çiçekçi, Günferi; Öztürk, ÖzcanObjective: To find out the prevalence and etiologies of middle ear disease among deaf children in a school for the deaf. Methods: A total of 162 students with hearing impairment attending a school for the deaf during the school year of 2001 2002 were admitted to this study. The range of age was from 6 to 20 years. The examination consisted of inspection of the auricle and external auditory canal, and otoscopic, audiometric and tympanometric evaluation. School performance was assessed using the results of end-of-year school examination and continuous assessments obtained from the school administration. Results: The demographic properties of the study group revealed that 81 (60.9%) of children were mate and 52 (39.09%) were female. Most of the children (45%) were in the group of 9-13 years of age. On pure tone audiometric evaluation, sensorineural hearing loss (HL) was found in 99 (85.3%) and mixed type HL in 17 (14.6%) of 116 cases. Impacted wax was the most common pathology and was seen in 15 (39.4%) of children. Middle ear diseases were detected in 38 (28.5%) of children with otoscopic examination. Conclusion: This study shows that hearing impairment and preventable ear diseases are important health problems among the school children for the deaf. It is essential to start the school education early in time and to start using hearing aid before 2.5 year of age. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.Öğe Effects of otorhinolaryngological diseases and socioeconomic status on school performance: a survey study(Elsevier Ireland Ltd, 2004) Egeli, Erol; Oğhan, Fatih; Öztürk, Özcan; Harputluoğlu, UğurObjective: The aim of the present study was to investigate the effects of otorhinolaryngological (ORL) diseases and socioeconomic status (SES) on school performance. Methods: This study was conducted in three primary schools located in Duzce. Of three schools, two schools (group A) are located in the suburb area of the city and students had a low SES. The other one (group B) is in the center of the city and students had a high SES. A total of 1282 (urban 609 and rural 673) students attending to these three schools were examined considering the ORL diseases. SES of the students were evaluated according to the mean monthly income within the family, educational level of parents and occupation, presence of conflict within the family, and smoking habits. School performance of the children is ranged between 1 and 5. School success of students were evaluated by asking their educators. Results: The mean (S.D.) age was 9.15 (1.48) years (range, 7-12). The students in group B were observed as more successful than that of group A. A major finding in this study is that the incidence of ORL diseases in the rural school is high and it was found that when ORL diseases increased, the mean school success grade of the students decreased in group B. The otological diseases were found to have an effect on school performance more than the other ORL diseases independently of SES. When we analyzed the effect of SES on school performance, we found that the students' school grade level in group A was low. Conclusions: ORL diseases are more commonly detected in the primary schools with tower socioeconomic level than the other and we found that the effects of ORL diseases and SES on school performance in group B was low. (C) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Epiglottic tuberculosis in a patient treated with steroids for Addison's disease(Tohoku Univ Medical Press, 2003) Egeli, Erol; Oğhan, Fatih; Alper, Murat; Harputluoğlu, Uğur; Bulut, İsmetIsolated epiglottic tuberculosis (TBC) is uncommon and has rarely been described. We report the case of a 40-year-old man with tuberculous involvement of the epiglottis and primary adrenal insufficiency. Endoscopic examination showed a severely swollen epiglottis with granulomatous and partially necrotic mucosa. The patient has been treated with glucocorticoids for four years due to primary adrenocortical. insufficiency. We therefore assume that tuferculous involvement of epiglottis is due to the reactivation of pulmonary TBC. We also discuss differential diagnosis and management of epiglottic TBC and Addison's disease.Öğe Etiology of deafness at the Yeditepe School for the deaf in Istanbul(Elsevier Sci Ireland Ltd, 2003) Egeli, Erol; Çiçekçi, Günferi; Sılan, Fatma; Öztürk, Özcan; Harputluoğlu, Uğur; Onur, Aşkın; Yıldız, AyselObjective: The etiology of deafness can be classified as genetic, acquired and unknown. An unknown etiology was a high incidence in previous reports. The aim of this study is to explore the etiology of deafness and to reduce the cases in the unknown group. Methods: This study was conducted on 162 students at the Yeditepe School for the deaf. Otologic, physical and psychological. examinations were performed by a team of doctors including four otologists, a geneticist, a dentist, an ophthalmologist and an audiologist. Results: A genetic cause was identified in 41.35%, acquired 37.65% and unknown 20.98%. Genetic etiologies were stratified as familial and syndromic subgroups. A familial cause was found in 60 of 162 children and in 22 of those 60 cases, the parents had a consanguineous marriage. There was 11 cases associated with a syndrome. Ninety four minor abnormalities have been established in some deaf children. Febrile convulsion (36%) was identified as the most common etiology in acquired cases. Conclusion: In contrast with other studies the consanguineous marriage was present in 36.6% of the familial cases and 38.8% in total of the school. An unknown etiology was reported in high rates in previous reports. These unknown cases could be described as a part of a syndrome by a crowded team of consultants. Evaluation of early diagnostic criterias and minor abnormalities can help us to provide early rehabilitation of deafness in childhood. Published by Elsevier Science Ireland Ltd.Öğe Evaluation of deaf children in a large series in Turkey(Elsevier Ireland Ltd, 2005) Öztürk, Özcan; Sılan, Fatma; Oğhan, Fatih; Egeli, Erol; Belli, Şeyda; Tokmak, Abdurrahman; Zafer, CansuObjective: Evaluation of the deafness etiology, ear examination findings and hearing levels of deaf children in a large series. Patients and methods: We studied 840 deaf primary school children (486 mate, 354 female, mean age 12.69 +/- 3.52, range 5-22). A questionaire investigating the prenatal, perinatal and postnatal etiological causes was prepared and pedigree analysis was performed. After ENT examination, odyologic tests were performed. Results: The etiological features of deafness were found for genetic causes as 429 cases (51.1%), 127 children (15.1%) for acquired group and 284 children (33.8%) for unknown group. We confirmed 136 (15.5%) syndromic deaf children and 19 of them (13.9%) were autosomal recessive (AR), 105 of them (77.2%) were autosomal dominant (AD), six (4.4%) of them were X-linked. Two hundred and ninety-three deaf (33.4%) children were in the familial nonsyndromic group. In this group, the inheritance of 255 (87%) were AR, 23 (7.8%) were AD and 15 (5.2%) were X-linked recessive. Febrile convulsion was identified as the most common etiology in 36 (4.3%) cases in the acquired group. Three hundred and twenty-two (67.7%) children had profound HL (above 91 dB), 111 (23.3%) had severe HL and 43 (9%) had moderately severe HL. Sensorineural. HL was found in 439 (92.2%) and mixed type hearing loss was seen 37 (7.8%) of 476 cases. We found many major and minor abnormalities and ocular, ear and dental pathologies. The prevalence of ear diseases was found in 203 (24.2%) of children. Impacted wax was found in 80 (9.5%) of 840 children with otoscopic examination and was the most common pathology, retraction in 70 (8.3%) and perforation in 15 (1.8%) followed it. Conclusion: Preventable ear disease are important health problems among school children for the deaf because these diseases can affect the real level and type of deafness, so determining early diagnostic criteria, ear diseases and minor abnormalities is important for early rehabilitation. Syndromes can be prevented in pregnancy, infections can be prevented in prenatal or postnatal period but unknown group cannot be prevented although the unknown etiology can be reduced by multidiciplinary approach. (c) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Evaluation of the inferior turbinate in patients with deviated nasal septum by using computed tomography(Lippincott Williams & Wilkins, 2004) Egeli, Erol; Demirci, Levent; Yazıcı, Burhan; Harputluoğlu, UğurObjectives/Hypothesis. The objective was to measure the dimensions, composition, and possible structural and radiological changes of the compensatory hypertrophic inferior turbinate in patients with deviated nasal septum. Study Design: A prospective, non-randomized clinical trial at a university medical center. Methods. Twenty-three patients with deviated nasal septum and compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity were examined by computed tomography. Results. The dimensions of the compensatory hypertrophic inferior turbinate in patients with septal deviation were compared with normal control subjects. The difference in width of the medial and lateral mucosa and the conchal. bone between the two groups was statistically significant (P <.05). Conclusion. The present study uncovers the dimensions and composition of the inferior turbinate with compensatory hypertrophy in patients with nasal septum deviation. The findings support the decision to excise the inferior turbinate bone at the time of septoplasty, because of the significant bony and mucosal expansion.Öğe Measuring the correlation between adenoidal-nasopharyngeal ratio (AN ratio) and tympanogram in children(Elsevier Ireland Ltd, 2005) Egeli, Erol; Oğhan, Fatih; Öztürk, Özcan; Harputluoğlu, Uğur; Yazıcı, BurhanObjective: To evaluate the correlation between adenoidal-nasopharyngeal ratio (AN ratio) and tympanogram in children. Study design: A prospective clinical study from June 2002 to May 2003. Method: A total of 64 children, aged 6-9 years who presented with nasal obstruction, snoring, mouth breathing, and hyponasal speech were examined and AN ratio was calculated by using the lateral neck radiograms and compared with the tympano-metric values. The relationship between AN ratio and middle-ear pressure was evaluated, regarding the AN ratio of 0.71. The chi-square test was used to analyze the correlation between AN ratio and middle ear pressures and Wilcoxon test was used to compare the changes between the mean AN ratio values, and mean middle ear pressures (including A and C type tympanograms) before and after medical therapy. Results: Middle-ear effusions and C type tympanograms in impedance audiometry were both related to eustachian tube dysfunction resulting from enlargement of the adenoids with AN ratios higher than 0.71. Middle ear pressures were found tower in children with AN ratio greater than 0.71 than in children AN ratio less than 0.71 and the difference was highly significant (p < 0.001). Although medical treatment of large adenoids was rather effective to shrink the adenoid tissue (p < 0.001), it did not cause a statistically significant change in tympanometric values (p > 0.05). Conclusions: Antibiotherapy is effective in reducing adenoid size without signs and symptoms of infection. The reduction of the adenoids in size after 3 weeks of antibiotherapy has an positive effect on recovery of eustachian tube function but is not sufficient in patients with middle ear effusion. Early ventilation tube insertion may be an alternative therapy for the middle ear effusions not improving by 3 weeks medical therapy. (C) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Nasal carriage of pathogenic bacteria in medical students: effects of clinic exposure on prevalence and antibiotic susceptibility(Springer, 2007) Güçlü, Ender; Yavuz, Tevfik; Tokmak, Abdurrahman; Behçet, Mustafa; Karalı, Elif; Öztürk, Özcan; Egeli, ErolStaphylococcus aureus is a major cause of community-acquired and nosocomial infections worldwide. One important source of this pathogen for nosocomial infections is the nasal carriage of S. aureus among hospital personnel. There are only a few studies investigating the carriage of S. aureus in a community of medical students. Oral and nasal flora of 179 medical students with varying clinical exposures were determined. Oral cultures revealed no nosocomial pathogen and nasal cultures showed an increasing rate of S. aureus carriage with increasing clinical exposure. Methicillin resistance also demonstrated a tendency toward increasing with increasing clinical exposure.Öğe Nasopharyngeal aerobic bacterial flora and Staphylococcus aureus nasal carriage in deaf children(Elsevier Ireland Ltd, 2005) Harputluoğlu, Uğur; Egeli, Erol; Şahin, İdris; Oğhan, Fatih; Öztürk, ÖzcanObjective: To determine the nasopharyngeal aerobic bacterial flora and Staphylococcus aureus nasal carriage in deaf children and the role of flora in deafness. Study design: A prospective, controlled study. Methods: Nasopharyngeal. and nasal swabs were collected from 87 deaf children with acquired etiology at Zonguldak primary school for the deaf and 56 healthy children. The children with genetic base (syndromic or nonsyndromic, familial or sporadic, AD, AR or X-linked recessive), and also with the history of drug exposure.. head trauma, birth trauma, prematurity, hyperbilirubinemia and the viral diseases with high fever (like mumps and measles) were excluded from the study. Swabs were inoculated on to a variety of bacteriological culture media. which were then incubated in an appropriate atmosphere. Colonisation of Group A beta hemolytic streptococcus, Streptococcus pneumoniae, Hoemophilus influenzae, Neisseria menengitidis, Moraxella catarrhalis and S. aureus in upper respiratory tract were investigated. Antimicrobial susceptibility testing of the isolates were determined according to National committee for clinical laboratory standards (NCCLS) Guidelines. Results: Although, the rates of colonization of the nasopharyngeal aerobic bacteria and nasal S. aureus did not differ significantly between deaf children and normal healthy subjects, Less colonization rates were found in deaf children than normal healthy subjects. S. aureus was isolated from 18 (20.7%) deaf children. All S. aureus isolates from deaf children were susceptible to oxacillin. Penicillin susceptibility rate was 22.2%. Conclusion: It is considered that nasopharyngeal and nasal colonizations of deaf children with potentially pathogenic aerobic bacteria flora is not a significant risk factor for acquired infections when compared with healthy children. (C) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Papillary carcinoma of the thyroglossal duct cyst in childhood(Springer-Verlag, 2003) Öztürk, Özcan; Demirci, Levent; Egeli, Erol; Çukur, Selma; Belenli, OlcayThyroglossal duct carcinoma is a rare malignancy that is usually diagnosed postoperatively. Approximately 150 cases have been reported in the literature. Eighty-five percent of these were papillary carcinomas. Controversies exist concerning its nature and treatment. In this report, we present an 11-year-old boy with an anterior cervical cystic mass originating in the thyroglossal duct. After a primary Sistrunk procedure, the cyst and tract extending to the foramen caecum at the base of the tongue in continuity with the midportion of the hyoid bone were resected. Histopathologic study demonstrated a papillary carcinoma. After 4 months of follow-up, the patient is asymptomatic without any evidence of recurrence. The clinical and histopathological features and therapeutic options are discussed.Öğe Relation of isolated tonsillar hypertrophy with body mass index(2006) Egeli, Erol; Belli, Şeyda; Oğhan, Fatih; Öztürk, ÖzcanObjective: The purpose of this study was to investigate the relationship between tonsillar hypertrophy and body mass index (BMI). Material and Methods: This is a cross-sectional study which was conducted in three primary schools located in Duzce. A total of 1,282 children between 7 and 12 years of age were evaluated and the size of their tonsils was investigated with regard to height and weight. This study was performed in the course of school screening, and the correlation between estimated tonsil size and BMIs of the children was investigated. Results: Sixteen of 1,282 students were excluded from the study, leaving 1,266 children in the study. The mean (±SD) age of the children was 9.13 ± 1.45 (range 7-12) years. The mean height of the 1,266 children was 129.07 ± 9.95 (range 105-163) cm, the mean weight was 28.81 ± 6.96 (range 15-68) kg, and the mean BMI was 17.09 ± 2.33 (range 12.07-30.0) kg/m2. There was no statistically significant effect of tonsil size on BMI. We could not find a significant relation of isolated tonsillar hypertrophy with BMI. Conclusions: No relation could be found between tonsillar hypertrophy and BMI. Copyright © 2006 S. Karger AG.Öğe Syndromic etiology in children at schools for the deaf in Turkey(Elsevier Sci Ireland Ltd, 2004) Sılan, Fatma; Demirci, Levent; Egeli, Ayten; Egeli, Erol; Önder, Halil İbrahim; Öztürk, Özcan; Ünal, Zehra SedaObjective: The aim of this study was to determine the syndromic etiology of bilateral severe sensorineural hearing disorders in children and current etiological causes to reduce the cases in the unknown group. Methods: This study was conducted on 550 students of five schools for the deaf in Istanbul and Zonguldak, Turkey. Otologic, audiologic, dysmorphologic, ophtalmologic and dental examinations were performed in all children. Familial and medical histories were obtained. Results: The etiology of hearing loss was genetic in 346 (62.90%), acquired in 107 (19.45%) and unknown in 97 (%17.63) cases. A total of 619 malformations were defined in 550 children and 99 of them belonged to a syndrome. We identified 33 different syndromes for these 99 syndromic children. Syndromic etiology was found in 18.0% of the total and 28.61% of the subjects with genetic etiology. Most common syndrome was Waardenburg syndrome which occurred in 33 children. Conclusion: The incidence of hereditary hearing impairment is very high in developing countries compared to developed countries. Prevention is essential to reduce the incidence, multidiciplinary approach and genetic counselling are necessarry in this regard. (C) 2004 Elsevier Ireland Ltd. All rights reserved.
