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  • Küçük Resim
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    The effectiveness of steroids for edema, ecchymosis, and intraoperative bleeding in rhinoplasty
    (Ocean Side Publications Inc, 2011) Koç, Sema; Gürbüzler, Levent; Yaman, Hüseyin; Eyibilen, Ahmet; Süren, Mustafa; Kaya, Ziya; Aladağ, İbrahim
    Background: The aim of this study was to investigate the dose-related effectiveness of steroids on periorbital edema, ecchymosis, and intraoperative bleeding in patients who underwent open rhinoplasty with osteotomy. Methods: Forty patients were divided into three groups: those in group 1 (n = 15) were given a single dose of 1-mg/kg intravenous (i.v.) methylprednisolone, those in group 2 (n = 15) were given a single dose of 3-mg/kg i.v. methylprednisolone preoperatively, and group 3 (n = 10) was the control group. Eyelid edema and periorbital soft-tissue ecchymosis were evaluated separately using a scale of 0-4. Results: In groups using the steroid preoperatively, periorbital edema and ecchymosis were significantly lower compared with the control group (p < 0.05). No significant differences were seen clinically or statistically in preventing or reducing either the periorbital ecchymosis or the periorbital edema between groups 1 and 2. Also, there was no significant difference among the groups in terms of bleeding (p > 0.05). No complications with regard to the operation or steroid use were observed. Conclusion: Our results support that steroids significantly decrease periorbital ecchymosis and periorbital edema in open rhinoplasty with osteotomy. Additionally, our results suggest that if the dose of steroids is adjusted according to body weight, there is no significant benefit in a single dose of 3 mg/kg of methylprednisolone over a lower dose of 1 mg/kg and there is no need for higher doses of methylprednisolone administration. (Am J Rhinol Allergy 25, e95-e98, 2011; doi: 10.2500/ajra.2011.25.3612)
  • Küçük Resim
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    Histopathologic examination of routine tonsil and adenoid specimens: Is it a necessary approach?
    (2012) Koç, Sema; Uysal, İsmail Önder; Yaman, Hüseyin; Eyibilen, Ahmet
    Amaç: Bu çalışmada adenoidektomi veya tonsilektomi spesimenlerinin rutin histopatolojik incelemesinin gerekli olup olmadığı araştırıldı. Hastalar ve Yöntemler: Retrospektif ve çok merkezli bu çalışmaya adenoidektomi veya tonsilektomi ameliyatı olan 1021 çocuk ve erişkin hasta (557 erkek 464 kadın; ortanca yaş 8 yıl; dağılım 5-13 yıl) dahil edildi. Toplam hastaların 809’u (%79.3) çocuk, 212’si (%20.7) erişkin idi. Hastaların yaş, cinsiyet, histopatolojik tanıları ile malign tanı konulan hastalarda malignite açısından risk faktörleri mevcut hasta kayıtları kullanılarak incelendi. Bulgular: Hastaların 396’sına (%38.8) adenotonsilektomi, 266’sına (%26) tonsilektomi, 359’una (%35.2) adenoidektomi yapıldı. Histopatolojik tanı 1021 hastanın 1011’inde (% 99) bening, 11’inde (%1) malign idi. Yalnızca erişkin hastalarda malign tanı mevcuttu. Malign tanı konulan hastaların tümünde cerrahi öncesinde malignite açısından bir veya daha fazla risk faktörü vardı. Cerrahi öncesi risk faktörü taşımayan hiçbir hastada beklenmedik malignite görülmedi. Sonuç: Adenotonsilektomi ameliyatı sonrası, özellikle çocuk hastalar başta olmak üzere, risk faktörü taşımayan hastalarda rutin histopatolojik incelemenin gerekli olmadığı sonucuna varıldı.
  • Küçük Resim
    Öğe
    Tularaemia presenting as parapharyngeal abscess: case presentation
    (Cambridge Univ Press, 2012) Koç, Sema; Gürbüzler, Levent; Yaman, Hüseyin; Eyibilen, Ahmet; Salman, Nergis; Ekici, Adnan
    Objective: We report an extremely rare case of the oropharyngeal form of tularaemia, causing a parapharyngeal abscess. Case report: A 48-year-old woman presented with fever, sore throat, breathing difficulty and a right-sided neck swelling. This mass had previously been treated with penicillin without response, and had already been surgically drained once in another hospital. On physical examination, the tonsils were exudative and hypertrophic and the pharynx was hyperaemic. A fluctuant, 4 x 4 cm mass was seen on endoscopic examination, originating from the left parapharyngeal area and protruding towards the pyriform sinus, and partly obstructing the airway. Microagglutination test antibody titres for Francisella tularensis were positive (1/1280). The patient healed completely after definitive drainage of the abscess and antimicrobial therapy for 14 days (streptomycin, 2 x 1 g intramuscularly). Conclusion: Tularaemia should be considered in the differential diagnosis of patients presenting with tonsillopharyngitis, cervical lymphadenitis and parapharyngeal abscess who do not respond to treatment with penicillin, even if they do not live in an endemic region.