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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 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 Does topical ropivacaine reduce the posttonsillectomy morbidity in pediatric patients?(Elsevier Ireland Ltd, 2008) Oğhan, Fatih; Harputluoğlu, Uğur; Güçlü, Ender; Kocaman, Buket; Öztürk, ÖzcanObjectives: To determine whether post-operative administration of topical ropivacaine hydrochloride decreases morbidity following adenotonsillectomy. Study Design: Prospective, randomized, double-blind clinical trial. Setting: University referral center; ENT Department. Participants: Fourty one children, aged 4-16 years, undergoing tonsillectomy. Methods: Patients received 1.0% ropivacaine hydrochloride soaked swabs packed in their tonsillar fossae while the control group received saline-soaked swabs. Mc Grath's face scale was used to compare the two groups in respect of pain control. Chi-square and two-tailed unpaired Student's t-tests or Mann-Whitney-U-tests were used to compare the two independent groups. As 10 we made 11 comparision between groups, for Bonferroni correction, p < 0.005 was accepted as statistically significant. Results: Only first hour there was no significant pain-relieving effect seen in the ropivacaine group (p > 0.05). The other hours and days there were statistically significance between the two groups (p < 0.001). Also, the other post-operative parameters such as nausea, fever, vomiting, odor, bleeding, otalgia and trismus were not statistically different between the two groups. There were no complications associated with ropivacaine hydrochloride. No patients in this study suffered systemic side effects related to the use of this medication. Conclusion: Locally 1.0% ropivacaine administiration significantly relieves the pain of pediatric tonsillectomy and, it is a safe and effective method. High concentrations of ropivaciane may produce clinically significant pain relief. It is more effective to reduce of post-operative analgesic requirement after first hour. (c) 2007 Elsevier 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 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 Hoarseness and laryngopharyngeal reflux: a cause and effect relationship or coincidence?(Springer, 2006) Öztürk, Özcan; Öz, Ferhan; Karakullukçu, Barış; Oğhan, Fatih; Güçlü, Ender; Ada, MehmetThe role of laryngopharyngeal reflux (LPR) on hoarseness is widely assumed and accepted. Few articles present objective information on the subject. One of the main problems in establishing a relationship is our lack of knowledge of what is normal. We compared patients with chronic hoarseness and healthy controls to establish three goals: (1) to demonstrate the presence of additional symptoms and signs of LPR in patients with hoarseness; (2) to find the prevalence of LPR by utilizing 24 h double-probe in patients with hoarseness and compare it with that of the control group; (3) to contribute data to establish prevalence of LPR in healthy population. Forty-three patients with hoarseness and 20 healthy volunteers were enrolled in the study. All the patients in the study group had hoarseness of more than 3 months duration. The subjects recieved videolaryngoscopic evaluation and 24 h double-probe pH monitoring, and the results were compared. In the study group, 27 patients (62.8%) out of 43 had LPR episodes, compared to 6 (30%) of 20 healthy volunteers. Mean number of LPR episodes recorded by the pharyngeal probe was 7.0 [standard deviation (SD): 8.8] in 24 h, and this was significantly higher than that of the healthy controls [0.9/24 h (SD: 1.9)] (P = 0.003). Mean number of LPR episodes of the study group in upright position was 5.8 (SD: 7,0) and in supine position was 1.2 (SD: 3.3). These numbers were also significantly higher from the controls (P = 0.005 and P = 0.014 respectively). The results of this study show that: (1) most common additional symptoms were heartburn and chronic throat clearing and most common finding is pachydermia; (2) LPR incidence in patients with chronic hoarseness is significantly higher than the LPR incidence in healthy controls; (3) LPR is present in healthy people. However, the severity of LPR seems to be the causative factor rather than its presence.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 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 Permanent t-tube insertion in two patients with Hurler's syndrome(Taylor & Francis Ltd, 2007) Oğhan, Fatih; Harputluoğlu, Uğur; Güçlü, Ender; Güvey, Ali; Turan, Nurşen; Öztürk, ÖzcanHearing loss in mucopolysaccharidosis is usually both conductive and sensorineural. The conductive component is attributable to serous otitis media secondary to dysfunction of the eustachian tube and chronic thickening of the mucosa of the middle ear. The conductive component may persist after myringotomy and insertion of short-term or long-term ventilation tubes. In Hurler's syndrome, death usually occurs in the first decade of life. In our study, we present two cases, a three-year-old girl and a four-year-old boy, who were diagnosed with Hurler's syndrome. Both children have a history of otitis media with effusion requiring repeated short-term ventilation tube insertions that were unsuccessful. Permanent t-tubes were inserted in both cases. Results showed an approximate 20 dB improvement in hearing sensitivity postoperatively for each patient.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.
