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    Pediatric Tracheotomies: A 5-Year Experience In 152 Children
    (Deomed Publ, Istanbul, 2018) Akcan, Fatih Alper; Dündar, Yusuf; Uluat, Ahmet; Cebeci, Derya; Sungur, Mehmet Ali; Salman, Nergis; Ünlü, İlhan
    Objective: To analyze the indications, complications, and outcomes of pediatric tracheotomies. Material and methods: All tracheotomies performed in a tertiary referral center between January 2011 and December 2015 were reviewed retrospectively. Demographic characteristics of patients, types of referral to hospital, tracheotomy indications, preoperative evaluation findings, surgical technique, postoperative care and complications, discharge and follow-up results were analyzed. Results: A total of 152 pediatric patients underwent tracheotomy at our hospital during this five year period. The median age of patients at the time of tracheotomy was 15.8 months, ranging from 24 days to 17 years. Of the 152 patients, 91 had neurological diseases, 38 had cardiopulmonary diseases, 14 had craniofacial abnormalities, seven had upper airway obstruction, and two underwent tracheostomy for trauma. Eleven (7.2%) patients experienced early complications, and 15 (9.8%) experienced late complications. Twenty (13.1%) patients were decannulated during the follow-up period. Unfortunately, 9 patients (5.9%) died of primary disease and 3 patients (1.9%) died of tracheostomy-related complications Conclusions: The majority of procedures were performed for diseases leading to prolonged mechanical ventilator support such as neurological and cardiopulmonary diseases. This study demostrates the importance of tracheotomy indications, which are the main predictors of decannulation rates. The other significant predictor is pulmonary complications that may cause permanent dependence of mechanical ventilator support as a result of pulmonary failure.
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    A Presentatıon Of Anunusual Nasal Dermoıd Cyst And Its Treatment
    (2017) Akcan, Fatih Alper; Dündar, Yusuf; Uluat, Ahmet; Salman, Nergis; Ünlü, Nisa
    A nasal dermoid cyst is a rare developmental anomaly seen in children. There are many classification systems of dermoid cysts according to anatomic localisation or extent of the lesions. However, comprehensive classifications have not been reached. We have reported a case of a nasal dermoid cyst located in a bone capsule in the left nasal passage. This is an unusual localisation for these cysts, which usually occur at the anterior skull base. A full endoscopic resection of the left nasal dermoid cyst was successfully performed. There were no peri-operative complications. All classifications describeintraosseous nasal dermoid cysts at the anterior skull base, at the nasal bone. This is the first case report of an intraosseous nasal dermoid cyst located at the posterior nasal passage. The clinical features and successful endoscopic treatment of this unusual patient are presented in the literature.
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    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.