European Archives of Oto-rhino-laryngology, Mar 18, 2012
The aim of this work is to describe our experience with the management of osteomas of the fronto-... more The aim of this work is to describe our experience with the management of osteomas of the fronto-ethmoidal region, and to evaluate the limits and possibilities of diVerent approaches: endonasal endoscopic versus external surgical resection of symptomatic osteomas. A review of 26 patients with detected osteomas in tertiary health care center was accomplished. We analysed the 26 adult patients, which detected paranasal sinus (PNS) osteomas-patients who underwent paranasal sinus CT examinations almost exclusively for other reasons. We analysed the patient's symptoms, localization and size of osteomas, clinical and imaging signs, in relation to adjacent structures. Of the 26 cases, 16 located in the etmoid sinus, eight in the frontal sinus, of which two with orbital one with an ethmoid extension, and one isolated maxillary and sphenoid sinus were involved. We treated 11 patients with endoscopic (eight cases) and external surgical approaches (three cases). Besides this surgical excision; 15 cases were kept in follow up, because of asymptomatic nature of the PNS osteomas or patients lack of consent. While the extranasal approach is still a part of the treatment concept for removing osteomas; over the last years, in suitable cases, the endoscopically controlled endonasal approach has greatly gained importance due to the improved surgical equipment and experience.
The aim of the authors was to discuss orbital complications of nasal cavity and paranasal sinus d... more The aim of the authors was to discuss orbital complications of nasal cavity and paranasal sinus diseases. Material and Method: Patients with nasal and paranasal sinus diseases that affected orbit were retrospectively reviewed. Patients with primary orbital abnormality and those without radiologic orbital signs were excluded. Data regarding age and gender distribution, orbital and ocular findings, radiologic findings, and presence of an additional sinonasal disease were analyzed. Results: Disorders affecting orbit were categorized into 6 categories. Mean age was 41.25 AE 22.14 (range: 6-88) years and male : female ratio was 23 : 18. Overall, there were 41 patients including 11 patients with mucocele, 9 patients with sinusitis, 7 patients with fibrous dysplasia, 4 patients with nasal polyp, 4 patients with paranasal osteoma, and 6 patients with neoplasm. Major clinical presentation was proptosis in these patients. Conclusions: Otolaryngologists should consider the possibility of sinonasal diseases to affect orbit because of vicinity of nasal cavity and paranasal sinuses to orbit. Radiologic imaging is essential to determine the extent, extension, relation with surrounding structures, and initial diagnosis of the disease, and to plan multidisciplinary management.
KBB-Forum: Elektronik Kulak Burun Boğaz ve Baş Boyun Cerrahisi Dergisi, Apr 1, 2011
Amaç: Bu çalışmanın amacı, tonsillektomi ve adenotonsillektomi yapılan çocuk hastaların erken ve ... more Amaç: Bu çalışmanın amacı, tonsillektomi ve adenotonsillektomi yapılan çocuk hastaların erken ve geç dönem postoperatif sonuçları ile ailelerinin ameliyat sonrası düşüncelerini araştırmak; bulguları hedef-sonuç ilişkisinde değerlendirmektir. Hastalar ve Metod: Çalışmaya Eylül 2008 ile Ekim 2011 tarihleri arasında kliniğimizde tonsillektomi ve adenotonsillektomi yapılan 34'ü erkek(%52.3), 31'i kız(%47.7) olmak üzere 65 çocuk hasta dahil edildi. Hastaların preoperatif yaş ortalaması 7.09±2.30 (min. 4, maks. 13) idi. 11 tanesi (%16.9) kronik/hipertrofik tonsillit, geri kalan 54 tanesi (%83.1) ise adenoid vejetasyon ile birlikte kronik/hipertrofik tonsillit tanısı bulunan çocuklar arasından rastgele seçilerek oluşturuldu. Kontrol amaçlı çağırılan tüm hastaların anamnezleri ve postoperatif şikayetleri anne/babalarından alındı. Çoktan seçmeli ve/veya ucu açık 19 kalem soruyu cevaplamaları istendi. Cevapların ardından hastaların muayeneleri yapılarak son klinik bulguları not edildi. Bulgular: Postoperatif takip süresi ortalama 15.18±7.4 ay(min. 1-maks. 36) idi. Ameliyatın bizim hastanemizde yapılması için verilen kararda en etkili faktör %55.4 ile fakülte olması iken, bu ameliyata karar verinceye kadar başvurulan KBB uzmanı sayısının ortalama 2.55±1.87 (min. 1-maks. 10) olduğu öğrenildi. Ameliyatın etkinliği 10 üzerinden ortalama 8.55±1.39 (min. 4-maks. 10) olarak tespit edildi. Tedavi sonrası hastaların 19'u (%29.2) aynı şikayetlerin devam ettiğini, 36'sı (%55.4) şikayetlerinin tamemen geçtiğini ve 10'u (%15.4) eskisine nazaran daha iyi olduğunu bildirdi. Cerrahi öncesi yaşıtlarına göre gelişme geriliği bulunan 39 hastanın(%60), postoperatif 24'ünde (%61.5) farkedilir bir gelişme olduğu söylendi. 4(%6.2) hasta tekrar başa dönebilseydik bu operasyonu yaptırmazdım yanıtını verdi. Çocukların, 25(%38.5)'inin okul öncesi olduğu, 1(%1.5)'inin özel eğitim öğrencisi olduğu, 19(%29.2)'unun cerrahi sonrası derslerindeki başarının ailenin farkedeceği düzeyde arttığı, 20(%30.8) çocuğun ise ders başarı düzeyinin aynı kaldığı saptandı. Hastaları erken postoperatif dönemde en fazla rahatsız eden semptomlar arasında ilk sırada ağrı(%35), ikinci sırada yutma güçlüğü(%32) ve üçüncü sırada iştahsızlık gelmekteydi(%15). Hastaların yaşları ile iyileşme süreleri arasında ve yapılan cerrahi ile iyileşme süreleri arasında anlamlı bir ilişki tespit edilemedi. Cinsiyete, yaşa ve tanıya bağlı olarak dağılım yapıldığında iyileşme süresi, komplikasyon gelişimi gibi diğer değişkenlerde de anlamlı bir fark bulunamadı. Sonuç: Sonuç olarak preoperatif değerlendirmelerde daha dikkatli olunması, sistemik hastalıklar yönünden detaylı sorgulanması, hasta ve ebeveynlerinin cerrahiden tam olarak ne beklediklerinin bilinmesi ve cerrahi kararın buna göre verilmesi gerektiği anlaşılmıştır. Seçilmiş hastalarda yapılacak adenotonsillektominin daha memnun edici sonuçlar verdiği görülmüştür.
European Archives of Oto-rhino-laryngology, Apr 30, 2004
Patients with acoustic neuroma in their only hearing ear are not frequently seen in clinical prac... more Patients with acoustic neuroma in their only hearing ear are not frequently seen in clinical practice. Managing this group of patients is a challenge to both the patient and surgeon. In this study we report on five cases of acoustic neuroma in an only hearing ear. Our decision for conservative management of those patients with regular follow-up using auditory brain stem response and magnetic resonance imaging is discussed. Other management options currently available are reviewed as well.
Although transposition of the facial nerve is crucial in infiltrative vascular lesions involving ... more Although transposition of the facial nerve is crucial in infiltrative vascular lesions involving the jugular foramen, the objective was to show that a conservative approach to management of the facial nerve is sufficient with jugular foramen neuromas because of their noninfiltrative, less vascular nature and medial location in the jugular foramen. Retrospective case review. Tertiary, private, multiphysician, otologic practice. Sixteen patients with jugular foramen schwannoma (18 procedures) treated between January 1975 and October 1995. The 8 male and 8 female patients ranged in age from 13 to 66 years (mean age 47.7 years). One-stage, total jugular foramen neuroma removal without transposition of the facial nerve, using a variety of surgical approaches. Facial nerve transposition (yes or no), House-Brackmann facial nerve grade, lower cranial nerve status, complications. One-stage total tumor removal was accomplished in all the cases. In 13 (72%) of the neuromas, removal was accomplished without facial nerve transposition. Transposition was performed in 2 revision cases in which scar tissue from a previous operation prevented complete control of the carotid artery and safe removal, 2 cases with large tumor extension anteriorly to the petrous apex, and 1 case with extensive involvement of the middle ear. A House-Brackmann facial nerve Grade I or II was obtained in 16 of the 18 procedures, with 1 Grade III and 1 case that remained Grade V, as it was preoperatively. One-stage, total tumor removal can be achieved with excellent control of the important vascular structures and without transposition of the facial nerve in a majority of jugular foramen schwannomas.
ÖZET Amaç: Bu çalışmanın amacı, tonsillektomi ve adenotonsillektomi yapılan çocuk hastaların erke... more ÖZET Amaç: Bu çalışmanın amacı, tonsillektomi ve adenotonsillektomi yapılan çocuk hastaların erken ve geç dönem postoperatif sonuçları ile ailelerinin ameliyat sonrası düşüncelerini araştırmak; bulguları hedef–sonuç ilişkisinde değerlendirmektir. Hastalar ve ...
Süperiyor semisirküler kanal dehissansı sendromu yeni tanımlanmış ve nadir izlenen bir hastalıktı... more Süperiyor semisirküler kanal dehissansı sendromu yeni tanımlanmış ve nadir izlenen bir hastalıktır. Hastalık yüksek ses ve basınçla ortaya çıkan vertigo ve nistagmusla kendini gösterir. Yüksek sesle ortaya çıkan vertigo ve nistagmusa Tullio fenomeni, basınçla ortaya ...
Understanding of the pathologies which cause the diseases is not always easy. In disclosing the a... more Understanding of the pathologies which cause the diseases is not always easy. In disclosing the aural diseases mechanism, temporal bone pathology provides us excellent clues. Such a study is essential for progress in the diagnosis, therapy, and prevention of disorders affecting this organ. But this involves a painstaking and long run procedures including a good record keeping and patient persuasion about postmortem research on their temporal bones. One of these few centers in the world is the House Ear Institute temporal bone research labaratory. In order to bring this subject into attention of Turkish otolaryngologists we reviewed the procedures and discussed the importance of this kind of laboratory. [Journal of Turgut Ozal Medical Center 1997;4(4):472-477] Key words: Temporal bone, pathology
Journal of Clinical and Experimental Investigations, Sep 11, 2012
Tüm hemanjiyomların %1'ini oluşturan intramuskuler hemanjiyomalar nadir görülen benign tümörlerdi... more Tüm hemanjiyomların %1'ini oluşturan intramuskuler hemanjiyomalar nadir görülen benign tümörlerdir. Sıklıkla gövde ve ekstremitelerde görülebilmektedir. Masseter ve trapezius kaslarından köken alabilen bu oluşumlar baş ve boyun bölgesinde nadir izlenmektedir. Hastalar genellikle parotis ve yüz bölgesinde zamanla büyüyen ağrısız kitleden şikayet eder. Lokalizasyonundan dolayı intramuskuler hemanjiyomaların %90'ında klinik olarak yanlışlıkla parotis kitlesi tanısı konulabilir. Bu kitlelerin tanısında görüntüleme yöntemleri önemli yer tutar.
Indian Journal of Otolaryngology and Head & Neck Surgery, Mar 3, 2013
Nasal obstruction most commonly occurs due to mucosal abnormalities and those in cartilage-bone s... more Nasal obstruction most commonly occurs due to mucosal abnormalities and those in cartilage-bone structure such as nasal polyp, septum deviation, concha hypertrophy and chronic sinusitis in adults. Adenoid vegetation is the most prominent cause in childhood. In the present study, we aimed to investigate whether maxillary and palatal bone developments continue in patients with abnormalities causing nasal obstruction. As computerized tomography is the optimal imaging modality in nasal cavity abnormalities, CT scan findings of patients with Control nasal polyp, chronic sinusitis and septum deviation were retrospectively evaluated; and palatal curve changes were compared. In our study, it was found that maxillary bone curve was widened in adult patients with nasal polyp; this angle was further narrowed in those with chronic sinusitis; and maxillary bone curve narrowing and increase in the distance to palatal bone was smaller in patients with septum deviation than those in chronic sinusitis. In the light of these findings, we concluded that, in adults, maxillary and palatal bone developments continue in certain circumstances including nasal polyp, chronic sinusitis or septum deviation.
Tissue expansion is a helpful technique in reconstructive plastic surgery. Unfortunately, tissue ... more Tissue expansion is a helpful technique in reconstructive plastic surgery. Unfortunately, tissue expansion still needs to be improved. Twenty-four male Wistar rats were used to evaluate the effect of estriol on tissue expansion. The agents hyaluronidase, estriol, and base cream (as a control) were applied topically to separate animal groups for 5 weeks, and their effects were studied on tissue expansion. Both hyaluronidase (p < 0.05) and estriol (p < 0.001) enhanced the rate of expansion when compared with control animals. Estriol was more effective than hyaluronidase (p < 0.05). Breaking strengths were measured in the estriol and the control groups. Breaking strength was not evaluated in the hyaluronidase group because of the necrotic changes seen at the end of the fifth week. The breaking strength was higher in the control group than in the estriol group (p < 0.05). The authors suggest that topical estriol be used as an adjunctive agent to facilitate tissue expansion.
European Archives of Oto-rhino-laryngology, Mar 18, 2012
The aim of this work is to describe our experience with the management of osteomas of the fronto-... more The aim of this work is to describe our experience with the management of osteomas of the fronto-ethmoidal region, and to evaluate the limits and possibilities of diVerent approaches: endonasal endoscopic versus external surgical resection of symptomatic osteomas. A review of 26 patients with detected osteomas in tertiary health care center was accomplished. We analysed the 26 adult patients, which detected paranasal sinus (PNS) osteomas-patients who underwent paranasal sinus CT examinations almost exclusively for other reasons. We analysed the patient's symptoms, localization and size of osteomas, clinical and imaging signs, in relation to adjacent structures. Of the 26 cases, 16 located in the etmoid sinus, eight in the frontal sinus, of which two with orbital one with an ethmoid extension, and one isolated maxillary and sphenoid sinus were involved. We treated 11 patients with endoscopic (eight cases) and external surgical approaches (three cases). Besides this surgical excision; 15 cases were kept in follow up, because of asymptomatic nature of the PNS osteomas or patients lack of consent. While the extranasal approach is still a part of the treatment concept for removing osteomas; over the last years, in suitable cases, the endoscopically controlled endonasal approach has greatly gained importance due to the improved surgical equipment and experience.
The aim of the authors was to discuss orbital complications of nasal cavity and paranasal sinus d... more The aim of the authors was to discuss orbital complications of nasal cavity and paranasal sinus diseases. Material and Method: Patients with nasal and paranasal sinus diseases that affected orbit were retrospectively reviewed. Patients with primary orbital abnormality and those without radiologic orbital signs were excluded. Data regarding age and gender distribution, orbital and ocular findings, radiologic findings, and presence of an additional sinonasal disease were analyzed. Results: Disorders affecting orbit were categorized into 6 categories. Mean age was 41.25 AE 22.14 (range: 6-88) years and male : female ratio was 23 : 18. Overall, there were 41 patients including 11 patients with mucocele, 9 patients with sinusitis, 7 patients with fibrous dysplasia, 4 patients with nasal polyp, 4 patients with paranasal osteoma, and 6 patients with neoplasm. Major clinical presentation was proptosis in these patients. Conclusions: Otolaryngologists should consider the possibility of sinonasal diseases to affect orbit because of vicinity of nasal cavity and paranasal sinuses to orbit. Radiologic imaging is essential to determine the extent, extension, relation with surrounding structures, and initial diagnosis of the disease, and to plan multidisciplinary management.
KBB-Forum: Elektronik Kulak Burun Boğaz ve Baş Boyun Cerrahisi Dergisi, Apr 1, 2011
Amaç: Bu çalışmanın amacı, tonsillektomi ve adenotonsillektomi yapılan çocuk hastaların erken ve ... more Amaç: Bu çalışmanın amacı, tonsillektomi ve adenotonsillektomi yapılan çocuk hastaların erken ve geç dönem postoperatif sonuçları ile ailelerinin ameliyat sonrası düşüncelerini araştırmak; bulguları hedef-sonuç ilişkisinde değerlendirmektir. Hastalar ve Metod: Çalışmaya Eylül 2008 ile Ekim 2011 tarihleri arasında kliniğimizde tonsillektomi ve adenotonsillektomi yapılan 34'ü erkek(%52.3), 31'i kız(%47.7) olmak üzere 65 çocuk hasta dahil edildi. Hastaların preoperatif yaş ortalaması 7.09±2.30 (min. 4, maks. 13) idi. 11 tanesi (%16.9) kronik/hipertrofik tonsillit, geri kalan 54 tanesi (%83.1) ise adenoid vejetasyon ile birlikte kronik/hipertrofik tonsillit tanısı bulunan çocuklar arasından rastgele seçilerek oluşturuldu. Kontrol amaçlı çağırılan tüm hastaların anamnezleri ve postoperatif şikayetleri anne/babalarından alındı. Çoktan seçmeli ve/veya ucu açık 19 kalem soruyu cevaplamaları istendi. Cevapların ardından hastaların muayeneleri yapılarak son klinik bulguları not edildi. Bulgular: Postoperatif takip süresi ortalama 15.18±7.4 ay(min. 1-maks. 36) idi. Ameliyatın bizim hastanemizde yapılması için verilen kararda en etkili faktör %55.4 ile fakülte olması iken, bu ameliyata karar verinceye kadar başvurulan KBB uzmanı sayısının ortalama 2.55±1.87 (min. 1-maks. 10) olduğu öğrenildi. Ameliyatın etkinliği 10 üzerinden ortalama 8.55±1.39 (min. 4-maks. 10) olarak tespit edildi. Tedavi sonrası hastaların 19'u (%29.2) aynı şikayetlerin devam ettiğini, 36'sı (%55.4) şikayetlerinin tamemen geçtiğini ve 10'u (%15.4) eskisine nazaran daha iyi olduğunu bildirdi. Cerrahi öncesi yaşıtlarına göre gelişme geriliği bulunan 39 hastanın(%60), postoperatif 24'ünde (%61.5) farkedilir bir gelişme olduğu söylendi. 4(%6.2) hasta tekrar başa dönebilseydik bu operasyonu yaptırmazdım yanıtını verdi. Çocukların, 25(%38.5)'inin okul öncesi olduğu, 1(%1.5)'inin özel eğitim öğrencisi olduğu, 19(%29.2)'unun cerrahi sonrası derslerindeki başarının ailenin farkedeceği düzeyde arttığı, 20(%30.8) çocuğun ise ders başarı düzeyinin aynı kaldığı saptandı. Hastaları erken postoperatif dönemde en fazla rahatsız eden semptomlar arasında ilk sırada ağrı(%35), ikinci sırada yutma güçlüğü(%32) ve üçüncü sırada iştahsızlık gelmekteydi(%15). Hastaların yaşları ile iyileşme süreleri arasında ve yapılan cerrahi ile iyileşme süreleri arasında anlamlı bir ilişki tespit edilemedi. Cinsiyete, yaşa ve tanıya bağlı olarak dağılım yapıldığında iyileşme süresi, komplikasyon gelişimi gibi diğer değişkenlerde de anlamlı bir fark bulunamadı. Sonuç: Sonuç olarak preoperatif değerlendirmelerde daha dikkatli olunması, sistemik hastalıklar yönünden detaylı sorgulanması, hasta ve ebeveynlerinin cerrahiden tam olarak ne beklediklerinin bilinmesi ve cerrahi kararın buna göre verilmesi gerektiği anlaşılmıştır. Seçilmiş hastalarda yapılacak adenotonsillektominin daha memnun edici sonuçlar verdiği görülmüştür.
European Archives of Oto-rhino-laryngology, Apr 30, 2004
Patients with acoustic neuroma in their only hearing ear are not frequently seen in clinical prac... more Patients with acoustic neuroma in their only hearing ear are not frequently seen in clinical practice. Managing this group of patients is a challenge to both the patient and surgeon. In this study we report on five cases of acoustic neuroma in an only hearing ear. Our decision for conservative management of those patients with regular follow-up using auditory brain stem response and magnetic resonance imaging is discussed. Other management options currently available are reviewed as well.
Although transposition of the facial nerve is crucial in infiltrative vascular lesions involving ... more Although transposition of the facial nerve is crucial in infiltrative vascular lesions involving the jugular foramen, the objective was to show that a conservative approach to management of the facial nerve is sufficient with jugular foramen neuromas because of their noninfiltrative, less vascular nature and medial location in the jugular foramen. Retrospective case review. Tertiary, private, multiphysician, otologic practice. Sixteen patients with jugular foramen schwannoma (18 procedures) treated between January 1975 and October 1995. The 8 male and 8 female patients ranged in age from 13 to 66 years (mean age 47.7 years). One-stage, total jugular foramen neuroma removal without transposition of the facial nerve, using a variety of surgical approaches. Facial nerve transposition (yes or no), House-Brackmann facial nerve grade, lower cranial nerve status, complications. One-stage total tumor removal was accomplished in all the cases. In 13 (72%) of the neuromas, removal was accomplished without facial nerve transposition. Transposition was performed in 2 revision cases in which scar tissue from a previous operation prevented complete control of the carotid artery and safe removal, 2 cases with large tumor extension anteriorly to the petrous apex, and 1 case with extensive involvement of the middle ear. A House-Brackmann facial nerve Grade I or II was obtained in 16 of the 18 procedures, with 1 Grade III and 1 case that remained Grade V, as it was preoperatively. One-stage, total tumor removal can be achieved with excellent control of the important vascular structures and without transposition of the facial nerve in a majority of jugular foramen schwannomas.
ÖZET Amaç: Bu çalışmanın amacı, tonsillektomi ve adenotonsillektomi yapılan çocuk hastaların erke... more ÖZET Amaç: Bu çalışmanın amacı, tonsillektomi ve adenotonsillektomi yapılan çocuk hastaların erken ve geç dönem postoperatif sonuçları ile ailelerinin ameliyat sonrası düşüncelerini araştırmak; bulguları hedef–sonuç ilişkisinde değerlendirmektir. Hastalar ve ...
Süperiyor semisirküler kanal dehissansı sendromu yeni tanımlanmış ve nadir izlenen bir hastalıktı... more Süperiyor semisirküler kanal dehissansı sendromu yeni tanımlanmış ve nadir izlenen bir hastalıktır. Hastalık yüksek ses ve basınçla ortaya çıkan vertigo ve nistagmusla kendini gösterir. Yüksek sesle ortaya çıkan vertigo ve nistagmusa Tullio fenomeni, basınçla ortaya ...
Understanding of the pathologies which cause the diseases is not always easy. In disclosing the a... more Understanding of the pathologies which cause the diseases is not always easy. In disclosing the aural diseases mechanism, temporal bone pathology provides us excellent clues. Such a study is essential for progress in the diagnosis, therapy, and prevention of disorders affecting this organ. But this involves a painstaking and long run procedures including a good record keeping and patient persuasion about postmortem research on their temporal bones. One of these few centers in the world is the House Ear Institute temporal bone research labaratory. In order to bring this subject into attention of Turkish otolaryngologists we reviewed the procedures and discussed the importance of this kind of laboratory. [Journal of Turgut Ozal Medical Center 1997;4(4):472-477] Key words: Temporal bone, pathology
Journal of Clinical and Experimental Investigations, Sep 11, 2012
Tüm hemanjiyomların %1'ini oluşturan intramuskuler hemanjiyomalar nadir görülen benign tümörlerdi... more Tüm hemanjiyomların %1'ini oluşturan intramuskuler hemanjiyomalar nadir görülen benign tümörlerdir. Sıklıkla gövde ve ekstremitelerde görülebilmektedir. Masseter ve trapezius kaslarından köken alabilen bu oluşumlar baş ve boyun bölgesinde nadir izlenmektedir. Hastalar genellikle parotis ve yüz bölgesinde zamanla büyüyen ağrısız kitleden şikayet eder. Lokalizasyonundan dolayı intramuskuler hemanjiyomaların %90'ında klinik olarak yanlışlıkla parotis kitlesi tanısı konulabilir. Bu kitlelerin tanısında görüntüleme yöntemleri önemli yer tutar.
Indian Journal of Otolaryngology and Head & Neck Surgery, Mar 3, 2013
Nasal obstruction most commonly occurs due to mucosal abnormalities and those in cartilage-bone s... more Nasal obstruction most commonly occurs due to mucosal abnormalities and those in cartilage-bone structure such as nasal polyp, septum deviation, concha hypertrophy and chronic sinusitis in adults. Adenoid vegetation is the most prominent cause in childhood. In the present study, we aimed to investigate whether maxillary and palatal bone developments continue in patients with abnormalities causing nasal obstruction. As computerized tomography is the optimal imaging modality in nasal cavity abnormalities, CT scan findings of patients with Control nasal polyp, chronic sinusitis and septum deviation were retrospectively evaluated; and palatal curve changes were compared. In our study, it was found that maxillary bone curve was widened in adult patients with nasal polyp; this angle was further narrowed in those with chronic sinusitis; and maxillary bone curve narrowing and increase in the distance to palatal bone was smaller in patients with septum deviation than those in chronic sinusitis. In the light of these findings, we concluded that, in adults, maxillary and palatal bone developments continue in certain circumstances including nasal polyp, chronic sinusitis or septum deviation.
Tissue expansion is a helpful technique in reconstructive plastic surgery. Unfortunately, tissue ... more Tissue expansion is a helpful technique in reconstructive plastic surgery. Unfortunately, tissue expansion still needs to be improved. Twenty-four male Wistar rats were used to evaluate the effect of estriol on tissue expansion. The agents hyaluronidase, estriol, and base cream (as a control) were applied topically to separate animal groups for 5 weeks, and their effects were studied on tissue expansion. Both hyaluronidase (p < 0.05) and estriol (p < 0.001) enhanced the rate of expansion when compared with control animals. Estriol was more effective than hyaluronidase (p < 0.05). Breaking strengths were measured in the estriol and the control groups. Breaking strength was not evaluated in the hyaluronidase group because of the necrotic changes seen at the end of the fifth week. The breaking strength was higher in the control group than in the estriol group (p < 0.05). The authors suggest that topical estriol be used as an adjunctive agent to facilitate tissue expansion.
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