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Öğe The effect of topical cefepime solution on outer hair cell function of rats(Aves, 2011) Apuhan, Tayfun; Yıldırım, Yavuz Selim; Aksoy, Fadlullah; Balıkçı, Hasan Hüseyin; Kaya, Mehmet OnurObjectives: The current study was designed to investigate the ototoxic effect of topical cefepime solution on the outer cell function of cochlea by measuring distortion product otoacoustic emission (DPOAE) amplitudes. Study Design: Prospective controlled animal study. Materials and methods: A 50 mg/ml cefepime solution was injected into the left middle ear space of 8 of the rats with dental needle via transtympanic route 2 times per day for 7 days (Group la), and a 1 ml %0.9 NaCl solution was injected to the right ear of the same rats 2 times per day for 7 days (Group 1b). An 80 mg/ml gentamycine solution was injected to the left middle ear space of 4 of the 12 rats of the same way (Group2a), and a 1 ml %0.9 NaCl solution was injected into the right ear of the same rats (Group 2b). DPOAE measurements were then obtained for both experimental and control ears before day 0 (baseline) and days 3, 7, and 28 after the initiation of treatment. Results: DPOEA measurements on day 0 were not significantly different between Groups 1a and 2a. DPOAE measurements during 0-28 days were not significantly different between Group 1a and Group 1b. Among groups 2a and 2b, DPOEA measurements on day 28 were significantly lower within all frequencies compared to day 0. Overall, DPOAE measurements decreased only with gentamycine (p<0,05). Conclusions: The present study demonstrates that a topical cefepime solution does not affect DPOAE amplitudes after application to the middle ear cavity of rats.Öğe The effects of desflurane and sevoflurane on the peri- and postoperative bleeding of adenotonsillectomy patients(Elsevier Ireland Ltd, 2011) Apuhan, Tayfun; Yıldırım, Yavuz Selim; Aksoy, Fadlullah; Borçin, Özlem; Özturan, OrhanObjective: To compare the effects of, volatile anesthetics, desflurane and sevoflurane on intra-operative and postoperative bleeding in patients who underwent tonsillectomy and adenoidectomy. Material and method: Totally 40 children (14 girl and 26 boys) aged between 2 and 16 years were included in this prospective randomized double-blind clinical trial. The patients underwent conventional cold tonsillectomy and curettage adenoidectomy under general anesthesia. For the maintenance of anesthesia, the patients were randomized into two groups: desflurane group and sevoflurane group, each including 20 subjects. Desflurane concentration was set between 4% and 6% (0.7-0.9 MAC), whereas sevoflurane concentration was set between 2% and 2.5% (0.7-0.9 MAC). The amount of perioperative bleeding in milliliters was measured by using separate aspirator bags for each patient. Results: Desflurane caused significantly lower amount of perioperative bleeding compared to sevoflurane (p = 0.03). No significant difference was observed between the two groups in terms of age, body mass index and operation duration, respectively (p = 0.20, p = 0.49, p = 0.07). Conclusion: Desflurane, which is one of the volatile anesthetics, leads to a lower amount of intraoperative bleeding than sevoflurane during tonsillectomy and adenoidectomy operations. (C) 2011 Elsevier Ireland Ltd. All rights reserved.Öğe Is Transnasal Endoscopic Examination Necessary Before and After Adenoidectomy?(2014) Yıldırım, Yavuz Selim; Apuhan, Tayfun; Aksoy, Fadlullah; Veyseller, Bayram; Özturan, OrhanThe present study aimed to investigate the amount of residual adenoid tissue following the conventional adenoidectomy as compared with preoperative values. A total of 32 girls and 44 boys (range, 3-15 years) in whom adenoidectomy procedure was planned were included in the study. Adenoid tissue sizes before adenoidectomy and residual tissue sizes after conventional curettage adenoidectomy were measured by transnasal endoscopic examination and were recorded. Adenoid tissue size before and after adenoidectomy was compared. The mean age of the patients was 7.7 years (range, 3-15 years). Before adenoidectomy grade 4 adenoid tissue was noted in 43.4% (n = 33), grade 3 was noted in 28.9% (n = 22), grade 2 was noted in 25% (n = 19), and grade 1 was noted in 2.6% (n = 2) of the patients. Following adenoidectomy, no significant difference was noted with respect to residual adenoid tissue sizes of grade 4 and grade 3 patients (P = 0.75, P = 0.76). Transnasal endoscopic examination is suggested to be the most appropriate method to assess the amount of residual adenoid tissue after conventional curettage adenoidectomy. The residual adenoid tissue with the help of a microdebrider in case of a large residual adenoid tissue located in the choana are necessary for complete adenoidectomy. © 2012 Association of Otolaryngologists of India.Öğe Severe saddle nose : choices for augmentation and application of accordion technique against warping(Springer, 2013) Özturan, Orhan; Aksoy, Fadlullah; Veyseller, Bayram; Apuhan, Tayfun; Yıldırım, Yavuz SelimSaddle nose deformity presents a significant challenge to surgeons. The reconstruction of a saddle nose requires structural addition to the nasal dorsum and tip. Costal cartilage grafts have been utilized for fixing severe saddle nose deformity, but costal cartilage is notorious for early and/or late warping. In addition to well-known measures, the efficacy of a preventive surgical technique against warping was investigated in this study. Costal cartilage grafts were used in 18 patients with severe saddle noses. Due to recurrent and late warping of the grafts, an additional measure was taken in 23 patients with a comparable deformity. In these 23 patients, just before insertion the costal cartilage was transected on 75 % of its horizontal width every 2 mm, alternating between both sides along the entire length of the implant, a so-called "accordion technique." With traditional measures early and/or late warping of the graft was observed in 7 (39 %) of 18 patients postoperatively. Two grafts warped so severely that they required revision surgery. On the other hand, additional use of the accordion technique prevented the costal cartilage from warping in all 23 cases. The warping complication rate was significantly higher in patients whose graft did not undergo the described accordion technique. The accordion technique is thought to break the recoil mechanism responsible for warping. Since incorporating this surgical technique, warping has not been seen in any saddle nose deformity patients treated by us in the last 5 years. This simple technique is strongly recommended in these cases. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
