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Öğe Association between nasal polyps and novel inflammatory parameters(Scientific Publishers of India, 2017) Apuhan, Tayfun; Aktas, GulaliNasal polyposis represents as a chronic hyperplastic sinusitis associated with chronic inflammation. In present retrospective study, we aimed to compare the Mean Platelet Volume (MPV), Red Cell Distribution Width (RDW) and Neutrophil to Lymphocyte Ratio (NLR) values of patients with nasal polyposis to those in healthy subjects. We included 35 nasal polyp patients and 45 healthy subjects into the study. White Blood Cell count (WBC), Neutrophil Count (NEU), Lymphocyte Count (LYM), Hemoglobin (Hb), Hematocrit (HTC), Mean Corpuscular Volume (MCV), RDW, Platelet Count (PLT) and MPV were recorded after obtaining from computerized database. There was statistically significant difference between study and control groups (p<0.001). Decreased MPV and elevated RDW and NLR are characteristics of nasal polyposis. These parameters may also be helpful in assessing the success of treatment. Further studies with a larger study population are needed to detect the possible correlation between MPV, RDW and NLR values in patients with nasal polyps. © 2017, Scientific Publishers of India. All rights reserved.Öğe Association between nasal polyps and novel inflammatory parameters.(Allied Acad, 2017) Apuhan, Tayfun; Aktaş, GülaliNasal polyposis represents as a chronic hyperplastic sinusitis associated with chronic inflammation. In present retrospective study, we aimed to compare the Mean Platelet Volume (MPV), Red Cell Distribution Width (RDW) and Neutrophil to Lymphocyte Ratio (NLR) values of patients with nasal polyposis to those in healthy subjects. We included 35 nasal polyp patients and 45 healthy subjects into the study. White Blood Cell count (WBC), Neutrophil Count (NEU), Lymphocyte Count (LYM), Hemoglobin (Hb), Hematocrit (HTC), Mean Corpuscular Volume (MCV), RDW, Platelet Count (PLT) and MPV were recorded after obtaining from computerized database. There was statistically significant difference between study and control groups (p<0.001). Decreased MPV and elevated RDW and NLR are characteristics of nasal polyposis. These parameters may also be helpful in assessing the success of treatment. Further studies with a larger study population are needed to detect the possible correlation between MPV, RDW and NLR values in patients with nasal polyps.Öğe Asymmetric dimethylarginine levels in allergic rhinitis and nasal polyposis(Tubitak Scientific & Technical Research Council Turkey, 2013) Tosun, Mehmet; Apuhan, TayfunAim: Asymmetric dimethylarginine (ADMA) is the major endogenous inhibitor of nitric oxide synthase. We aimed to investigate the ADMA levels in allergic rhinitis (AR) and nasal polyposis (NP). Materials and methods: A total of 29 AR patients, 21 NP patients, and 30 healthy subjects to be used as a control group were enrolled in the study. ADMA was measured in the AR, NP, and control groups with enzyme-linked immunosorbent assay. Any patients or control subjects with coronary artery disease, renal failure, diabetes mellitus, or hypertension were excluded from the study. Results: The mean ADMA serum concentration was 0.52 +/- 0.08 mu mol/L in the AR group, 0.62 +/- 0.10 mu mol/L in the NP group, and 0.67 +/- 0.09 mu mol/L in the control group. The ADMA serum concentration in the AR group was significantly lower than in the control group (P < 0.001). Considered together, the NP and AR groups had ADMA levels that were significantly lower than in the control group (P < 0.001). Conclusion: In the present study, lower ADMA levels were found in the AR and NP groups.Öğe A case of anesthesia mumps after general anesthesia(Springer Tokyo, 2012) Tekelioğlu, Ümit Yaşar; Akkaya, Akcan; Apuhan, Tayfun; Demirhan, Abdullah; Bayır, Hakan; Koçoğlu, HasanÖğe Celiac disease and sensorineural hearing loss in children(Taylor and Francis, 2012) Solmaz, Fevzi; Ünal, Fatih; Apuhan, TayfunConclusion: Sensorineural hearing loss (SNHL) is a neurological situation and celiac disease (CD) may be seen coincidentally. Children with clinical signs of hearing deficiency of unknown etiology should be assessed for CD. Objective: CD is a chronic inflammatory gluten-dependent intestinal disease and has extraintestinal findings. The aim of this study was to determine the incidence of CD and SNHL in our pediatric patients. Methods: A total of 25 pediatric patients (50 ears) with biopsy-proven CD were diagnosed in the pediatric gastroenterology department; 25 healthy control subjects (50 ears) were also included in the study. All subjects underwent pure tone audiometry at frequencies of 250-8000 Hz and tympanometry. Results: In the patients and controls, normal peak compliance, gradient, peak pressure, ear canal volume, and acoustic reflexes were obtained by tympanometry. There was no air-bone gap in any of the participants. There was a statistically significant difference between the audiometric results in the CD and control groups (right ear and left ear) (p < 0.05).Öğe Comparison of lidocaine and levobupivacaine in transnasal fiberoptic laryngoscopy(Sage Publications Inc, 2012) Apuhan, Tayfun; Koçoğlu, Hasan; Gülcü, NebahatBackground: The anatomy of the nasal passages, pharynx, and larynx and evaluation of mucous membranes and laryngeal function is well observed by transnasal fiberoptic laryngoscopy (TFL). In this procedure, to provide good local infiltrative analgesia, medication such as anesthetics is important for the otolaryngologist. The aim of this study was to evaluate the efficacy of lidocaine (L) spray, compared with levobupivacaine solution, used for local anesthetic in patients undergoing TFL for complete examination. Methods: Sixty-two subjects (39 men and 23 women; mean age, 36 +/- 7 years) were enrolled in the study. Patients were randomly classified into two groups as levobupivacaine hydroclorur (LB) and L groups. A standard flexible transnasal fiberoptic 4.2-mm-diameter laryngoscope was passed through the nasal cavity and into the aerodigestive tract. Patients were asked to evaluate the intensity of the pain they experienced during the TFL, using a visual analog scale (VAS) and Ramsay sedation scale. Results: Demographic data were similar in both groups. There was no difference in VAS and Ramsay scores between both groups (p > 0.05). Conclusion: Our findings indicated that topical levobupivacaine seems to be an effective medication for anesthesia of the nasal mucosa and may be used to allow complete examinations involving TFL. (Am J Rhinol Allergy 26, e104-e106, 2012; doi: 10.2500/ajra.2012.26.3757)Öğe Comparison of the effects of magnesium sulphate and dexmedetomidine on surgical vision quality in endoscopic sinus surgery : randomized clinical study(Elsevier Science Inc, 2014) Akkaya, Akcan; Tekelioğlu, Ümit Yaşar; Demirhan, Abdullah; Bilgi, Murat; Yıldız, İsa; Apuhan, Tayfun; Koçoğlu, HasanBackground and objectives: Even a small amount of bleeding during endoscopic sinus surgery can corrupt the endoscopic field and complicate the procedure. Various techniques, including induced hypotension, can minimize bleeding during endoscopic sinus surgery. The aim of this study was to compare the surgical vision quality, haemodynamic parameters, postoperative pain, and other effects of magnesium, a hypotensive agent, with that of dexmedetomidine, which was initially developed for short-term sedation in the intensive care unit but also is an alpha 2 agonist sedative. Method: 60 patients between the ages of 18 and 45 years were divided into either the magnesium group (Group M) or the dexmedetomidine group (Group D). In Group M, magnesium sulphate was given at a pre-induction loading dose of 50 mg kg(-1) over 10 min and maintained at 15 mg kg(-1) h(-1); in Group D, dexmedetomidine was given at 1 mcg kg(-1) 10 min before induction and maintained at 0.6 mcg kg(-1) h(-1). Intraoperatively, the haemodynamic and respiratory parameters and 6-point intraoperative surgical field evaluation scale were recorded. During the postoperative period, an 11-point numerical pain scale, the Ramsay sedation scale, the nausea/vomiting scale, the adverse effects profile, and itching parameters were noted. Results: Group D showed a significant decrease in intraoperative surgical field evaluation scale scale score and heart rate. The average operation time was 50 min, and Group M had a higher number of prolonged surgeries. No significant difference was found in the other parameters. Conclusions: Due to its reduction of bleeding and heart rate in endoscopic sinus surgery and its positive impacts on the duration of surgery, we consider dexmedetomidine to be a good alternative to magnesium. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe Comparison of topical tramadol and ketamine in pain treatment after tonsillectomy(Wiley, 2013) Tekelioğlu, Ümit Yaşar; Apuhan, Tayfun; Akkaya, Akcan; Demirhan, Abdullah; Yıldız, İsa; Şimşek, Tuğçe; Gök, Üzeyir; Koçoğlu, HasanObjectives/Aim The primary objective of this study is to evaluate the effects of topically applied ketamine or tramadol on early postoperative pain scores in children undergoing tonsillectomy. The secondary aim of the study is to assess nausea, vomiting, difficulty in swallowing, and sore throat characteristics of the patients. Background Tonsillectomy surgery is frequently associated with postoperative pain, which usually requires substantial consumption of analgesics including opioids. Safe and effective post-tonsillectomy pain control is still a clinical dilemma, in spite of the use of various surgical and anesthetic techniques. Methods A total of 60 children, aged between 4 and 10years, scheduled for tonsillectomy, were randomly assigned to one of three groups. Study drugs were administered to both tonsillar fossae for 5min. In 5ml artificial saliva, Group K (n=20) received 0.4ml (20mg) ketamine and Group T (n=20) received 0.8ml tramadol HCl solution. Group C (n=20) received only 5ml saline as a control. Ramsay Sedation Scale and FACES PRS Score, nausea, vomiting, difficulty in swallowing, and sore throat were evaluated. Results There was no difference among the groups in terms of baseline characteristics, including age, sex, and ASA profile (0.05 for all). Systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate, respiratory rate, and saturation of peripheral oxygen (SpO2) values were not significantly different among the groups in all time points (0.05 for all). There was a statistically significant difference among the groups according to Ramsay Sedation Scales in 40th minute (P<0.001). There were statistically significant differences among the groups in terms of Wong-Baker FACES Pain Rating Scale Score in all time points (P<0.004 for all). There was a statistically significant difference among the groups in terms of rescue analgesia necessity in 5th and 10th minute (P<0.001 and P=0.003). There was a statistically significant difference among the groups in terms of sore throat in 5th and 10th minute (P<0.001 for both). Neither rescue analgesia necessity nor sore throat characteristics was different between the Group T and Group K in all time points. Conclusion Topical tramadol and ketamine seem to be safe, effective, and easy analgesic approach for decreasing tonsillectomy pain.Öğe Concha bullosa surgery and the distribution of human olfactory neuroepithelium(Springer, 2013) Apuhan, Tayfun; Yıldırım, Yavuz Selim; Şimşek, Tuğçe; Yılmaz, Fahrettin; Yılmaz, FahriIn bullous middle turbinate surgery, controversy exists over which side of the bullous middle turbinate should be removed, as the distribution of human olfactory neuroepithelium is unclear. This study evaluated whether the middle turbinate tissue of patients undergoing endoscopic concha bullosa surgery contains functional olfactory epithelium. This prospective clinical study was conducted in tertiary referable center. It detected 70 conchae bullosa in 48 patients with sinonasal symptoms, who underwent paranasal computed tomography (CT) that showed pneumatization of the middle concha. All samples were obtained under general anesthesia. Three samples were obtained from each bullous middle turbinate: one each from the anterior, medial, and lateral portions. The mucosa from each sample was stained with olfactory marker protein (OMP). In total, 210 middle turbinate samples were taken from 48 patients during endoscopic surgery for conchae bullosa. The patients were 22 females and 26 males. Of the 70 conchae bullosa, OMP-stained nerve tissue was found in the lateral, anterior and medial aspects of 57 (81.4 %), 42 (60.0 %) and 23 (32.8 %) of the bullous middle turbinates, respectively. OMP-stained nerve tissue was found in 122 (58.1 %) of the 210 bullous middle turbinate tissue samples. OMP-stained nerve tissue was found on the lateral surface of the bullous middle turbinate more often than the medial surface. Therefore, during the concha bullosa surgery, OMP-stained nerve tissue found at least in the medial part of concha, suggested that the opening of the medial part of middle concha.Öğe Cytotoxic effects of nasal buserelin on nasal mucosal tissue in rabbits(Springer, 2012) Oğhan, Fatih; Apuhan, Tayfun; Terzi, Hakan; Kükner, Aysel; Çoksuer, Hakan; Yılmaz, FahrettinTo investigate the cytotoxic effects of nasal buserelin on rabbit nasal mucosal tissue, twenty-four female rabbits were studied prospectively. The rabbits were divided into 4 groups including 6 rabbits. The rabbits' left noses were included in the all study groups: 150 mu g/puff/day of buserelin acetate was administered topically twice daily during 21, 42 and 63 days. Saline was administered topically twice daily to the left nasal cavity in the control group. The nasal septal mucosal stripe tissue was carefully removed from underlaying cartilage after sedation. HE staining, Masson's trichrome, toluidine blue and TUNEL staining were used to evaluate mucosal changes. Each preparation was investigated via apoptotic cells, and they were accounted. Kruskal-Wallis test was used to evaluate nonparametric comparison of apoptotic cells. Mononuclear cells have been raised in the sub-epithelial connective tissue, nucleuses of epithelial cells in the apical region were pyknotic, and apoptotic cells were determined on 21-day group. In the 42-day group, nasal epithelial tissue was similar to 21-day group and epithelial cells including pyknotic nucleus were present in this group, too. In the 63-day group, epithelial cells were light colored. Venous sinuses in the sub-epithelial connective tissue were wide but not congested and not raised collagen filaments. In the intra-epithelial tissue, some of cells were TUNEL (+). Apoptotic cells were fewer in the control group according to 21-day group. In 42- and 63-day groups, these cells were fewer than in 21-day group. Numerical difference was present between the groups, but statistical significance was not found between the groups. We concluded that nasal buserelin cytotoxicity was not potent in the nasal cavity in rabbits. We use nasal buserelin in all indications with confidence.Öğe The developmental relation between adenoid tissue and paranasal sinus volumes in 3-dimensional computed tomography assessment(Sage Publications Ltd, 2011) Apuhan, Tayfun; Yıldırım, Yavuz Selim; Özaslan, HakkıObjective. The aim of this study was to evaluate the developmental relationship between the volumes of paranasal sinuses and adenoid tissue by using a 3-dimensional (3D) reconstruction technique. Study Design. Cross-sectional study. Setting. Tertiary referral center. Subjects and Methods. Multislice computed tomography (MSCT) images were obtained using 3D reconstructions and a volume-rendering technique (VRT) in 69 boys and 35 girls aged 3 to 16 years, and bilateral maxillary, frontal, and sphenoid sinus volumes, as well as adenoid tissue volume marked in axial-coronal-sagittal planes, were calculated. The patients were grouped in 3 categories according to adenoid tissue volumes, and comparisons were made. Results. There was no significant difference between the right maxillary volume and left maxillary volume (P = .93). No significant difference was noted between the groups in terms of age and gender. There was no significant correlation between frontal, sphenoid, right and left maxillary, or total maxillary sinus volumes in all 3 groups of patients. Conclusion. When classified according to adenoid tissue size, it was observed that increasing adenoid tissue volumes did not significantly affect the development of paranasal sinuses. Developmentally, there are no statistically significant correlations between the volumes of paranasal sinuses and adenoid tissues.Öğe Effect of mitomycin C on endoscopic dacryocystorhinostomy(Lippincott Williams & Wilkins, 2011) Apuhan, Tayfun; Yıldırım, Yavuz Selim; Eroğlu, Faruk; Sipahier, AliObjective: The objectives of the study were to retrospectively analyze the efficacy of intraoperative mitomycin C (MMC) in endoscopic dacryocystorhinostomy (END-DCR) and compare it with external dacryocystorhinostomy (EXT-DCR). Methods: For the comfort of the patients, the procedures were performed under general anesthesia. Intraoperatively during the END-DCR, we applied a cotton pledget soaked in a 0.5 mg/mL solution of MMC for 2.5 minutes. In each patient, a silicone tube was placed into the nasal cavity via the superior and inferior punctae and fixed in the vestibule. We retrospectively analyzed the medical records of patients who underwent END-DCR and EXT-DCR. Results: A retrospective review was performed on the medical records of 43 patients (with a total of 49 affected cases) who were admitted to our clinics with a primary complaint of epiphora. The overall success rates were 91% in END-DCR+MMC and 71.5% in EXT-DCR. Conclusions: Mitomycin C, in appropriate doses, minimizes postoperative granulations and fibrosis. Adjunctive use of MMC is considered to increase the success rate of END-DCR.Öğe Effect of pregabalin and dexamethasone addition to multimodal analgesia on postoperative analgesia following rhinoplasty surgery(Springer, 2013) Demirhan, Abdullah; Tekelioğlu, Ümit Yaşar; Akkaya, Akcan; Bilgi, Murat; Apuhan, Tayfun; Karabekmez, Furkan Erol; Bayır, Hakan; Kurt, Adem Deniz; Koçoğlu, HasanWe investigated the effect of a combination of pregabalin and dexamethasone, when used as part of a multimodal analgesic regimen, on pain control after rhinoplasty operations. Sixty patients were enrolled in this study. They were randomly assigned into three groups: Group C (placebo + placebo), Group P (pregabalin + placebo), and Group PD (pregabalin + dexamethasone). Patients received either pregabalin 300 mg orally 1 h before surgery, dexamethasone 8 mg intravenously during induction, or placebo according to their allocation. Postoperative pain was treated with intravenous patient-controlled analgesia (tramadol, 20-mg bolus dose, 45-min lockout time). The numeric rating scale (NRS), side effects, and consumption of tramadol, pethidine, and ondansetron were assessed. The median NRS scores at 0, 1, and 6 h after surgery were significantly higher in Group C than in Group PD (p < 0.001 for all). The 24-h consumption of tramadol and pethidine was significantly reduced in Groups P and PD compared to Group C (p < 0.01 and p < 0.01). The total tramadol consumption was decreased by 54.5 % in Group P and 81.9 % in Group PD compared to Group C (p < 0.001 for both). The incidence of nausea was higher in Group C than in Groups P and PD between the postoperative 0-2 and 0-24-h periods (p < 0.05 for both). The frequency of blurred vision was significantly higher in Groups P and PD than in Group C within the 0-24-h period (p < 0.05 for both). We found that the addition of a single dose of pregabalin and dexamethasone to multimodal analgesia in rhinoplasty surgeries provided efficient analgesia and thus decreased opioid consumption. 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.Öğe Effect of pregabalin and dexamethasone on postoperative analgesia after septoplasty(Hindawi Publishing Corporation, 2014) Demirhan, Abdullah; Akkaya, Akcan; Tekelioğlu, Ümit Yaşar; Apuhan, Tayfun; Bilgi, Murat; Yurttaş, Veysel; Bayır, Hakan; Yıldız, İsa; Gök, Üzeyir; Koçoğlu, HasanObjectives. The aim of this study was to explore effect of a combination of pregabalin and dexamethasone on pain control after septoplasty operations. Methods. In this study, 90 patients who were scheduled for septoplasty under general anesthesia were randomly assigned into groups that received either placebo (Group C), pregabalin (Group P), or pregabalin and dexamethasone (Group PD). Preoperatively, patients received either pregabalin 300 mg one hour before surgery, dexamethasone 8 mg intravenously during induction, or placebo according to their allocation. Postoperative pain treatment included tramadol and diclofenac sodium 30 minutes before the end of the operation. Numeric rating scale (NRS) for pain assessment, side effects, and consumption of tramadol, pethidine, and ondansetron were recorded. Results. The median NRS score at the postoperative 0 and the 2nd h was significantly higher in Group C than in Group P and Group PD (P?0.004 for both). The 24 h tramadol and pethidine, consumptions were significantly reduced in Groups P and PD compared to Group C (P<0.001 and P<0.001). The incidence of blurred vision was significantly higher in Group PD compared to Group C within both 0-2 h and 0-24 h periods (P=0.002 and P<0.001, resp.). Conclusions. We conclude that administration of 300 mg pregabalin preoperatively may be an adequate choice for pain control after septoplasty. Addition of dexamethasone does not significantly reduce pain in these patients.Öğe The effect of prilocaine or levobupivacaine infiltration on pain during nasal packing removal(Sage Publications Ltd, 2011) Apuhan, Tayfun; Yıldırım, Yavuz Selim; Gülcü, Nebahat; Koçoğlu, Hasan; Karagöz, YalçınObjective. The aim of this study was to evaluate the efficacy of rehydration of Merocel nasal packs with prilocaine or levobupivacaine on reducing pain and discomfort of nasal packing removal in patients who had undergone septoplasties or endoscopic sinus surgery. Study Design. Prospective clinical study. Setting. Tertiary referral center. Methods. This prospective study was conducted on 72 patients, aged 18 to 55 years, who had undergone septoplasty, bilateral functional endoscopic sinus surgery, or both. The patients were divided into 2 groups: prilocaine group (group P, n = 36), who received 2.5 mL of 2% prilocaine, and levobupivacaine group (group L, n = 36), who received 2.5 mL of levobupivacaine hydrochloride dilution. These solutions were diluted with 2.5 mL saline to a final volume of 5 mL, which was then injected into the Merocel packing 15 minutes before removal of the pack. In both groups, 5 mL of saline was injected into the packing in the contralateral nostril as a control 15 minutes before removal of the pack. Visual analog score (VAS) and the Ramsay sedation score were recorded. Results. Statistically significant differences were found in VAS and Ramsay sedation scale scores of levobupivacaine and prilocaine groups compared to controls. No significant difference was noted between the groups in terms of levobupivacaine and prilocaine. Conclusions. Levobupivacaine or prilocaine infiltration before removal of nasal packs in patients who undergo septoplasties or endoscopic sinus surgery can decrease discomfort and improve patient tolerability.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 Effects of anesthesia on patients undergoing surgery for obstructive sleep apnea(2011) Yıldırım, Yavuz Selim; Apuhan, Tayfun; Ersözlü, Tolga; Bahar, İlhanAnesthesia and sleep both predispose to upper airway obstruction induced reductions in pharyngeal dilator muscle activation. Symptoms of obstructive sleep apnea are common in patients presenting for surgery and are associated with increased morbidity. Analgesia contributes significantly to postoperative respiratory depression and obstruction. Screening for sleep apnea should be done for all surgical patients. Every patient diagnosed with OSA, or with clinical suspicion of OSA, should be considered to have a difficult airway, and consequently has increased risk of anesthesia. The possible problems may arise during tracheal intubation, extubation, or with postoperative analgesia, since opioids increase the incidence of pharyngeal collapse. Patients with known or suspected obstructive sleep apnea need careful postoperative management. Postoperative monitoring for apnea, desaturation, and dysrhythmias is a necessity in sleep apnea patients. © 2011 Yildirim YS, et al.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 Effects of intranasal phototherapy on nasal microbial flora in patients with allergic rhinitis(Iranian Scientific Society Medical Entomology, 2013) Yıldırım, Yavuz Selim; Apuhan, Tayfun; Koçoğlu, EsraThe objective of this study was to investigate the effect of intranasal phototherapy on nasal microbial flora in patients with allergic rhinitis. This prospective, self-comparised, single blind study was performed on patients with a history of at least two years of moderate-to-severe perennial allergic rhinitis that was not controlled by anti-allergic drugs. Thirty-one perennial allergic rhinitis patients were enrolled in this study. Before starting the test population on their intranasal phototherapy, the same trained person took a nasal culture from each subject by applying a sterile cotton swab along each side of the nostril and middle meatus. Each intranasal cavity was irradiated three times a week for two weeks with increasing doses of irradiated. At the end of the intranasal phototherapy, nasal cultures were again obtained from the each nostril The study found that after intranasal phototherapy, the scores for total nasal symptoms decreased significantly but bacterial proliferation was not significantly different before and after phototherapy. We have shown that intranasal phototherapy does not change the aerobic nasal microbial flora in patients with perennial allergic rhinitis.Öğe Effects of isoflurane on postoperative olfactory memory(Carbone Editore, 2014) Bilgi, Murat; Demirhan, Abdullah; Akkaya, Akcan; Tekelioğlu, Ümit Yaşar; Erdem, Kemalettin; Apuhan, Tayfun; Kurt, AdemPurpose: In this study, we planned to investigate the effects of isoflurane 1.2%, on olfactory memory. Methods: This is a prospective clinical study conducted over 40 patients aged 18-50 who had elective surgery and American Society of Anesthesiologists (ASA) physical status I-II. The Brief Smell Identification Test (BSIT) was used for interpreting patients' olfactory memories before and after the surgical procedure. Patients received standard general anesthesia protocol and routine monitoring. For induction, 1.5 mg/kg of fentanyl, 2 mg/kg of propofol, and 0.5 mg/kg of rocuronium bromide were administered. Anesthesia was maintained with the inhalational of anesthetic isofluraine (1.2%). The scores are recorded 30 minute before the surgery and when the Aldrate Recovery Score reached 10 in the postoperative period. Preoperative and postoperative results were compared and p-values <0.05 were considered statistically significant. Results: The patients' mean age were 38.4 +/- 13.8. Preoperative total correct answer rate to odorous substances was 91.4%, and postoperative rate was 90.8%. Percentage of the odor substance identification by the patients revealed no statistically significant difference when pre and post-operative rates have been compared. (P>0.05) Conclusion: In conclusion, it is the first time we demonstrate general anesthesia with isoflurane 1.2 % has no significant effect on the olfactory memory. Further studies with larger samples will be required to confirm our findings.
