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Öğe Auditory evaluation in Parkinsonian patients(Springer, 2009) Yylmaz, Sueleyman; Karaly, Elif; Tokmak, Abdurrahman; Guclu, Ender; Kocer, Abdulkadir; Ozturk, OzcanTwenty Parkinson's disease (PD) patients (mean age 69.9 years) and 24 normal individuals' (mean age 63.8) both ears were investigated by brainstem auditory evoked potentials (BAEPs) and pure tone audiometry (PTA). There were no statistically significant age differences between the patients and control subjects. PTA results were significantly elevated for PD patients in 4,000 and 8,000 Hz (P < 0.05). Parkinsonian patients showed significantly increased latencies in wave V and I-V interpeak latencies (P < 0.05). The results of this study suggest that PTA and BAEPs could be affected in parkinson disease.Öğe Congenital unilateral intranasal membranous septa with choanal atresia dividing the nasal cavity into two blind pouch: A case report(Elsevier Ireland Ltd, 2010) Yilmaz, Suleyman; Guclu, Ender; Karali, Elif; Subasi, BugraCongenital nasal anomalies are rare disorders. An 11-year-old girl presented to our clinic with a left sided nasal obstruction and chronic nasal discharge since birth. Clinical evaluation revealed membranous septa which divided the left nasal cavity into two blind pouch and left sided choanal atresia with alar cartilage asymmetry. This congenital anomaly was not defined in the English literature. The membranous septa in the left nasal cavity were excised, alar reconstruction were performed and the choanal atresia were repaired by a transnasal endoscopic approach. In this article we reported a case of membranous septa which divided the left nasal cavity into two blind pouch associated with unilateral choanal atresia and alar cartilage asymmetry. Also the nasal anomalies and associated disorders in the literature were reviewed. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Öğe The effects of topical levobupivacaine on morbidity in pediatric tonsillectomy patients(Elsevier Ireland Ltd, 2009) Yilmaz, Sueleyman; Demiraran, Yavuz; Akkan, Nermin; Yaman, Hueseyin; Iskender, Abdulkadir; Guclu, Ender; Ozturk, OzcanObjective: To reduce the post-tonsillectomy morbidity by swab soaked with 5 ml levobupivacaine hydroclorur (25 mg/10 ml). Study design: A double-blind prospective randomized controlled clinical study. Methods: In this randomized double-blind study in group I (30 children, mean age 7.5 +/- 2.6) we tightly packed swab soaked with 5 ml levobupivacaine hydroclorur (25 mg/10 ml) and in group II (21 children, mean age 7.9 +/- 3.7) we used 5 ml saline swabs into each of the two tonsillar fossae after tonsillectomy for 5 min. We used McGrath's face scale to compare the two groups in respect of pain control. Results: There was statistically significant pain relieving effect in the levobupivacaine group in the first 24 h (p < 0.05). But after 24 h pain relieving effect of levobupivacaine was not significant (p > 0.05). We did not see any serious complications for both groups. Postoperative morbidity mean results (nausea, vomiting, fever, bleeding, halitosis and ear pain) were not statistically different between the two groups (P > 0.05). Conclusion: Topical levobupivacaine seems to be a safe and easy medication for postoperative pain control in pediatric tonsillectomy patients. (c) 2009 Elsevier Ireland Ltd. All rights reserved.Öğe Efficacy of Topical Levobupivacaine in Control of Postoperative Pain after Septoplasty(Bmc, 2010) Yilmaz, Suleyman; Akbay, Buket Kocaman; Yildizbas, Sahnur; Guclu, Ender; Yaman, Huseyin; Sezen, Gulbin YalcinObjective: To search the efficacy of using Merocele (Medtronic, Minneapolis, MN) soaked with 5 mL of levobupivacaine hydrocloride as a nasal pack in control of postoperative pain after septoplasty. Design: The study was designed as a prospective, double-blind, randomized, controlled study. Forty-one patients who underwent septoplasty operation were included in the analysis. Setting: A tertiary referral hospital in Turkey. Material and Methods: Forty-one patients undergoing septoplasty were divided into two groups. At the end of the operation, Merocele packs were placed inside the nasal cavity. In the levobupivacaine group, each Merocele pack was soaked with 5 mL of levobupivacaine hydrochloride (25 mg/10 mL), and in the control group, Merocele packs were soaked with 5 mL of saline. Main Outcome Measures: Postoperative pain levels were recorded using a visual analogue scale (VAS score, 0-100) at 30 minutes and 1, 2, 8, 12, and 24 hours. Results: We did not find any significant difference between groups regarding age, gender, American Society of Anesthesiologists status, and body mass index. Postoperative VAS values at 30 minutes and 1, 2, 8, and 12 hours were significantly lower in the levobupivacaine group compared with the control group (p < .05). The need for supplemental analgesia was significantly lower in the levobupivacaine group compared with the control group (p < .01) Conclusion: Postoperative pain after septoplasty owing to nasal packing is an important problem, and using levobupivacaine-soaked Merocele as a nasal pack after septoplasty is an effective method for the control of this pain. It is a very easy, effective, and quick method and it improves patient comfort after septoplasty.Öğe Myringosclerosis after tympanostomy tube insertion: Relation with tube retention time and gender(Elsevier Sci Ltd, 2010) Yaman, Huseyin; Guclu, Ender; Yilmaz, Suleyman; Ozturk, OzcanObjective: To determine relationship between myringosclerosis and tube retention time and sex in children with chronic otitis media with effusion who were treated with tympanostomy tube insertion. Also, the relationship between myringosclerosis both sex and initial age of tube insertion were investigated. Methods: A total of 101 children (195 ears) were reviewed. Ears were divided into four groups according to retention time of tympanostomy tubes. Group I: Retention time of tympanostomy tube less than 6 months. Group 11: Retention time of tympanostomy tube from 6 months to 12 months. Group III: Retention time of tympanostomy tube of 12 months or more. Group IV: Myringotomy group without tympanostomy tube insertion. Results: The order of the myringosclerosis rates were as follows from the highest to lowest one; group III (44.1%), group II (42.4%), group I (14.3%), and group IV (7.7%). Myringosclerosis was more common in group I compared with group IV, but the difference was statistically not significant (p > 0.05). There were no statistically significant differences in myringosclerosis rates between the group II and group III (p > 0.05). On the other hand, statistically significant differences were observed in myringosclerosis rates between group I and group II (p < 0.05), and between group I and group III (p < 0.05); also similar significant differences were present in myringosclerosis rates between group Wand group II (p < 0.05), and between group IV and group 111 (p < 0.05). There was no significant difference between preschool age group and school age group. Myringosclerosis was observed in 40% of boys and in 51.2% of girls. Conclusion: Myringosclerosis is frequent in patients who underwent tympanostomy tube insertion. The frequency of myringosclerosis is much higher in tympanic membranes with tympanostomy tube insertion than tympanic membranes with myringotomy, and the location of sclerotic plaques does not always correspond to the tympanostomy area. The myringosclerosis rate was increased when the tympanostomy tubes stay on tympanic membrane for a long time. Highest myringosclerosis rates were observed if the extrusion time was 12 months or longer. In our analysis, sex and initial age of tube insertion were not significant factors for the development of myringosclerosis after extrusion of tympanostomy tubes. (C) 2010 Elsevier Ireland Ltd. All rights reserved.Öğe Otitis media with effusion: Recurrence after tympanostomy tube extrusion(Elsevier Ireland Ltd, 2010) Yaman, Huseyin; Yilmaz, Suleyman; Guclu, Ender; Subasi, Bugra; Alkan, Nihal; Ozturk, OzcanObjective The incidence rate of recurrence of otitis media with effusion (OME) in children after tympanostomy tube extrusion and the relationship between recurrence and tube retention time was investigated. Also relationship between recurrence rate and initial age of tube insertion was analysed. Study Design A retrospective case series of patients who had tympanostomy tube insertion. Methods A total of 91 children (169 ears) were reviewed Ears of children divided into three groups according to retention time of tympanostomy tubes. Group I tympanostomy tube retention time less than 6 months. Group II tympanostomy tube retention time 6 months to 12 months. Group III: tympanostomy tube retention time 12 months or more Results OME recurrence rate after tube extrusion was 20 7% in the study The longer the tympanostomy tube retention time was the lower was the recurrence rate of OME. The comparison of the three groups indicated that recurrence rates were higher in group I (36 54%), than in group II (17 74%) and in group III (9 1%) There were statistically significant differences in recurrence rates between group I and group III, and between group I and II (p < 0 05, p < 0.05). However, the difference in recurrence rates between group II and group III was statistically not significant (p > 0 05) In the preschool age group and school age group, the recurrence rates were 5 5% and 15.4%. respectively There was no significant difference between these two groups (p > 0.05) OME recurrence was observed in 9.9% of males and in 11% of females. There was no significant difference in recurrence rates between males and females (p > 0.05) Conclusion. After extrusion of tympanostomy tube, children should be followed-up regularly for recurrence of OME The shorter the retention time of tympanostomy tubes was the higher was the recurrence rate. For the treatment of OME the ideal type of tubes should have the lowest complication and recurrence rates Further studies are needed to ascertain the relationship between the incidence of OME and optimal tympanostomy tubes duration of tube stay in tympanic membrane Therefore, new studies with larger series are necessary to investigate the correlation between the recurrence rates and different tympanostomy tubes after extrusion of tubes (C) 2009 Elsevier Ireland Ltd All rights reserved.Öğe A Rhinolith Surrounded by a Nasal Polyp(Lippincott Williams & Wilkins, 2010) Yilmaz, Suleyman; Guven, Damla Guclu; Subasi, Bugra; Guler, Sahnur Yildizbaz; Guclu, EnderRhinoliths are uncommon mineralized nasal mass in children and adolescents. We reported a case of unilateral rhinolith that presented as a nasal polyp. A 29-year-old woman who had right-sided nasal purulent discharge, nasal obstruction, intermittent epistaxis, and posterior nasal drip for 6 months was admitted to our department. Nasal examination revealed a nasal mass between the inferior turbinate and the nasal septum, presenting as a nasal polyp or a nasal tumor. Paranasal sinus computed tomographic scan confirmed a calcified mass in soft tissue. We removed the rhinolith and the soft tissue that was around it with a transnasal endoscopic approach. Histologic analysis of the soft tissue identified inflammatory nasal polypoid tissue.Öğe Shepard grommet tympanostomy tube complications in children with chronic otitis media with effusion(Springer, 2010) Yaman, Huseyin; Yilmaz, Suleyman; Alkan, Nihal; Subasi, Bugra; Guclu, Ender; Ozturk, OzcanThe objective of this study was to determine tympanostomy tube complications in children with chronic otitis media with effusion who were treated with Shepard grommet tympanostomy tube insertion. This tube type was selected as it is the most commonly used one in our clinic. The medical records of 162 ears of 87 children (52 male and 35 female) were reviewed retrospectively. The children were between 3 to 16 years old (mean age = 8.1 +/- A 3.1). The patients were followed up 6-66 months (mean 23.3 +/- A 14.9 months) after tympanostomy tube insertion. We reviewed age, sex, time to tube extrusion and complications. In all patients the indication for surgery was chronic middle ear effusion. Otorrhea occurred in nine ears (5.6%). Granulation tissue was seen in two ears (1.2%). Complications after tympanostomy tube extrusion included myringosclerosis (34.6%), persistent perforation (5.6%), atrophy (23.5%), retraction (16.7%) and medial displacement of tubes (1.2%). The average extrusion time was 8.5 +/- A 4.6 months (range 1-24) for Shepard grommet tympanostomy tubes. Complications of tympanostomy tube insertion are common. Myringosclerosis, tympanic membrane atrophy and otorrhea are the most frequently appearing complications. But they are generally insignificant and cosmetic. Consequently, in the majority of these complications there is no need for any management.Öğe Stridor in a newborn caused by a congenital laryngocele and bifid epiglottis: A case report and review of the literature(Elsevier Ireland Ltd, 2010) Yilmaz, Suleyman; Yildizbas, Sahnur; Yaman, Huseyin; Guclu, Ender; Ozturk, OzcanA laryngocele is a rare, an abnormal cystic dilatation of the laryngeal saccule. A bifid epiglottis is also an extremely rare congenital anomaly of larynx that is often associated with other congenital defects. In this article, we report a case of an internal laryngocele and bifid epiglottis in a one hour old newborn girl that presented as acute airway obstruction who also have imperforate hymen, hydrocolpos, bilateral hydronephrosis and polydactyly. The patient underwent endoscopic microsurgical excision of internal laryngocele using suspension laryngoscopy and cold blade. We also review the anatomy, etiology and clinic course of the different types of laryngoceles, bifid epiglottis and related congenital defects. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Öğe Topical Levobupivacaine Efficacy in Pain Control after Functional Endoscopic Sinus Surgery(Sage Publications Inc, 2013) Yilmaz, Suleyman; Yildizbas, Sahnur; Guclu, Ender; Yaman, Huseyin; Sezen, Gulbin YalcinObjectiveThe aim of this study was to find out the efficacy of a polyvinyl alcohol (PVA) sponge (Merocel Kennedy; Medtronic Xomed, Jacksonville, Florida) sinus pack soaked with levobupivacaine hydrochloride to control postoperative pain and analgesic need following functional endoscopic sinus surgery (FESS). Study DesignThe study was designed as a prospective, double-blind, randomized, controlled study. Forty-one patients who underwent FESS were included in the analysis. SettingA tertiary referral hospital in Turkey. Materials and MethodsPatients who underwent FESS were divided into 2 groups. The PVA sponge sinus packs were soaked with 5 mL of levobupivacaine hydrochloride (chirocaine 25 mg/10 mL; Abbott, Nycomed Pharma AS, Elverum, Norway) in group I and with 5 mL of saline in group II. Main Outcome MeasuresPostoperative pain levels were recorded using a visual analog scale (VAS score, 0-100) at 30 minutes and 1, 2, 8, 12, and 24 hours. ResultsThere were no statistically significant differences between groups regarding age, sex, and American Society of Anesthesiologists status. Postoperative VAS values at 30 minutes and 1, 2, 8, 12, and 24 hours were significantly lower in group I than in group II (P <. 05). Supplemental analgesia amount was significantly lower in group I than in group II (P =. 003). ConclusionUsing levobupivacaine-soaked PVA sponge sinus packs after FESS is an effective, easy, and quick method to control postoperative pain, and it improves patient comfort and tolerability.Öğe Topical Levobupivacaine Efficacy in Pain Control after Functional Endoscopic Sinus Surgery(Sage Publications Inc, 2013) Yilmaz, Suleyman; Yildizbas, Sahnur; Guclu, Ender; Yaman, Huseyin; Sezen, Gulbin YalcinObjective. The aim of this study was to find out the efficacy of a polyvinyl alcohol (PVA) sponge (Merocel Kennedy; Medtronic Xomed, Jacksonville, Florida) sinus pack soaked with levobupivacaine hydrochloride to control postoperative pain and analgesic need following functional endoscopic sinus surgery (FESS). Study Design. The study was designed as a prospective, double-blind, randomized, controlled study. Forty-one patients who underwent FESS were included in the analysis. Setting. A tertiary referral hospital in Turkey. Materials and Methods. Patients who underwent FESS were divided into 2 groups. The PVA sponge sinus packs were soaked with 5 mL of levobupivacaine hydrochloride (chirocaine 25 mg/10 mL; Abbott, Nycomed Pharma AS, Elverum, Norway) in group I and with 5 mL of saline in group II. Main Outcome Measures. Postoperative pain levels were recorded using a visual analog scale (VAS score, 0-100) at 30 minutes and 1, 2, 8, 12, and 24 hours. Results. There were no statistically significant differences between groups regarding age, sex, and American Society of Anesthesiologists status. Postoperative VAS values at 30 minutes and 1, 2, 8, 12, and 24 hours were significantly lower in group I than in group II (P < .05). Supplemental analgesia amount was significantly lower in group I than in group II (P = .003). Conclusion. Using levobupivacaine-soaked PVA sponge sinus packs after FESS is an effective, easy, and quick method to control postoperative pain, and it improves patient comfort and tolerability.
