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    Effects of Osteotomy on Hemodynamic Parameters and Depth of Anesthesia in Rhinoplasty Operations
    (NLM (Medline), 2020) Gencay I.; Muluk N.B.; Kilic R.; Yazici I.; Aydin G.; Sencan Z.; Tozar M.
    BACKGROUND: Bleeding during rhinoplasty leads to many undesirable effects, such as loss of vision in the surgery area, complications during the procedure, and postoperative complications. The most important effect that increases bleeding is hemodynamic changes during surgery. Considering that osteotomy is the most challenging process in rhinoplasty, this study aimed to examine the hemodynamic changes during osteotomy and changes in the depth of anesthesia. METHODS: A total of 50 patients, aged 18 to 65 years with an ASA (American Society of Anesthesiology) score of 1 and 2, who underwent osteotomy during rhinoplasty under general anesthesia, were examined retrospectively. After routine monitoring, the patients underwent general anesthesia induction and endotracheal intubation. Before the surgery, they received remifentanil 1??g/kg as an intravenous bolus followed by 0.5??g/(kg·min) as intravenous infusion until the end of the surgery. The hemodynamic parameters and depth of anesthesia [bispectral index (BIS) values] of the patients were examined before anesthesia, 10?minutes before osteotomy, during osteotomy, and 10?minutes after osteotomy. RESULTS: A significant difference was found in heart rate (beats/min), systolic and diastolic blood pressures (mm Hg), and BIS values of the patients measured before, during, and after osteotomy (P < 0.001). The heart rate, systolic and diastolic blood pressures, and BIS values were significantly higher during osteotomy. Until the 10th minute after osteotomy, all 4 parameters nearly reached the values measured before osteotomy. CONCLUSIONS: Osteotomy directly affects hemodynamic parameters and depth of anesthesia. Hence, it is of utmost importance that the analgesic need and depth of anesthesia are adequately monitored and adjusted during osteotomy. By suppressing hemodynamic stress responses, the amount of bleeding can be reduced, thus increasing the surgical success and the patient's comfort.
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    Familial Mediterranean fever and ankylosing spondylitis: A case report
    (2005) Güliter S.; Özkurt Z.N.; Keleş I.; Keleş H.; Aydin G.
    Familial Mediterranean fever (FMF) is an inherited disease characterized by recurrent attacks of fever and accompanying peritonitis, pleuritis, arthritis or erysipelas-like skin disease. The relationship between FMF and spondyloarthropathy (SpA) remains controversial. We described a particular case of 36-yr-old male patient with FMF and ankylosing spondylitis with negative HLA-B27. This case had late-onset FMF in spite of homozygote M694V mutation and his typical acute attacks of FMF began many years after the initiation of complaints related to sacroiliitis. There is no general consensus on whether the association of FMF and SpA is only an occasional coincidence or they are clinically and pathologically linked two conditions. Further studies with larger series are required to clarify the relationship between FMF and SpA.
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    Öğe
    How does the habit of teeth clenching affect the symptoms and signs of patients with temporomandibular disorders?
    (2004) Aydin G.; Keleş I.; Zög G.; Orkun S.
    OBJECTIVES: We aimed to compare the symptoms and signs of patients with temporomandibular disorders (TMD) with and without a history of diurnal teeth clenching. PATIENTS AND METHODS: The study was designed prospectively and included 34 patients with a diagnosis of bilateral temporomandibular joint pain and/or dysfunction. A "Patient Questionnaire Form" and "Patient Assessment Form" generated by the Diagnosis and Treatment Unit of Temporomandibular Disorders, Istanbul Medical Faculty, Istanbul University, were used in the evaluation of the patients. RESULTS: The mean ages of patients with (group I, n=17) and without (group II, n=17) teeth clenching habit were 28.6+/-10.6 and 31.5+/-13.8 years, respectively. Female patients accounted for 76.5% and 47.1% in group I and group II, respectively. The age and gender showed no significant difference between the two groups (p>0.05). Stress factor was significantly higher in group I and was found to aggravate pain and other complaints, according to the questionnaire (p<0.05). Pain associated with jaw movements of all directions and pain radiating to the ear region were found to be significantly higher in group I (p<0.05). Total palpation index, based on physical examination of bilateral extra- and intra-oral masticatory muscles, neck muscles, and capsule of the temporomandibular joints was significantly higher in group I (p<0.05). CONCLUSION: Our findings indicate that habit of teeth clenching in patients with TMD affects biomechanically both muscles and joints of the masticatory system, resulting in muscle/joint pain, and that stress factor aggravates those symptoms. This finding may be useful in the treatment of symptoms and signs of patients with TMD.