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Öğe Comparison of anterior palatoplasty and uvulopalatal flap placement for treating mild and moderate obstructive sleep apnea(Sage Publications Inc, 2018) Haytoglu, Suheyl; Arikan, Osman Kursat; Muluk, Nuray Bayar; Tuhanioglu, Birgul; Cortuk, MustafaWe prospectively compared the efficacy of anterior palatoplasty and the uvulopalatal flap procedure for the treatment of patients with mild and moderate obstructive sleep apnea syndrome (OSAS). Our study group was made up of 45 patients who had been randomly assigned to undergo one of the two procedures. Palatoplasty was performed on 22 patients-12 men and 10 women, aged 28 to 49 years (mean: 39.2)-and the flap procedure was performed on 23 patients-14 men and 9 women, aged 28 to 56 years (mean: 41.3). Our primary outcomes measure was the difference in pre- and postoperative apnea-hypopnea index (AHI) as determined by polysomnography at 6 months after surgery. Surgical success was observed in 18 of the 22 palatoplasty patients (81.8%) and in 19 of the 23 flap patients (82.6%). Compared with the preoperative values, mean AHIs declined from 17.5 to 8.1 in the former group and from 18.5 to 8.6 in the latter; the improvement in both groups was statistically significant (p < 0.001). In addition, significant postoperative improvements in both groups were seen in mean visual analog scale (VAS) scores for snoring, in Pittsburgh Sleep Quality Index values, and in Epworth Sleepiness Scale scores (p < 0.001 for all). VAS scores for pain at rest were significantly lower in the palatoplasty group than in the flap group at 2, 4, and 8 hours post-operatively and on postoperative days 4 through 7 (p < 0.002). Likewise, VAS scores for pain during swallowing were significantly lower in the palatoplasty group at 2, 4, 8, and 16 hours and on days 4 through 7 (p < 0.009). We conclude that both anterior palatoplasty and uvulopalatal flap procedures are effective for the treatment of mild and moderate OSAS in patients with retropalatal obstruction. However, our comparison of postoperative pain scores revealed that anterior palatoplasty was associated with significantly less morbidity.Öğe Comparison of two incisionless otoplasty techniques for prominent ears in children(Elsevier Ireland Ltd, 2015) Haytoglu, Suheyl; Haytoglu, Tahir Gokhan; Muluk, Nuray Bayar; Kuran, Gokhan; Arikan, Osman KursatObjectives: In the present study, we applied two incisionless suture techniques for otoplasty: Haytoglu et al.'s modification of incisionless otoplasty technique and Fritsch's incisionless otoplasty technique for correction of prominent ears. Methods: In this prospective study, 60 patients with prominent ears were included in the study. In Group 1, 55 ears of 30 patients (25 bilateral and 5 unilateral) were operated with Haytoglu et al.'s modification of incisionless otoplasty technique. In Group 2,57 ears of 30 patients (27 bilateral and 3 unilateral) were operated with Fritsch's incisionless otoplasty technique. For comparison of two methods, auriculocephalic distances were measured at three levels which were level 1 (the most superior point of the auricle), level 2 (the midpoint of the auricle) and level 3 (level of the lobule) pre-operatively (preop); and measurements were repeated at the end of the surgery (PO0-day, 1st month (PO1-Mo) and 6th month (PO6-Mo) after the surgery, in both groups. Patient satisfaction was evaluated using a visual analog scale (VAS). Moreover, Global Aesthetic Improvement Scale (GAIS) was rated by an independent, non-participating plastic surgeon at 6 months after the surgery. Results: Operation time was 15.9 +/- 5.6 min in Group 1 (Haytoglu et al.'s) and 19 +/- 4.7 min in Group 2 (Fritsch). Hematoma, infection, bleeding, keloid scar formation, sharp edges or irregularities of the cartilage were not observed in any group. Suture extrusion was detected in 14.03% of Group 1 and 16.1% of Group 2. No statistically significant difference was observed between auriculocephalic distances at levels 1-3 of groups at. pO(0-day) preop, PO1-Mo and PO6-Mo separately. Similarly, difference in auriculocephalic distances (preop values-PO6-mo values) was not detected as statistically significant in Groups 1 and 2 at three levels. In both techniques, No statistically significant difference was observed in patient satisfaction at 6th months after the operation which was measured using Visual Analogue Scale (VAS) on 0 to 100 scales. According to GALS, the patients were rated as 92.9% "improved" and 7.1% "no change" in Group 1; as 94.6% "improved" and 5.4% "no change" in Group 2. Conclusions: Due to the similar results, Haytoglu et al.'s and Fritsch's incisionless otoplasty techniques are good options in the treatment of prominent ears, especially in pediatric patients with isolated inadequate development of antihelical ridge, and with soft auricular cartilage. (C) 2015 Elsevier Ireland Ltd. All rights reserved.Öğe Different anesthetic agents-soaked sinus packings on pain management after functional endoscopic sinus surgery: which is the most effective?(Springer, 2016) Haytoglu, Suheyl; Kuran, Gokhan; Muluk, Nuray Bayar; Arikan, Osman KursatIn the present study, we investigated the efficacy of local anesthetics soaked non-absorbable sinus packs on pain management after functional endoscopic surgery (FESS). One hundred and fifty patients with the diagnosis of bilateral chronic sinusitis with or without nasal polyps who underwent FESS were included into the study. Their pre-operative Lund-Mackay computerized tomography (CT) Scores were similar. We applied anesthetic agents of 2 % lidocaine HCl, 0.25 % Bupivacaine HCl, 0.2 % Ropivacaine, 2 % Prilocaine and 0.9 % NaCl (Saline) in groups 1-5 onto the sinus packs after FESS. At postoperative period, acetaminophen (250 mg/5 ml) was used in 10-15 mg/kg per dose (4 times a day). Bleeding grade, operation duration, postoperative number of gauze/24 h, additional painkiller need, pain values at 1, 2, 4, 8, 12 and 24 h were noted. Lund-Kennedy endoscopic scores were also evaluated at 1st, 2nd and 4th weeks postoperatively. In saline group, 93.3 % of the patients needed additional painkiller. Whereas, in Bupivacaine group, additional painkiller use (20.0 %) is less than the other groups. In Bupivacaine group, number of gauze/24 h use was lower than lidocaine, ropivacaine and prilocaine groups. In our study, except 1st and 24th hours, pain values of groups can be written in ascending order (from less to higher) as Bupivacaine, Lidocaine, Prilocaine, Ropivacaine and Saline. In the first hour, pain values of groups can be written in ascending order (from less to higher) as Lidocaine, Prilocaine, Bupivacaine, Ropivacaine and Saline. In the 2nd week, in the Bupivacaine and Lidocaine Groups separately, postoperative Lund-Kennedy scores were lower than the Prilocaine and Saline Groups. In the 1st month, Lidocaine Group's Lund-Kennedy scores were significantly lower than the Saline Group. Synechia values were not different between groups. Bupivacaine help the lower pain values and less additional painkiller need after FESS. Therefore, we recommend to use Bupivacaine soaked sinus packs after FESS for achieve less pain values and to improve patient satisfaction.Öğe Effect of Continuous Positive Airway Pressure Treatment on Mean Platelet Volume and Platelet Distribution Width in Patients with Sleep Apnea Syndrome(Aves, 2016) Cortuk, Mustafa; Simsek, Gokce; Kiraz, Kemal; Haytoglu, Suheyl; Zitouni, Burcak; Muluk, Nuray Bayar; Arikan, Osman KursatObjective: Obstructive sleep apnea (OSA) syndrome is a common disorder that can cause hypercoagulation. Mean platelet volume (MPV) and platelet distribution width (PDW) are associated with hypercoagulability. This study aimed to investigate whether MPV and PDW values change in patients with OSA who were treated with continuous positive airway pressure (CPAP) device. Methods: A total of 43 adult patients with OSA who were treated with CPAP were included in this retrospective study. Patients who underwent CPAP treatment for <5 days/week and <4 h/day were excluded. Blood parameters, including MPV and PDW, were recorded before CPAP treatment and at the third month of CPAP treatment. All patients underwent polysomnographic evaluation with full night polysomnography and in the second night CPAP titration was performed together with full night polysomnography and MPV and PDW values were statistically compared before and after CPAP treatment. Results: Apnea hypopnea index was significantly reduced, whereas oxygen saturation was significantly increased at CPAP titration night (p<0.001). The third month of CPAP treatment resulted in significantly low PDW (p=0.004) values, but MPV values did not change. Conclusion: PDW value at the third month of CPAP treatment revealed a significant improvement compared with the values before treatment; moreover, no change was observed in MPV values. It was concluded that in patients with OSA who were treated with CPAP, activation of platelets may result in recovery.Öğe Effects of septoplasty on olfactory function evaluated by the Brief Smell Identification Test: A study of 116 patients(Vendome Group Llc, 2017) Haytoglu, Suheyl; Dengiz, Ramazan; Muluk, Nuray Bayar; Kuran, Gokhan; Arikan, Osman KursatWe conducted a prospective study of 116 patients-61 men and 55 women, aged 17 to 64 years (mean: 26.4)- to investigate the effects of septoplasty on olfactory function in patients with septal deviation (SD). The Mladina classification system was used to define SD types, and olfactory function was assessed with the Brief Smell Identification test (BSIT). The BSIT, which includes 12 odorants, was administered preoperatively and at postoperative months I and 3. The most common SD types were types 2 (20.7% of patients) and 1 (19.0%), followed by types 3 and 5 (both 16.4%). At postoperative month 1, the mean BSIT score was significantly higher in men than in the women. For patients with types 1 and 2 SD, BSIT scores at 1 month were significantly lower than the scores preoperatively and 3 months postoperatively. For types 3 and 4, BSIT values were significantly higher at 3 months than preoperatively or at 1 month. For type 3 SD, the preoperative mean score was significantly lower than those for types 1, 4, 5, 6, and 7; for type 2 SD, the BSIT score was significantly lower than those of types 5 and 6 only. At 1 month, the scores for types 2 and 3 were significantly lower than those for types 4, 5, 6, and 7. At 3 months, the BSIT score for type 2 was significantly lower than those of types I, 3, 4, 5, and 6; the type 3 SD score at 3 months was significantly higher than those for types I, 2, 5, 6, and 7. We conclude that septoplasty surgery for patients with a type 3 SD may improve olfactory function. In contrast, we found that olfactory function in patients with a type 2 SD did not improve to a satisfactory degree, even when good nasal patency was achieved with a corrected septum and an enlarged intranasal volume. Our findings should be investigated further in future studies.Öğe Mean Platelet Volume Decreases in Adult Patients With Obstructive Sleep Apnea After Uvulopalatal Flap Surgery(Lippincott Williams & Wilkins, 2015) Simsek, Gokce; Haytoglu, Suheyl; Muluk, Nuray Bayar; Arikan, Osman Kursat; Cortuk, Mustafa; Kiraz, KemalAim:The main purpose of the study was to investigate changes in mean platelet volume (MPV) values in patients with obstructive sleep apnea syndrome (OSAS) who had undergone uvulopalatal flap (UPF) surgery.Method:The study included a review of the medical records of 37 adult patients who had undergone UPF surgery after being diagnosed with OSAS. The baseline blood parameters of patients, including the MPV and platelet distribution width (PDW) values, were measured and repeated 3 months after treatment. Polysomnographic evaluations of the patients were also performed during admission and the 3rd month control. Comparisons of MPV values and their correlation with polysomnographic parameters were the main outcomes measured.Results:The blood parameters of all patients were similar except for MPV values, which were significantly lower after treatment (P<0.001). Patients' apnea hypopnea index (AHI) and apnea episodes were significantly reduced after the UPF surgery, whereas their oxygen saturation significantly increased (P<0.001). The MPV values were not correlated with polysomnographic parameters (P>0.05).Conclusion:The UPF surgery, which is a relatively simple surgical intervention to treat OSAS, alleviates nocturnal hypoxic episodes and lowers platelet volume. These may both be important predictors of adverse cardiovascular outcomes related to OSAS.Öğe Relief of Pain at Rest and During Swallowing After Modified Cautery-Assisted Uvulopalatopharyngoplasty: Bupivacaine Versus Lidocaine(Lippincott Williams & Wilkins, 2015) Haytoglu, Suheyl; Arikan, Osman Kursat; Muluk, Nuray Bayar; Kuran, GokhanObjectives: We investigated the efficacy of bupivacaine, lidocaine, and saline infiltrations to peritonsillar region and uvula and soft palate regions for pain relief after tonsillectomy and modified cautery-assisted uvulopalatopharyngoplasty (MCAUP) in patients with obstructive sleep apnea. Methods: In this prospective study, 91 patients (32-65 years old) with obstructive sleep apnea underwent tonsillectomy and MCAUP and were divided into 3 groups. In group 1 patients (n = 31), 0.25% bupivacaine HCl + 1/200,000 epinephrine (10 mL); in group 2 patients (n = 31), 1% lidocaine HCl+1/200,000 epinephrine (10 mL); and in group 3 patients (n = 29), 0.9% saline (10 mL) were injected to peritonsillar region and uvula and soft palate regions. Operation duration, amount of bleeding, and analgesic requirement and visual analog scale for pain at rest and at swallowing were evaluated in all groups. Results: Mean body mass index values were between 27.0 and 27.3 kg/m(2) in all groups. Their apnea-hypopnea index values were between 15.3 and 16.9 per hour, and there were no significant differences between their body mass index and apnea-hypopnea index values. Duration of operation of patients in the bupivacaine group was significantly lower than that of patients in the lidocaine and saline groups. In addition, in the lidocaine group, operation duration was significantly lower than that in the saline group. Bleeding amount and postoperative analgesic requirement of the saline group were significantly higher than those of the bupivacaine and lidocaine groups. Although both these measures (operation duration and amount of bleeding) were statistically significant, a mean operating time of 44.3 versus 46.0 minutes and 64.4-mL versus 68.4-mL blood loss for the bupivacaine and lidocaine groups were clinically irrelevant and not too important. In terms of visual analog scale for pain at rest and/or swallowing, Bupivacaine provided more relief than lidocaine and saline injections. The lidocaine provides pain relief less than bupivacaine and more than saline at rest and/or swallowing. Conclusion: We recommend the use of bupivacaine injections in peritonsillar, uvular, and soft palate regions during tonsillectomy + MCAUP operations. It reduces operation duration and provides more pain relief postoperatively. When patients had cardiac problems, lidocaine may also be recommended because of its cardiac depressant and antiarrhythmic effects and positive effects for pain relief compared with saline injections.