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    Comparison of Three Tonsillectomy Techniques: Cold Dissection, Monopolar Electrocautery, and Coblation
    (Georg Thieme Verlag Kg, 2023) Kandemir, Suheyla; Pamuk, Ahmet Erim; Ozel, Gokce; Sencan, Ziya
    Introduction Tonsillectomy is among the most common otolaryngological surgeries. Objective To evaluate and compare three tonsillectomy techniques: cold steel dissection (CSD), monopolar electrocautery (MEC), and coblation. Methods The present study retrospectively reviewed the medical records of patients who underwent tonsillectomy between January 2014 and January 2016. Postoperative visual analog scale (VAS) pain scores, analgesic use, surgical duration, time to return to normal activity, and postoperative bleeding status were noted. Results The CSD group had less analgesic use and shorter return to normal activity than the MEC group ( p =0.037 and p <0.001, respectively). The coblation group had lower VAS pain scores than the MEC group only at 1hour to 4hours postsurgery ( p <0.016). The postoperative bleeding rate was similar in all groups ( p =0.096). Conclusion Cold steel dissection tonsillectomy is associated with less postoperative pain and shorter recovery than MEC. Coblation is better than MEC in terms of postoperative pain at 1hour to 4hours only, whereas CSD is associated with less postoperative pain than coblation at 2 days to 7 days.
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    Powered Micro-saw Versus Conventional Osteotome for Septorhinoplasty: A Prospective, Double-Blind, Comparative Study
    (Springer, 2023) Pamuk, Gozde; Pamuk, A. Erim; Kandemir, Suheyla
    Background Various powered instruments are used to perform osteotomy. A consensus on the best method has not been established due to discrepancies in previous studies. This study aimed to compare the conventional osteotome and a powered micro-saw during septorhinoplasty. Methods The single-center, prospective cohort study included 60 patients that were grouped into two groups of 30 each. Group 1 underwent open septorhinoplasty using a conventional osteotome, and group 2 underwent open septorhinoplasty using a powered micro-saw. Postoperative edema, ecchymosis, pain, and nasal blockage were compared between groups. Preoperative and postoperative (6 months) functional and aesthetic outcomes were compared based on FACE-Q, SNOT-22, and T-NOSE scores. Results There were not any differences in age, gender, follow-up duration, the Brinkman index, or level of education between groups. Postoperative pain scores were significantly lower in group 2 on d 1 and d 3 postsurgery. Nasal blockage scores were significantly higher in group 1 on d 3 and d 7 postsurgery. Edema and ecchymosis scores were similar in both groups at all time points. Preoperative and postoperative (6 months) functional and aesthetic outcomes were also similar in both groups. Conclusion Osteotomy using a powered micro-saw is an effective technique that results in less postoperative pain and nasal blockage than when using conventional osteotome. Early postoperative period edema and ecchymosis scores and long-term functional and aesthetic outcomes are similar when using a powered micro-saw and a conventional osteotome. Osteotomy using a powered micro-saw can be considered an alternative to using a conventional osteotome.
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    The Efficacy of Gabapentin plus Dexamethasone for Postoperative Analgesia Following Septoplasty: A Prospective Randomized Placebo-Controlled Trial
    (Sage Publications Inc, 2023) Kandemir, Suheyla; Pamuk, A. Erim; Ozel, Gokce; Gencay, Isin; Kilic, Rahmi
    Aims: This study aimed to compare the efficacy of gabapentin, dexamethasone, and gabapentin + dexamethasone for pain control after septoplasty. Materials and Methods: This prospective randomized trial included 120 patients that underwent septoplasty and were randomly divided into 4 groups: group G (preoperative gabapentin 600 mg p.o.); group D (intraoperative dexamethasone 8 mg i.v.); group GD (preoperative gabapentin 600 mg p.o. + intraoperative dexamethasone 8 mg i.v.); group C (placebo control). Results: The median VAS score was significantly lower in groups G and GD at 1, 2, 4, 6, 12, and 24 hours postsurgery than in group C (P < .008 for all). The median VAS score was significantly lower in group D than in group C at 1, 2, and 4 hours postsurgery (P < .008 for all). There weren't any significant differences in the VAS score between groups D, G, and GD at any time point. Groups G, D, and GD had a significantly lower frequency of rescue analgesic use than group C; however, there were no differences between groups G, GD, and C (P < .001 and P = .108, respectively). Conclusion: Gabapentin, dexamethasone, and gabapentin + dexamethasone are equally more effective analgesics during the first 4 hours postsurgery than placebo. The addition of dexamethasone to gabapentin does not provide extra analgesia. Both gabapentin and gabapentin + dexamethasone have a more prolonged analgesic effect than dexamethasone alone.