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Öğe 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.Öğe Glioblastoma located in posterior fossa(2013) Bakar B.; Yazici I.; Kose E.A.; Ayva S.K.; Kasimcan M.O.A 63-year-old woman operated eight months ago for glioblastoma (GB) located in posterior fossa was admitted to emergency room for stuporous, nausea, vo-miting and headache. CT and MR showed recurrence of posterior fossa cystic-necrotic tumour without any other intracranial contrast enhancing lesion. Tumour was removed near totally. Perseverative cerebrospinal fluid (CSF) fistula from the incision was occurred and contaminated by multidrug resistant Acinetobacter ba-umannii. Two months after the tumour removal she was expired because of the septicaemia. GB located in posterior fossa is uncommon in both adults and child-ren; and it appears as two different subsets: de novo (primary type) and secondary glioblastomas. Although our patient's immunohistochemical findings werenot enough to demonstrate the tumour subset, we have thought that her tumour was de novo because of no other brain involvement, staining with GFAP, vimentin, and nearly absent p53 mutation.Öğe Posterior auricular muscle flap with otoplasty(Springer Berlin Heidelberg, 2013) Yazici I.In order to overcome some of the drawbacks of conchal reduction and to present another reliable prominent ear correction technique, the author has used the posterior auricular muscle. The purpose was to overcome the risks of conchal reduction surgery and to utilize the muscle combined with perichondrioplasty (perichondrial flap tacked posteriorly) for better results with repositioning. The author describes the technique of using the posterior auricular muscle flap in otoplasty. © Springer-Verlag Berlin Heidelberg 2013.Öğe The use of tissue expander in the management of staged proximal hypospadias repair: Report of case(2012) Çakmak M.; Vargel I.; Soyer T.; Çavuşoğlu T.; Yazici I.; Hançerlioğullari Ö.; Türkmen F.Multiple failed hypospadias reconstructions may cause minimal residual skin, as a result of extensive scarring. However, extragenital full thickness skin grafts or mucosal grafts are often used for urethral substitutions; local tissue expansion can provide additional matched skin, which can be easily harvested and used for penile constructions. Though tissue expanders were used as the choice of treatment in children with multiple failed hypospadias repairs, the use of tissue expander in the management of staged proximal hypospadais repair has not been reported previously. A 3-year-old boy with proximal hypospadias is presented to discuss the use of tissue expansion in the management of staged proximal hypospadias repair. © 2010 Springer-Verlag.
