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Öğe Anterior palatoplasty for selected mild and moderate obstructive sleep apnea: preliminary results(Springer, 2014) Ugur, Kadriye Serife; Ark, Nebil; Kurtaran, Hanifi; Kizilbulut, Gultekin; Yuksel, Alper; Gunduz, MehmetThe aim of this prospective study was to evaluate the long-term efficacy anterior palatoplasty (AP) technique in treatment of patients with mild to moderate obstructive sleep apnea (OSA). Forty-two patients were diagnosed with mild to moderate OSA. Participants were treated with AP for mild or moderate OSA. Patients were evaluated with one night polysomnography before the surgery and 24 months after the surgery. Patients completed Epworth sleepiness scale (ESS), snoring VAS (visual analog scale) before and 24 months after the surgery. Forty two patients with a mean age of 39.2 +/- A 7.6 were included study. Success rate was 57.1 %. Total apnea-hypopnea index (AHI) values significantly decreased after 2 years (p < 0.025). Non-REM AHI and supine AHI values significantly decreased after 2 years (p < 0.025). The oxygen desaturation index changes significantly decreased after AP (p < 0.025). Snoring VAS values significantly decreased after AP (p < 0.025). ESS scores of patients significantly decreased (p < 0.001). We believe that AP is an effective, inexpensive technique for mild and moderate OSA patients.Öğe Comparing anterior palatoplasty and modified uvulopalatopharyngoplasty for primarysnoring patients: Preliminary results(2013) Uğur, Kadriye Şerife; Kurtaran, Hanifi; Ark, Nebil; Kizilbulut, Gultekin; Yüksel, Alper; Gündüz, MehmetObjectives: To evaluate and compare the long-term efficacy of modified uvulopalatopharyngoplasty (mUP3) and anterior palatoplasty (AP) techniques for treating snoring in a prospective clinical trial. Methodology: Patients with total apnea-hypopnea index values <5/per hour sleep were included in the study. Patients completed the Epworth sleepiness scale (ESS) and snoring visual analogue scale (VAS) before and 24 months after surgery, and a VAS for pain after the operation. Results: Twenty-four patients were in the mUP3 group with a mean age of 42.1 ± 11.8 years, and 26 in AP group with a mean age of 43.2 ± 10.4 years. Snoring VAS values were significantly decreased after surgery in both groups (p<0.025), but changes between operative groups were not statistically significant (p>0.05). Patients' ESS scores in both groups significantly decreased (p<0.025), but ESS score changes between groups were not significantly different (p>0.05). Two years postoperatively, patient satisfaction was 85% in the AP group, and 70% in the mUP3 group. Pain VAS values were significantly lower in the AP group than in the mUP3 group (p<0.001). Eight patients (33.3%) in the mUP3 group and one (7.7%) in the AP group reported nasal regurgitation of liquids upon swallowing during the first week postoperatively. Two years after the operation, 10 patients (41.6%) in the mUP3 group and 9 (34.6%) in AP group still had a lump sensation in the throat. Conclusions: We compared the efficacy of the mUP3 and AP techniques to treat patients with primary snoring and found less morbidity and more patient satisfaction in the AP group. © 2014 Elsevier B.V., All rights reserved.Öğe Giant Cell Reparative Granuloma in the Maxilla and Mandibula(Galenos Yayincilik, 2014) Akdere, Elif; Kurtaran, Hanifi; Ark, Nebil; Ugur, Kadriye Serife; Yuksel, Alper; Songur, Timur; Gunduz, MehmetGiant cell reparative granuloma is a disease with an unknown etiology, characterized of benign locally aggressive lesions invading mandible and maxilla in the head and neck region. These lesions usually present as a mass and cause deformities at bony structures. The use of various medical and surgical procedures in the treatment of the disease with its rare occurrence makes these lesions interesting. In this case report we present a 47 years old female patient who had a painful swelling in the left lower left jaw and oral cavity since 8 months. After her complaints proceeded despite medical therapy, she has been operated and pathology report confirmed a giant cell reparative granuloma. We also discuss differential diagnosis and the achievements in treatment procedures.Öğe Hearing loss after spinal anesthesia: A comparative prospective randomized cohort study(ARSMB-KVBMG aob.edit@skynet.be Avenue W. Churchill-laan 11/30 Brussels B-1180, 2016) Karabayirli, Safinaz; Uğur, Kadriye Şerife; Ayrim, Aylin; Demircioğlu, Rüveyda İrem; Ark, Nebil; Usta, Burhanettin; Kurtaran, HanifiObjective: In this comparative randomized cohort study, we aimed at evaluating the occurrence of sensorineural hearing loss after general and spinal anesthesia using both subjective and objective tests. Material and Methods: Fifty patients scheduled for elective cesarean section were approached, of which 21 patients received spinal anesthesia (group S), and 16 patients received general anesthesia (group G). In group S, a 27 G pencil point spinal needle was used. Pure tone audiometry and Distortion Product Otoacoustic Emissions (DPOAE) were performed before and 48 hours after surgery. Results: No between-group significant difference in pre and postoperative audiometric hearing threshold and pure tone average value were noticed, as well as in pre and postoperative DPOAE amplitude and signal-to-noise ratio (SNR). Conclusion: In this study, we did not observe any hearing loss after cesarean section under general or spinal anesthesia. Using the non-traumatic 27 gauge pencil point needle for performing spinal anesthesia does not seem to be associated with a risk of hearing loss, similarly to general anesthesia. © 2018 Elsevier B.V., All rights reserved.Öğe Letter to the Editor on Comparative Effectiveness of the Different Treatment Modalities for Snoring(Sage Publications Ltd, 2016) Ugur, Kadriye Serife; Dagli, Elif; Ark, Nebil; Kurtaran, Hanifi[Abstract Not Available]Öğe Long-term results of one staged multilevel surgery with tongue suspension surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea(Springer, 2016) Yuksel, Alper; Ugur, Kadriye Serife; Kizilbulut, Gultekin; Ark, Nebil; Kurtaran, Hanifi; Kaya, Mesut; Gunduz, MehmetThe objective of this study is to evaluate and compare the long-term efficacy of the one staged multilevel surgery (MLS) with tongue suspension (TBS) surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea (OSA). This is a prospective cross-sectional study. Setting: University hospital. Thirty-three patients diagnosed as moderate to severe OSA. Patients, with a parts per thousand yen50 % retropalopharyngeal obstruction on the Muller maneuver, were treated with palatal surgeries (PS) and patients, with a parts per thousand yen50 % retropalopharyngeal obstruction on the Muller maneuver with a parts per thousand yen50 % base of the tongue collapse, were treated with palatal surgeries and tongue suspension surgery (TBS). Patients were evaluated with one night polysomnography before the surgery and 24 months after the surgery. Patients completed Epworth sleepiness scale (ESS), snoring VAS (visual analog scale) before and 24 months after the surgery. Nine-teen patients with a mean age of 46.1 +/- A 8.3 underwent palatal surgeries (PS) and 14 patients with a mean age of 41.4 +/- A 8.9 underwent PS plus TBS. Success rate in TBS+PS group was 57.1 % and in PS group was 42.1 %. In both groups total apnea-hypopnea index (AHI) values significantly decreased after 2 years (p < 0.025) but there was no statistically significant difference between TBS+PS and PS groups. Supine AHI levels were reduced statistically significant in both groups postoperatively (p < 0.025). There was not any significant difference postoperatively in non-supine AHI levels in both groups (p > 0.025). There were significant postoperative changes in ODI, AVO2, MOS, ESS, Snoring VAS values in PS group (p < 0.025). In TBS+PS group there was a significant difference postoperatively only in ODI values. Treatment of OSA patients with retropalatal or retropalatal and retroglossal obstruction, in a one staged surgery, is a safe and easy procedure. We have achieved favorable long-term outcomes in moderate-severe OSA patients undergoing both palatal surgery and tongue suspension surgery.Öğe Natural and easily accessible sinonasal care product, virgin olive oil: A prospective controlled clinical trial(Acta Medica Mediterranea, 2015) Kankılıç, Ekrem Said; Kurtaran, Hanifi; Yüksel, Alper; Ark, Nebil; Uğur, Kadriye Şerife; Yildirim, Yusuf; Kurt, KenanIntroduction: We aimed to investigate the efficiency of virgin olive oil for postoperative nasal care in patients who underwent sinonasal surgery. Materials and methods: Forty patients who underwent sinonasal surgery were prospectively randomized into two groups (Groups S, the study group, and C, the control group). In both groups, isotonic saline was applied to both nasal cavities, and subsequently, virgin olive oil was applied to a random nasal cavity in the study group during the postoperative period. Patients were examined at postoperative day 2, 7, and 15, and crusting and wound healing were evaluated. Patient nasal comfort was assessed using the Visual Analogue Scale (VAS). Results: When the groups were evaluated for crusting, wound healing, and the VAS, the results for Groups S and C were significantly different. The VAS scores were statistically significant in Group S compared with Group C only on postoperative day 15. Crusting was statistically significant on the Group S compared with Group C on postoperative days 2 and 15. Wound healing was statistically significant in Group S compared with Group C only on postoperative day 15. Conclusion: We have demonstrated that the benefit of using virgin olive oil after sinonasal surgery. Olive oil was found to be effective for increasing patient comfort, decreasing crusting, and accelerating wound healing. © 2020 Elsevier B.V., All rights reserved.Öğe NATURAL AND EASILY ACCESSIBLE SINONASAL CARE PRODUCT, VIRGIN OLIVE OIL: A PROSPECTIVE CONTROLLED CLINICAL TRIAL(Carbone Editore, 2015) Kankilic, Ekrem Said; Kurtaran, Hanifi; Yuksel, Alper; Ark, Nebil; Ugur, Kadriye Serife; Yildirim, Yusuf; Kurt, KenanIntroduction: We aimed to investigate the efficiency of virgin olive oil for postoperative nasal care in patients who underwent sinonasal surgery. Materials and methods: Forty patients who underwent sinonasal surgery were prospectively randomized into two groups (Groups S, the study group, and C, the control group). In both groups, isotonic saline was applied to both nasal cavities, and subsequently, virgin olive oil was applied to a random nasal cavity in the study group during the postoperative period. Patients were examined at postoperative day 2, 7, and 15, and crusting and wound healing were evaluated. Patient nasal comfort was assessed using the Visual Analogue Scale (VAS). Results: When the groups were evaluated for crusting, wound healing, and the VAS, the results for Groups S and C were significantly different. The VAS scores were statistically significant in Group S compared with Group C only on postoperative day 15. Crusting was statistically significant on the Group S compared with Group C on postoperative days 2 and 15. Wound healing was statistically significant in Group S compared with Group C only on postoperative day 15. Conclusion: We have demonstrated that the benefit of using virgin olive oil after sinonasal surgery. Olive oil was found to be effective for increasing patient comfort, decreasing crusting, and accelerating wound healing.Öğe Surgical conditions during FESS; comparison of dexmedetomidine and remifentanil(Springer, 2017) Karabayirli, Safinaz; Ugur, Kadriye Serife; Demircioglu, Ruveyda Irem; Muslu, Bunyamin; Usta, Burhanettin; Sert, Huseyin; Ark, NebilTo compare dexmedetomidine with remifentanil in functional endoscopic sinus surgery (FESS) in regards to intra-operative bleeding, anesthetic consumption and post-operative recovery. Randomized, double blind study. Tertiary care medical center. Fifty patients with nasal polyposis who had been scheduled for FESS were randomly divided into two groups. In group D (n = 25), dexmedetomidine 1 A mu g/kg infused intravenous (IV) over 10 min before anesthesia induction, followed by a continuous of 0.7 A mu g/kg/h infusion during operation. In group R (n = 25), 1 A mu g/kg remifentanil IV bolus, was administered with induction of anesthesia and continued 0.25-0.50 A mu g/kg/min during operation. Heart rates, mean arterial pressure, end tidal CO2, end tidal sevoflurane were recorded. The amount of bleeding, surgical field condition for bleeding and the time to reach Aldrete recovery score 9-10 were recorded. Postoperative nausea, vomiting, pain, shivering, sedation were followed up over 24 h. There was no significant difference between groups according to the amount of bleeding during surgery, assessment of surgical field condition, consumption of sevoflurane, scores of postoperative VAS, rates of nausea and vomiting, shivering, demands of additional analgesic medication (P > 0.05). The time to reach Aldrete recovery score 9-10, sedation scores at the postoperative first hour were significantly higher in group D (P = 0.001). We concluded that in comparison to remifentanil, dexmedetomidine during FESS for controlled hypotension is of limited value as it has no additional benefits in terms of control of hypotension and amount of bleeding in the surgical field and it is associated with higher recovery time and first-hour postoperative sedation scores.Öğe The comparison of preincisional peritonsillar infiltration of ketamine and tramadol for postoperative pain relief on children following adenotonsillectomy(Elsevier Ireland Ltd, 2013) Ugur, Kadriye Serife; Karabayirli, Safinaz; Demircioglu, Ruveyda Irem; Ark, Nebil; Kurtaran, Hanifi; Muslu, Bunyamin; Sert, HuseyinObjective: To investigate and compare the effectiveness of preincisional peritonsillar infiltration of ketamine and tramadol for post-operative pain on children following adenotonsillectomy. Study design: Prospective randomized double blind controlled study. Methods: Seventy-five children aged 3-10 years undergoing adenotonsillectomy were included in study. Patients received injections in peritonsillar fossa of tramadol (2 mg/kg-2 ml), ketamine (0.5 mg/kg-2 ml) or 2 ml serum physiologic. During operation heart rate, oxygen saturation, average mean blood pressures were recorded in every 5 min. Operation, anesthesia and the time that Alderete scores 9-10, patient satisfaction, analgesic requirements were recorded. Postoperatively nausea, vomiting, sedation, dysphagia, bleeding scores were recorded at 0, 10, 30, 60 min and 2, 4, 8, 12, 18, 24 h postoperatively. Pain was evaluated using modified Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS) at fixed intervals after the procedure (15 min and 1, 4, 12, 16, and 24 h postoperatively). Results: The recordings of heart rate, mean arterial pressure, nausea, vomiting, sedation and bleeding scores were similar in all groups (p > 0.05). The mCHEOPS scores at 10 min, 30 min, 1 h, 8 h were significantly lower in both tramadol and ketamine group when compared with control (p < 0.05). Use of additional analgesia at 10 min and 18 h were higher in control group than ketamine, tramadol group (p < 0.05). Dysphagia scores were significantly lower for both ketamine and tramadol group when compared with control group (p < 0.05). mCHEOPS, additional analgesia, dysphagia, patient satisfaction scores were similar in tramadol, ketamine groups (p > 0.05). Conclusions: Preincisional injection of ketamine and tramadol prior to tonsillectomy is safe, effective method and equivalent for post-tonsillectomy pain, patient satisfaction, postoperative nausea, vomiting, dysphagia. (C) 2013 Elsevier Ireland Ltd. All rights reserved.Öğe The effect of different nasal irrigation solutions following septoplasty and concha radiofrequency: a prospective randomized study(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2018) Kurtaran, Hanifi; Ugur, K. Serife; Yilmaz, Ceyda Sel; Kaya, Mesut; Yuksel, Alper; Ark, Nebil; Gunduz, MehmetIntroduction: Nasal irrigation solutions are widely used following endonasal surgery. These irrigation solutions remove infective debris and crusts, reducing the probability of synechia formation, and accelerate mucosal healing. Objective: The aim of the present study was to compare the effects of nasal irrigation solutions with different contents following septoplasty and concha radiofrequency. Methods: The present study was a prospective, randomized, controlled simple blind study of 120 patients who underwent septoplasty and bilateral concha radiofrequency. Patients were divided into four groups according to the nasal irrigation solution used: tap water, buffered isotonic saline, saline with xylitol, and hypertonic sea water. Patients were examined on the 7th and 15th postoperative days. A saccharine test was applied to determine mucociliary activity preoperatively and on the 7th and 15th postoperative days. Patients were asked about drying and obstruction using a 10 cm visual analog scale. In addition, patients were examined to determine the crusting score. Results: There was no significant difference found in the preoperative and 7th and 15th postoperative days' mucociliary clearance times among the four groups. The crusting score was found to be significantly lower in the hypertonic sea water group (p < 0.001). Drying and obstruction on the 7th and 15th postoperative days were found to be significantly more comfortable in the hypertonic sea water group (p < 0.001). Conclusion: Hypertonic sea water is the recommended irrigation solution, as it is associated with Less crusting, drying, and obstruction in the nose for the postoperative period following septoplasty and concha radiofrequency. (C) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.
