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Öğe A Comparison of Fas-Fas Ligand Mediated Apoptosis with Clinical and Pathological Parameters in Larynx Cancers; Twenty Years After Laryngectomy(2022) Bilgili, Ahmet Mert; Ersözlü, TolgaObjective: Larynx cancer constitutes 2% of all cancers in adults with 96% of larynx malignancies being squamous cell carcinoma (SHC). Apoptosis is a cell death mechanism that is quite different from necrosis. It is also known as programmed cell death, physiological cell death, or cell suicide. Physiological mediators that activate programmed cell death (apoptosis) are Fas and Fas Ligand (FasL). Materials and Methods: In a thesis study conducted by our authors in 2004, we investigated the relationship of Fas-Fas ligand-mediated apoptosis with survival in laryngeal cancer, prognostic factors (age, localization, histological grade, tumor size, lymph, blood vessel invasion), stage, and inflammatory response of the tumor. In this study, we investigated the relationship between survival and death rates after 20 years and Fas-FasL. Results: When FAS was evaluated 20 years later, a statistically significant difference was found between mortality rates depending on stage (p=0.023; p<0.05). While the survival rate is higher in stage 1 cases, the rate of death is higher in stage 3 cases. No statistically significant difference was found between mortality rates according to stages for FAS Ligand 20 years later (p>0.05). Conclusion: In conclusion, we found that the Fas/Fas-L system was not associated with clinical parameters in laryngeal cancers in our short-term follow-up. However, when we repeated our follow-up 20 years later, we found that Fas system deficiency, although not in FAS Ligand, adversely affected survival in the long term in laryngeal cancer patients.Öğe A Comparison of the Autologous Platelet-Rich Plasma Gel Fat Graft Myringoplasty and the Fat Graft Myringoplasty for the Closure of Different Sizes of Tympanic Membrane Perforations(Sage Publications Inc, 2020) Ersözlü, Tolga; Gültekin, ErdoğanObjective: We aimed to evaluate the effect of autologous platelet-rich plasma gel (PRPG) on fat graft myringoplasty (FGM) in tympanic membrane perforations caused by chronic otitis media. Methods: This retrospective study involved 63 patients who underwent operations between 2015 and 2018. Fat graft myringoplasty was performed with the transcanal approach with and without the use of PRPG in the surgical field. The patients were classified into 2 groups: group A, which included 32 patients who underwent FGM with the use of autologous PRPG, and group B, which included 31 patients who underwent FGM alone. Tympanic membrane perforations were divided into 2 groups: small perforations (1-2 mm) in a single quadrant and large perforations (2-4 mm) in at least 2 quadrants. Results: Both groups were statistically matched regarding age and sex. The mean postoperative follow-up was 11.6 and 12.1 months for groups A and B, respectively. Four months postoperatively, the success rate of the graft in group A (100%) was significantly higher than that in group B (83.8%; P = .03). The preoperative and postoperative median air-bone gaps of the groups were similar (P = .653 and P = .198, respectively). No worsening of the air-bone gap was noted postoperatively in either group. Conclusions: This study demonstrated that autologous PRPG application during FGM allows for a higher success rate than FGM alone. Furthermore, the use of PRPG with FGM for large perforations increases the success rate. Further studies are needed to investigate the PRPG healing effect on other tympanic membrane perforation closure techniques.Öğe A New Instrument For Rhinoplasty: the Osteotom With Lighting Guide Transilluminating Osteotomy(Sage Publications Inc, 2020) Ersözlü, TolgaRhinoplasty remains one of the most commonly performed aesthetic surgical procedure that demands a meticulous intraoperative precision as well as maximum precaution and control. Nasal osteotomy is a key component to shape the bony vault in aesthetic rhinoplasty, but it is also the so versatile, dangerous, and difficult to learn. The present study aims to evaluate the usefulness of our locator instrument for beginners which is called transilluminating osteotome. The use of transilluminating osteotome instead of guided lateral nasal osteotome is a reliable instrument since it facilitates the localization of osteotome and osteotomy line beneath the soft tissue with a limited damage to the surrounding soft tissues. Level of Evidence: IIIÖğe Are fungi and EBV effective in cholesteatoma etiology?(2022) Karabağ, Sevil; Ersözlü, Tolga; İsal Arslan, AyşegülAim: Cholesteatoma is a commonly seen disease whose pathogenesis remains unknown. Although not a neoplastic process, it may progress to a fatal condition with local bone destruction. In this study, we aimed to present new insights concerning the etiology of cholesteatoma triggered by an inflammatory process.Materials and Methods: The study included 34 patients diagnosed with cholesteatoma upon mastoidectomy performed between 2011-2019. Due to a provisional diagnosis of cholesteatoma. The cases were investigated for the latent membrane protein (LMP-1) encoded by the Epstein-Barr Virus (EBV) using the immunohistochemical method and for the presence of fungi using Grocott’s methenamine silver (GMSII) stain.Results: No fungi was detected in any of the 34 patients by GMSII staining. Thirty-two of the 34 patients were negative with but a suspicious result was seen in 2 patients with the immunohistochemical EBV antibody. EBV-encoded RNA (EBER) analysis was applied to these 2 cases with the silver in situ hybridization method and no reaction was observed.Conclusion: In our study, we investigated the presence of fungi and EBV, which can trigger the inflammatory process. However, no EBV or fungi was detected in the tissues. Our study is the first to investigate the presence of EBV and fungi in formalin-fixed tissue in cases of aggressive cholesteatoma.Öğe Can Ultrasound-Guided Regional Anesthesia Techniques For Tracheostomy Be An Alternative To General Anesthesia?(Sage Publications Inc, 2021) Şahin, Ayhan; Baran, Onur; Gültekin, Ahmet; Gücer Şahin, Gülcan; Ersözlü, Tolga; Arar, Makbule CavidanIntroduction The cervical plexus block (CPB) has been used for a long time for both analgesia and anesthesia in carotid endarterectomy and thyroid operations. To be unfamiliar with the technique and its perceived difficulty, potential risks, and possible adverse effects such as intravascular injection has limited broader use before the practical use of ultrasound. We hypothesize that the cervical plexus block can provide adequate anesthesia in tracheostomy cases and provide excellent anesthesia comfort when combined with a translaryngeal block. Methods This double-blinded, randomized 29 patients undergoing primary tracheostomy operation to receive either CPB (Group S) or CPB with translaryngeal block (Group ST). The primary outcome was cumulated analgesic consumption during the first 24 postoperative hours. Secondary outcomes were as follows: pain related to incision, patient tolerance as assessed by tracheostomy cannula comfort score, cough and gag, pain at rest, nausea and vomiting, and time to first analgesic demand. Results The patient tolerance for tracheostomy was higher in Group ST than Group S. The median tracheostomy cannula comfort score was 4.0 in Group S. In contrast, the median score was significantly lower in group ST (P<.001). The cough and gag reflex scores were significantly lower in Group ST than Group S (1.0 vs 4.0, P<.001). Conclusion This trial supported the hypothesis that the CPB combined with the translaryngeal block yields excellent anesthesia for tracheostomies. The technique we briefly described, in a way, is the equivalent of awake fiberoptic intubation to awake tracheostomy with minimal sedation adjusted according to airway patency.Öğe Effects of Silicone Nasal Septal Splints and a Polyvinyl Alcohol Sponge After Septoplasty on Postoperative Pain and Pain During Pack Removal(Aves, 2018) Ersözlü, Tolga; Çakmak, AdemObjective: To compare silicone nasal septal splints with integral airway and a polyvinyl alcohol (PVA) sponge after septoplasty in terms of patient comfort (both with the pack in place and during removal) and postoperative complications. Methods: This study involved 169 patients who underwent septoplasty without additional nasal procedures due to nasal septal deviation. They were allocated into two groups. Group A comprised 90 patients who underwent septoplasty and who were packed with silicone nasal septal splints. Group B comprised 76 patients who underwent septoplasty and who were packed with a PVA sponge. They were removed on the second postoperative day. Patients were asked to record pain levels using a visual analog scale (VAS). Results: The patients in the groups had similar mean ages: 29.77 years (range, 19-74 years) and 23.77 years (range, 21-37 years) in Group A and Group B, respectively (p>0.05). VAS scores were significantly lower in Group A than in Group B at the 1st, 2nd, 4th, 8th, 12th, 24th, 48th, and 72nd postoperative hours (p<0.0001). There were significantly higher pain levels associated with PVA sponge pack removal than with silicone nasal septum splint removal (average pain scores: 3.57 vs. 1.99, respectively; p<0.05). Conclusion: Intranasal septal splints with integral airway result in less postoperative pain during removal without increasing postoperative complications; thus, they can be used as an effective alternative to PVA sponge packing after septoplasty.Öğe Evaluation of Serum Endocan Levels in Sensorineural Hearing Loss(Aves, 2019) Gültekin, Erdoğan; Ersözlü, Tolga; Demirel, Oral Burak; Kaymaz, Özlem; Topçu, Birol; Çiftçi, ZaferOBJECTIVES: The aim of this study was to reveal the possible role of endothelial dysfunction in sensorineural hearing loss (SNHL) by determining the serum endocan levels of patients with varying degrees of SNHL. MATERIALS and METHODS: Patients with documented SNHL and healthy controls were included in the study, whereas those with a known history of chronic inflammatory condition were excluded. In addition, a recent history of use of glucocorticoids, nonsteroid anti-inflammatory drugs, or any ototoxic medications was also considered as an exclusion criterion due to its potential impact on endocan synthesis and metabolism. Following overnight fasting, blood samples were collected, and serum endocan levels were measured. For statistical analysis of the data, PASW Statistics for Windows version 18 was used. RESULTS: The comparison of the subgroups yielded no statistically significant difference between the control and mild-to-moderate SNHL groups. Despite the increase in hearing loss, the difference between the endocan levels in these patients did not increase proportionately and was not statistically significant (p>0.05). The patients in the severe SNHL group had a higher level of serum endocan than those in other groups, and the difference was statistically significant (p<0.05). CONCLUSION: The serum endocan levels failed to show a proportionate increase with increasing degree of SNHL, indicating that there is no precise association between SNHL and serum endocan levels. The serum endocan levels of patients with SNHL did not significantly differ from those of the healthy controls.Öğe Evaluation of the changes in the hearing system over the years among patients with OSAS using a CPAP device(Taylor & Francis Ltd, 2020) Deniz, Mahmut; Ersözlü, TolgaObjective To evaluate whether patients using a continuous positive airway pressure (CPAP) device for obstructive sleep apnea syndrome (OSAS) have improvement or deterioration in their auditory systems. Methods Charts of OSAS patients who were followed up at the ENT clinic were retrospectively reviewed starting from 2018. The hearing tests performed at least 2 years before and after CPAP use in patients were compared with themselves and with the test results of patients with no CPAP use. Results No improvement in the hearing system on the patients using a CPAP device was detected. Deterioration in hearing was detected in 13.63% and 9.09% of the patients with and without CPAP use, respectively. No statistically significant difference was found between the two groups. Conclusion The use of a CPAP device does not affect hearing positively or negatively.Öğe Evaluation of the Hearing System in Chronic Obstructive Pulmonary Disease Patients(2021) Demirel, Oral Burak; Ersözlü, Tolga; Deniz, MahmutAim: This study aimed to examine the effect of chronic hypoxemia on auditory functions in chronic obstructive pulmonary disease (COPD) patients.Materials and Methods: Sixty patients who had pulmonary function test (PFT) and diagnosed with COPD were included in the study. Four studygroups and a control group were created in the study. Each study group was determined based on forced expiratory volume (FEV1) and FEV1/forcedvital capacity (FVC) ratio. Groups consisted of mild, moderate, severe and very severe COPD patients. Each group included 15 patients. The controlgroup consisted of 30 patients with an FEV1/FVC ratio of >70%. All patients underwent pure tone audiometry and otoacoustic emission (OAE) test.Results: According to the audiological evaluation, a statistically significant difference was found between the severe and very severe group andthe control group (p<0.01).Conclusion: The results of the present study showed that auditory mechanisms may also be affected in patients with severe and very severe COPD.The authors of this study argue that necessary measures should be taken in the early stages of the disease for COPD patients to prevent the negativeeffects of chronic hypoxemia on the auditory system.Öğe Namık Kemal Üniversitesi Sağlık Uygulama Ve Araştırma Merkezinde Tıbbi Sekreterlik Hizmetlerinde Çalışan Personelin Bilgisayar Kullanma Bilgi Düzeyleri(Namık Kemal Üniversitesi, 2018) Ersözlü, Tolga; Çitak, Elif Eren; Aydoğdu, Deniz Zerrin; Boztepe, Nur; Dilek, Filiz; Bulut, YücelBu çalışma, sağlık kurumlarında tıbbi sekreterlik hizmetlerinde çalışan personelin bilgisayar kullanma bilgi düzeyi ve etkili faktörleri belirlemek amacıyla planlanmıştır. Tanımlayıcı tipteki araştırmada örneklemi, Namık Kemal Üniversitesi Sağlık Uygulama ve Araştırma Merkezi tıbbi sekreterlik hizmetlerinde çalışan, araştırmaya katılmaya gönüllü 250 kişi oluşturmuştur. Araştırmada, ölçüm aracı olarak araştırmacılar tarafından geliştirilmiş, bireylerin sosyo-demografik özelliklerini ve bilgisayar kullanma bilgi düzeylerini belirleyen anket formu kullanılmıştır. Çalışmanın sonuçları ortalama±standart sapma ve yüzde olarak belirtilmiştir. Çalışanların yaş ortalaması 32.31±6.91, %87.2’sikadın, %60’ı üniversite, mezunudur. Çalışanların %68’i hizmet içi eğitim almakla birlikte %32.35’i aldıkları eğitimin yetersiz olduğunu belirtmiştir. Çalışanların %58.8’i F klavye, %65.6’sı klavyede 10 parmak tekniği bilmemektedir. %67.7’si bilgisayara program kurup kaldırabilmekte, %57.2’si virüs, %26’sı ICD sınıflama sistemini kullanabilmektedir. Tıbbi dokümantasyon sisteminden sorumlu tıbbi sekreterlerin bilgisayar kullanma bilgi düzeylerinin yeterli olmadığı belirlenmiştir. Hizmet içi eğitimlerle desteklenmesi önerilmektedir.Öğe Nazal Kavite Yerleşimli Renal Hücreli Karsinom Metastazı(2019) Karabağ, Sevil; Öznur, Meltem; Arslan, Ayşegül; Ersözlü, TolgaRenal hücreli karsinom, erişkin neoplazilerinin %3’ünü oluşturan agresif bir tümördür. En sık metastaz yaptığı yerler akciğer, adrenal, barsak, beyin ve intraabdominal organlardır. Bunun yanı sıra literatürde kalp, mesane, meme, tonsil ve tiroide yerleşen metastaz olguları bildirilmiştir. Bu yazıda bir nazal kavite yerleşimli renal hücreli karsinom metastazı olgusunu, nazal obstrüksiyon ve epistaksis görülen ve renal hücreli karsinomu olan hastalarda metastaz olasılığının akılda tutulmasını vurgulamak amacıylasunduk.Öğe Otorhinolaryngology practices during the COVID-19 pandemic(Aves, 2021) Deniz, Mahmut; Ersözlü, TolgaThe COVID-19 epidemic, caused by SARS-CoV-2, broke out in December 2019 in the province of Wuhan, China. On March 12, 2020, the World Health Organization declared the COVID-19 outbreak as a pandemic. Although typical symptoms of the disease include fever, dry cough, and shortness of breath, complaints such as anosmia and dysgeusia also occur. The swab polymerase chain reaction tests, which were taken from the nasopharynx, became negative among asymptomatic individuals from the third day onward, whereas virus positivity was still detected among symptomatic individuals from the 12th to 20th days. Risk factors such as chronic diseases increase the rate of acute respiratory distress syndrome during COVID-19. It has been reported that the virus is transmitted more commonly through the contact of respiratory secretions. Thus, it has been reported that there is an increased risk of virus transmission particularly to physicians who are frequently exposed to aerodigestive secretions, such as otorhinolaryngologists, gastroenterologists, pneumologists, dentists, speech therapists, ophthalmologists, and infectious diseases physicians. Promising results have been reported from vaccine development studies currently in process. Although in some countries, vaccinations have been almost completed, there are a few countries where it has not started yet. Therefore, it is believed that it will take months or years for vaccines to be produced, distributed, and reach all people worldwide. During this period, it is our aim to protect our patients. hospital teams, and ourselves by examining and assessing the experiences of our international colleagues.Öğe Parotidektomi Yapılan Olguların Histopatolojik ve Cerrahi Sonuçları: Tek Merkez Deneyimi(2020) Sapmaz Karabağ, Sevil; Ersözlü, TolgaAmaç: Bu çalışmanın amacı parotidektomi yapılan 67 hastanın yaş, cinsiyet, pre-operatif ince iğne aspirasyon sitolojisi ve insizyonel biyopsi tanı, uygulanan cerrahi işlem ve histopatolojik sonuçlarını retrospektif olarak değerlendirmektir. Materyal ve Metot: Çalışmaya Tekirdağ Namık Kemal Üniversitesi Tıp Fakültesi ‘nde farklı lezyonlar sebebiyle 2011-2019 yılları arasında opere edilen 67 parotidektomi hastası dahil edilmiştir. Hastaların yaş, cinsiyet, ince iğne aspirasyon sitolojisi ve biyopsi sonuçları ile ameliyat şekli ve ameliyat sonrası histopatolojik sonuçları ve tümör boyutları değerlendirilmiştir. İnce iğne aspirasyon sitolojisi ve insizyonel biyopsi sonuçları histopatolojik verilerle kıyaslanarak bu yöntemlerin etkinliği karşılaştırılmıştır. Bulgular: Altmışyedi hastanın parotidektomi sonuçlarına göre 58’i(%86,5) benign(Pleomorfik adenom, Whartin, Sebase lenfadenom, Siyalolitiyazis), dokuzu(%13,5) malign tanı almıştır. Altmışyedi hastadan ameliyat öncesi 20’sine ince iğne aspirasyon sitolojisi ve 25’ine insizyonel biyopsi uygulanmıştır. İİAS uygulanan 20 hastadan 16’sı(%80) tanısal, dördü tanısal değildir. İnsizyonel biyopsi uygulanan 25 hastadan 21’i(%84) tanısal, dördü tanısal değildir. Sonuç: Parotiste meydana gelen tükrük bezi tümörlerinin %80’i benign karakterdedir. Bu benign tümörlerin de çoğunluğu (%61-90) pleomorfik adenomdan oluşmaktadır. Bizim çalışmamızda da literatürdekine benzer şekilde parotidektomi olgularımızn %86,5’i benign tümörlerdir. Bu benign olgularımızın %52’si pleomorfik adenom, ikinci sıklıkta görülen benign tümör ise whartin olup benign tümörlerin %43’ünü oluşturmaktadır.Öğe Rhinolith in the concha bullosa as a rare location: a case report(Sage Publications Ltd, 2020) Ersözlü, Tolga; Gültekin, ErdoğanThe presence of a rhinolith is a rare condition, which can cause long-standing symptoms, such as rhinorrhea, foul-smelling discharge, nasal obstruction, and headache. A rhinolith is usually easily diagnosed by a clinical examination and a paranasal computed tomographic scan. Rhinoliths are usually found in nasal cavities, but rare locations are also possible. We report a patient who was evaluated in our clinic for nasal obstruction, headache, and snoring symptoms. A clinical examination showed no major findings, but a paranasal computed tomographic scan of coronal sections showed a hyperdense mass within the right concha bullosa. A rhinolith in the concha bullosa is a rare condition. Our case is the third case of a rhinolith in the concha bullosa to be reported in the literature.Öğe The Effect of EGFR, P16 and Ki67 Expression on Prognosis in Head and Neck Squamous Cell Carcinoma(2022) İsal Arslan, Ayşegül; Ersözlü, Tolga; Karabağ, SevilObjective: HPV and EGFR expression status may be utilized as an independent prognostic factor owing to the different clinical and demographic characteristics head and neck cancers. In the study, it was aimed to investigate the association between EGFR, p16 and ki67 expression and survival in patients with head and neck squamous cell carcinoma (SCC).Materials and Methods: A total of 43 patients with SCC of the head and neck region were included in the study. EGFR, p16 and Ki67 were examined by means of immunohistochemistry. The association between these markers and survival was investigated.Results: EGFR expression was detected in 14 cases (32.5%), Staining with p16 was positive in 20 cases (46.5%). Mean duration of follow up was 32 months. There was a statistically significant difference between ki67 proliferation indices of patients who survived and those who died (p=0.037). Survival was significantly shorter in EGFR positive patients compared to those negative for EGFR expressions (p=0.037). Mean survival was 30 months in the 20 p16 positive patients and 33.5 months in p16 negative patients (p=0.847).Conclusion: This study supports that EGFR and Ki67 may be important markers to predict prognosis and survival in patients with head and neck SCC.Öğe The evaluation of auditory system in obstructive sleep apnea syndrome (OSAS) patients(W B Saunders Co-Elsevier Inc, 2016) Deniz, Mahmut; Çiftçi, Zafer; Ersözlü, Tolga; Gültekin, Erdoğan; Alp, RecepObjective: The authors of the present study aimed to investigate the impact of hypoxemia on the auditory functions of OSAS patients and discussed their findings under the scope of the existing literature. Materials and methods: 160 patients who underwent a polysomnographic analysis for the diagnosis of possible sleep disordered breathing between January 2015 and December 2015 were enrolled in this study. Polysomnography tests were conducted at the sleep laboratory of the department of neurology at the same institute. Comprehensive otorhinolaryngological examinations of all participants were conducted by the same senior otorhinolaryngologist. Three study groups and a control group were designated in the study. Each study group was designated according to the severity of the apnea hypopnea index (AHI) and blood oxygen saturation values of the participants. All participants underwent pure tone auditometry and otoacoustic emission testing (OAE). Statistical data analysis was performed using SPSS for Windows, version 17 (SPSS Inc., Chicago, IL, USA). Results: Audiological assessment of the patients revealed that all patients in the control group and in mild OSAS group had normal hearing thresholds (lower than 26 dB). However, the patients who had moderate and severe OSAS had varying degrees of sensorineural hearing losses. As far as body mass indexes are concerned, statistically significant differences were observed among the groups (p = 0.038). Conclusion: There is convincing evidence that the risk of progressive dysfunction in vascular and neural structures of the body is inevitable for the Patients who suffer from a chronic hypoxemic condition secondary to OSAS. The findings of the present study indicated auditory transduction and transmission mechanisms may also be affected in moderate and severe OSAS patients. Therefore, via taking necessary steps in preventing hypoxemia at the outset, OSAS patients may be protected from the long term detrimental effects of chronic hypoxemia on the auditory system. (C) 2016 Elsevier Inc. All rights reserved.Öğe The Impact of Scroll Ligament Preservation on Nasal Airway Patency in Rhinoplasty: An Objective Study with Rhinomanometry and Acoustic Rhinometry(Springer, 2024) Agdoğan, Özgür; Ersözlü, TolgaBackground: Rhinoplasty is a critical surgical intervention aimed at enhancing nasal form and function. However, traditional approaches often compromise the integrity of nasal scroll ligaments, vital for the functionality of the internal nasal valve, leading to potential postoperative nasal dysfunction. Despite the importance of scroll ligaments in maintaining nasal structure and function, the literature lacks objective, quantifiable evidence of their role. This study sought to objectively compare nasal functionality and anatomy between patients undergoing rhinoplasty with bilateral preservation of scroll ligaments and those with bilateral sacrifice of these ligaments, employing computerized rhinomanometric and acoustic rhinometric measurements as evaluative tools. Methods: This retrospective, double-blind study was conducted at Tekirdağ Namık Kemal University's Plastic Reconstructive and Aesthetic Surgery and Ear, Nose, and Throat Clinics. The study population comprised patients who underwent rhinoplasty between May 1, 2018, and October 1, 2019. Patients were rigorously selected based on their medical history, including previous nasal surgeries, aesthetic dissatisfaction, and minimal nasal septum deviation. They were then categorized into two distinct groups: one undergoing rhinoplasty with an emphasis on preserving the scroll ligaments (n = 31) and the other where these ligaments were intentionally sacrificed (n = 30). A comprehensive analysis involving preoperative and six-month postoperative computerized rhinomanometry and acoustic rhinometry measurements was conducted to assess the surgical impact on nasal functionality and structure. The statistical comparison focused on evaluating the changes in air pressure and airflow rates, aiming to delineate the functional outcomes attributable to the differing surgical techniques. Results: Our findings reveal a stark contrast in postoperative nasal functionality between the two groups. In the group with preserved scroll ligaments, there was a significant improvement in postoperative computerized rhinomanometric measurements, indicating enhanced nasal airflow and reduced airway resistance. Conversely, the group with sacrificed scroll ligaments exhibited deteriorated postoperative outcomes, with increased nasal airway resistance and decreased airflow. These differences underscore the pivotal role of scroll ligaments in maintaining nasal airway patency and functionality. Conclusion: The study unequivocally demonstrates that the preservation of scroll ligaments during rhinoplasty significantly benefits nasal airway function, as evidenced by improved postoperative rhinomanometry and acoustic rhinometry measurements. This objective data provide a compelling argument for the functional importance of scroll ligaments, advocating for surgical techniques that prioritize their preservation. By highlighting the positive correlation between ligament preservation and enhanced nasal functionality, this research contributes valuable insights into rhinoplasty practices, suggesting a paradigm shift towards approaches that safeguard nasal structural integrity for optimal functional outcomes. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2024.Öğe THE IMPLICATION OF THE PREOPERATIVE PLATELET TO LYMPHOCYTE RATIO IN THE DIAGNOSIS OF LARYNGEAL CARCINOMA(Namık Kemal Üniversitesi, Tıp Fakültesi, 2016) Ersözlü, Tolga; Demirel, Oral BurakObjectives: To investigate the diagnostic implication of the platelet to lymphocyte ratio (PLR) as a biological marker in predicting the malignancy of space-occupying laryngeal lesions. Methods: The medical records of the patients who underwent an operation for a laryngeal pathology between September 2010 and January 2015 in a tertiary referral center were retrospectively reviewed. For the control group, 50 age and sex matched patients were selected among the patients who underwent septoplasty. Preoperative platelet to lymphocyte ratio was calculated for each subject in the malignant, benign and control groups. Results: Comparison of the three groups using Kruskal Wallis test showed that there was no statistical difference between the groups. (p>0.05, p=0.871) The median PLR of the patients in the malignant group was lower than the benign group and the control group. Conclusions: In conclusion, squamous laryngeal carcinoma was not found to be associated with an increased preoperative PLR. Our findings indicated that, PLR may not be used as a biological marker for the diagnosis of laryngeal malignancy.Öğe Tracheostomy and Tracheostomy Care During the COVID-19 Pandemic(2020) Ersözlü, Tolga; Gültekin, ErdoğanCovid-19 pandemic is a global health problem that affects the whole world and can progress with asymptomatic or viral symptoms of pneumonia or cause severe acute respiratory failure. SARS-CoV-2 has spread much more widely and quickly than other viruses and has caused a significant number of life losses globally. Tracheostomy is a surgical procedure that is frequently performed by ENT and head & neck surgeons with various indications, and its implementation can facilitate weaning patients from mechanical ventilation, thereby potentially increasing the availability of beds in the intensive care unit (ICU). Since tracheostomy causes a large amount of aerosol formation, it is a serious risk process for the spread of covid-19 infection even if personal protective equipment (PPE) is used both during surgery and postoperative care. There is not enough experience on how to perform tracheotomy in Covid-19 patients. Therefore, thesurgical procedure and indications for tracheostomy should be revised during the covid-19 pandemic process. We aim to provide authoritative guidance for healthcare providers and healthcare systems by synthesizing our experience with tracheostomy, available evidence, and information in the literature data during the current COVID-19 pandemic.Öğe Transient postsurgical gastroparesis is accompanied by reversible changes of the cervical vagus nerve's morphology after neck dissection - An ultrasound study(Societatea Romana de Ultrasonografie in Medicina si Biologie, 2020) Özçağlayan, Ömer; Ersözlü, TolgaAims: During neck dissection (ND), the vagus nerve (VN) may be exposed to manipulation together with common carotid artery and internal jugular vein. The postsurgical gastroparesis was previous related to the VN injury. The aim of our study was to evaluate by ultrasound the VN changes in patients with unilateral and bilateral ND and to establish if there is a relationship between postoperative findings of VN and postsurgical gastroparesis. Material and methods: Seventeen patients in which 30 ND (4 unilateral and 13 bilateral) were performed, were enrolled in the study. The VN’s area and diameter were measured preoperative (baseline), one week (T1) and one month (T2) postoperative. Gastrointestinal symptoms were evaluated at T1 and T2 phases using the patient assessment of the upper gastrointestinal symptom severity index (PAGI-SYM). Results: There was a statistical difference between area and diameters of VN between T1 and baseline (p<0.001), and T1 and T2 phases (p<0.001), respectively. No statistical differences were detected at baseline and T2 phases in areas (p=0.934) and diameters (p>0.999). Gastrointestinal symptoms, found at the T1 phase regressed at T2 phase, were correlated with VN area and diameter changes (p<0.001). Conclusions: VN ultrasound clearly showed the transient dimensional changes of VN caused by manipulation in ND, which may lead to temporary gastrointestinal symptoms due to reversible dysfunction of VN. © 2020 Societatea Romana de Ultrasonografie in Medicina si Biologie. All rights reserved.
