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Öğe Absorbable versus non-absorbable sutures in open rhinoplasty: a comparative analysis of columellar scarring(Ahead of Print, 2021) Bozan, Aykut; Dizdar, DenizhanIntroduction: Open rhinoplasty involving columellar incision has gained popularity since the 1930s. Many surgical incision techniques have been employed to obtain better results in terms of postoperative scarring. This study evaluated and compared the results of absorbable and non-absorbable sutures used in open technique rhinoplasty, assessed scar properties regardless of the techniques used, from the perspectives of patients and surgeons. Objective: This study evaluated and compared the results of absorbable and nonabsorbable sutures used in open technique rhinoplasty from the perspectives of patients and surgeons. Material and methods: Study population included 70 patients who underwent primary open rhinoplasty between 2013 and 2018. Rhinoplasty Operations were performed in 2 different centers by a total of 2 rhinoplasty surgeons. Both surgeons used suture materials, which can be used for columellar closure, regardless of patients' skin characteristics. Columellar scars were assessed at an outpatient clinic at least 6 months postoperatively. Patients who could not come to the clinic were excluded from the study. Columellar Scars were assessed using the Turkish Patient Observer Scar Assessment Questionnaire. Patients were also asked to complete a Scar Assessment Analysis Questionnaire at the outpatient clinic, and were photographed from the front, basal, and right and left oblique sides. Three surgeons, who were not part of the research team but routinely performed rhinoplasty, completed the Observer Scar Assessment Questionnaire by examining patients in person at the clinic as well as their photographs. Results: Observer Scar Assessment Questionnaire results; for the Vicryl group, surgeons ranked pigmentation of the scar as the best criterion (3.34 ± 0.97) and irregularity of the scar as the worst (3.82 ± 1.01). For the Prolene group, surgeons ranked irregularity as the best criterion (3.30 ± 0.97) and stiffness as the worst (3.54 ± 0.94). Although there was no statistically significant result between the two groups in the criteria, the mean scores of the Prolene group were less than the Vicryl group. (3.36 ± 0.46, 3.50 ± 0.65 respectively).Scar Assessment Analysis Questionnaire Results; patients in both the Vicryl and Prolene groups ranked pain as the least important factor (mean 2.9 ± 1.11 and 3.33 ± 1.35, respectively). The Prolene group scored lower than the Vcryl group in terms of overall scarring (3.49 ± 0.72, 3.66 ± 1.37, respectively, P > 0,05).Öğe Awareness of facial asymmetry and Its impact on postoperative satisfaction of rhinoplasty patient(Springer, 2021) Sözen, Tevfik; Dizdar, Denizhan; Göksel, AbdulkadirAbstract View references (16) Introduction: Rhinoplasty surgeons often find that despite their best efforts to straighten the nose, patients often continue to perceive their nose as deviated, and this perception is particularly prevalent in patients with concurrent facial asymmetry. The aims of this study were to determine whether facial asymmetry influences the satisfaction of rhinoplasty patients and whether there is a difference in postoperative happiness between patients with and without facial asymmetry. Materials and Methods: In this retrospective study, we reviewed the charts and photographs of patients who underwent rhinoplasty between 2016 and 2018. Patient photographs were analysed; 30 patients with facial asymmetry and 30 patients with symmetric faces were randomly selected for the study. The preoperative and postoperative rhinoplasty outcome evaluation (ROE) and standardized cosmesis and health nasal outcomes survey (SCHNOS) scores were compared between the two groups. Results: The mean preoperative symmetry scores of the group with facial asymmetry were significantly higher than those of the group with symmetric faces. The magnitude of increase in the average ROE score from pre- to postoperatively was significantly larger in the group with symmetric faces than in the group with facial asymmetry. The magnitude of decrease in the mean SCHNOS score from pre- to postoperatively was significantly larger in the group with symmetric faces than in the group with facial asymmetry (p: 0.006). Conclusion: It is important to clearly evaluate patients with facial asymmetries before surgery to increase their postoperative satisfaction and outcomes and make their expectations more realistic. 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.Öğe Investigation of the prognostic value of the neutrophil/lymphocyte ratio in bell palsy(Deomed Publ, Istanbul, 2018) Dizdar, Denizhan; Avincsal, Mehmet Özgür; Dizdar, Senem KurtObjectives: Bell palsy (BP), also known as idiopathic facial paralysis, is a unilateral, acute-onset, isolated lower motor neuron weakness. It accounts for 60% to 75% of all cases of unilateral facial paralysis. The estimated annual incidence ranges between 11 and 40 per 100.000 people, with 40.000 new cases each year in different parts of the world. The neutrophil/lymphocyte ratio (NLR), calculated as the ratio of absolute neutrophil count to absolute lymphocyte count, is an easily measurable and inexpensive systemic inflammation marker. This study investigated the association between the NLR and BP by comparing clinical characteristics and functional outcomes of patients with BP and healthy controls. Methods: Thirty patients (24 women, 6 men) who presented to our clinic with BP between 2014 and 2016 were included in the study. The subjects underwent a general physical examination and an assessment of laboratory blood parameters. All patients were treated with prednisone, 1 mg/kg per day with a progressive dose reduction. The NLR was calculated as the simple ratio between absolute neutrophil and absolute lymphocyte counts. Results: The mean (SD) NLR values were 2.141 (0.80) in patients with BP and 1.41 (0.46) in the control group. The difference between groups was significant (p=0.0001). There was a positive correlation between grade of facial paralysis and NLR values (r=0.663, p=0.0001). There was a positive correlation between prognosis of facial paralysis and NLR values (r=0.239, p=0.0251). Conclusion: The NLR was a valuable marker in BP patients in this study. Moreover, this study demonstrated a linear relationship between the NLR and BP severity and prognosis.Öğe Radix saw: a useful tool for rhinoplasty to correct high radix(Elsevier Editora Ltda, 2021) Şeneldir, Süreyya; Dizdar, Denizhan; Tuna, AltuğIntroduction: The most difficult aspect of radix lowering is determining the maximum amount of bone that can be removed with osteotomes; here, we describe use of a radix saw, which is a new tool for determining this amount. Objective: In this study, we describe use of a radix saw, which is a new tool to reduce the radix. Methods: The medical charts of 96 patients undergoing surgery to lower a high radix between 2016 and 2017 were assessed retrospectively. All operations were performed by the senior surgeon. Outcomes were assessed by comparing preoperative photographs with the most recent follow-up photographs (minimum of 6 months postoperatively). The photographs were all taken using the same imaging settings, and with consistent subject distance and angulation. The photographs were subsequently analysed by authors. Results: The study population consisted of 96 patients (70 women, 26 men) who underwent rhinoplasty between 2016 and 2017. The mean age of the patients was 28.8 years (range: 18–50 years) and the mean clinical follow-up period was 1.8 years. No patient required revision surgery due to radix problems, and there were no cases with unwanted bone fragments or radix asymmetry. The swelling and oedema seen immediately after surgery subsided after an average of 7–10 days. Conclusion: In conclusion, a radix saw can be used for rhinoplasty requiring delicate bone removal in patients with a high radix. Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence. © 2019 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial
