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Öğe The Effects of the COVID-19 Pandemic on Patients with Trauma Presented to the Emergency Department: A Multicentre Experience in Istanbul(Galenos Publ House, 2023) Ceylan, Ahmet; Kara, Eyyup; Kesimli, Mustafa Caner; Kaya, Deniz; Atas, AhmetObjective: This study examines the characteristics of patients with trauma who presented to the emergency department before and after the novel coronavirus disease-2019 (COVID-19) pandemic and analyze the effects on the traumatic injuries.Methods: In this study, medical records of patients who presented to the emergency departments of seven hospitals operating as tertiary level hospitals in Istanbul between March-June 2018, March-June 2019, and March-June 2020 are due to trauma were retrospectively analyzed. The clinical and demographic characteristics of traumatic injuries before and after the pandemic were compared.Results: In our study, 4088 trauma patients' data were reviewed: 1279 in March-June 2018, 1684 in March-June 2019, and 1125 in March-June 2020. When the total number of patients was examined, it was noticed that the number of patients decreased significantly during the COVID-19 pandemic. No significant difference was found between the periods regarding the sex and trauma mechanisms of the patients. The mean age was higher in patients admitted in 2020 compared to previous years. In our study, incidences of intracranial hemorrhage, femur fracture, lung injuries, and mortality rates were higher in March-June 2020 compared to previous years.Conclusion: In March-June 2020, compared to the previous year, there was a 34% decrease in trauma cases admitted to the emergency department. Albeit no difference was found between the periods regarding trauma mechanisms, the higher mortality in the March-June 2020 period indicates that trauma continues to be one of the major causes of death despite the pandemic.Öğe The efficacy of Epley and Semont maneuvers in posterior semicircular canal benign paroxysmal positional vertigo treatment: A short-term comparative study(KBB-BBC Uzmanları Derneği, 2021) Kesimli, Mustafa Caner; Kaya, Deniz; Ceylan, Sedanur; Ceylan, Ahmet; Ünal, MuratObjectives: This study aimed to compare the effectiveness of the Epley maneuver with the Semont maneuver in the treatment of posterior semicircular canal benign paroxysmal positional vertigo and observe differences in the resolution time of symptoms in the short-term follow-up. Patients and Methods: Sixty patients with posterior semicircular canal benign paroxysmal positional vertigo (23 males, 37 females; median age: 44.9 years; range, 14 to 80 years) were included in the prospective randomized comparative study conducted in our clinic between April 2019 and October 2019. Diagnosis and treatment maneuvers were performed under videonystagmography examination. Participants were randomly selected after the diagnostic tests for the Epley maneuver and the Semont maneuver treatment groups. Results: In the evaluation of vertigo with videonystagmography, 25 (83.3%) patients in the Epley maneuver group and 20 (66.6%) patients in the Semont maneuver group recovered in the one-week follow-up, and 28 (93.3%) patients in the Epley maneuver group and 24 (80%) patients in the Semont maneuver group recovered in the two-week follow-up. All patients in the Epley maneuver group recovered at the end of one month; four patients in the Semont maneuver group still had vertiginous symptoms (100% vs. 86.6%, p=0.04). There was a statistically significant difference between the Epley and Semont groups regarding visual analog scores at the one-week, two-week, and onemonth follow-ups (p=0.002, p<0.001, p=0.001, respectively). Conclusion: The Epley maneuver was significantly more effective than the Semont maneuver in resolving vertigo in the short-term treatment of posterior semicircular canal benign paroxysmal positional vertigoÖğe Evaluation of olfactory bulb volume in patients with diabetic olfactopathy and comparison with healthy individuals(AVES, 2021) Gürbüz, Defne; Kesimli, Mustafa Caner; Bilgili, Ahmet Mert; Durmaz, Hacı ÖmerObjective: Diabetic olfactopathy is defined as olfactory dysfunction in patients with diabetic neuropathy. In this study, we evaluated the olfactory bulb volume (OBV) using magnetic resonance imaging in patients with diabetic olfactopathy and compared the results with those of healthy individuals. Methods: This study included 12 patients who were diagnosed with type 2 diabetes mellitus (T2DM) and were found to have diabetic olfactopathy using the Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test (Group 1); their OBV was evaluated using MRI. For comparison, 13 healthy individuals of a similar age, without any medical problems, were included as a control group (Group 2); their OBV and olfactory functions were also evaluated. Results: Total CCCRC scores were 4.27 +/- 0.67 in Group 1 and 6.42 +/- 0.31 in Group 2; these scores significantly differed between the groups. The mean CCCRC scores in Groups 1 and 2 were moderately hyposmic and normosmic, respectively. The mean OBV values were 65.04 +/- 6.97 mm(3) and 76.46 +/- 11.36 mm(3) in Groups 1 and 2, respectively. Group 1 had significantly lower OBV values and CCCRC scores, compared with Group 2 (p < 0.01 for both groups). Conclusion: The OBV was lower in patients with T2DM who developed diabetic olfactopathy than that in healthy individuals; the olfactory bulb was adversely affected by diabetes mellitus. This is the first study to demonstrate that the olfactory bulb is adversely affected by the presence of diabetic olfactopathy.Öğe Evaluation of School-age Hearing Screening Applications: The Tele-audiological Perspective(Galenos Publ House, 2023) Ceylan, Ahmet; Kara, Eyyup; Kesimli, Mustafa Caner; Kaya, Deniz; Atas, AhmetObjective: Hearing health is one of the areas that should be considered especially in childhood. School-age hearing screening (SAHS) is important for the detection and prevention of hearing loss. The aim of our study is to compare the use of teleaudiological applications for SAHS with standard SAHS applications and to determine possible similarities or differences between the methods. Methods: The study was carried out with a total of 224 students who were first-year students in the same primary school within the borders of Istanbul. The study was completed in two phases with a test session at 15-day intervals. In the first stage, video-otoscope images of all individuals who would be subjected to standard SAHS were recorded and tympanometry test was performed. In the second stage, SAHS results were recorded with the tele-audiological method. Results: According to the tympanometry results obtained from the participants, it was determined that the rate of abnormal hearing was 4.5%. According to the video-otoscope results, which were evaluated as asynchronous, the number of students suspected of dense earwax plug and membrane pathology was 6.7% in the left ear and 5.8 in the right ear. According to the SAHS method results, the average rate of passing and failing the test in the standard method was 12.9% in the right ear, and 12.9% in the left ear. According to the results of the tele-audiological method of the same student group, the rate of failing the test was 16.1% in the right ear and 15.2 in the left ear. Conclusion: Measuring tele-audiologically or using the standard method did not affect the test results. Accordingly, the test result is independent of whether the test is performed with the tele-audiological or standard method.Öğe Evaluation of the factors affecting the necessity for revision surgery in choanal atresia(Elsevier, 2021) Aydemir, Levent; Sen, Comert; Kara, Hakan; Pamuk, Saim; Kesimli, Mustafa CanerObjective: This study aims to compare the effects of different surgical techniques for congenital choanal atresia (CCA), and particular emphasis is given to the analysis of the factors affecting the surgical outcome. The necessity for revision surgery and surgical outcomes were retrospectively investigated in patients undergoing revision surgery according to a recently proposed classification system. Material and method: A retrospective study was conducted on patients operated for CCA between January 2007 and December 2018 at a university hospital. Data in the medical records, including patient age when the initial surgery was performed, gender, additional anomalies and medical conditions, the duration of gestation, side and type of atresia, type of surgery and need for revision surgery were reviewed. Results: Forty-five patients treated for CCA in our university hospital were screened. The mean follow-up duration was 82.16 months. Revision surgery was required in 9 of 26 cases, which are included in the study (34.6%). Fourteen patients presented with bilateral CCA, while 12 were unilateral cases. Sixteen patients (61.5%) had comorbid medical conditions. While the removal of vomer and mucoperiosteal flap use affects successful surgical repair, no differences were observed in choanal atresia type, laterality, use of stent and the presence of additional medical conditions. Conclusion: The most important factors affecting surgical success for CCA are the removal of the vomer and closure of all bare bone tissues using a mucoperiosteal flap. Use of stents provides no additional benefit, apart from preventing synechiae formationÖğe Free flap reconstruction of the head and neck region: a series of 127 flaps performed by otolaryngologists(GALENOS YAYINCILIK, 2021) Başaran, Bora; Unsaler, Selin; Kesimli, Mustafa Caner; Aslan, İsmetObjective: To determine flap success rate and complications in patients who underwent microvascular free tissue reconstruction after major head and neck ablative surgery and to report the improvement in the results. Methods: Medical records of 124 patients who were operated on in 2012 to 2019 were retrospectively reviewed. Indications for different free flap types, success rates and re-exploration rates, donor site morbidities, and reasons for flap loss were analyzed. Patients were divided into two groups to identify the effects of the anticoagulant and the antiaggregant treatments on postoperative results. Results: There were 127 flaps in 124 patients, including two different free flaps each in three patients that were harvested and used in the same surgical session. Of the total 127 flaps, 82 (64.6%) were radial forearm flaps, 39 (30.7%) were fibula flaps, and 6 (4.7) were rectus abdominis flaps. Four patients were re-explored for flap perfusion problems, and 18 patients were re-explored for hematoma drainage (n=22/124, %17.3). The rate of hematoma and re-exploration was higher in patients who received anticoagulant and antiaggregant treatments synchronously (p=0.02). Three flaps were lost, and the overall success rate was 97.6%. Two patients died from perioperative complications. No major complications were observed at the donor site; minor complications were observed in 30 patients. Conclusion: The success rate for the 127 flaps in 124 patients were found comparable to those reported in the literature. These results show that successful outcomes can be achieved with experience and a head and neck team dedicated to improving the results in microsurgical reconstruction, and flap failure rarely occurs if perioperative care of the patients is given meticulously.Öğe Modified olfactory training is an effective treatment method for COVID-19 induced parosmia(LARYA, 2022) Aldundag, A.; Yilmaz, E.; Kesimli, Mustafa CanerObjectives: Coronavirus disease (COVID-19) infection often causes olfactory dysfunction and parosmia may occur in some patients with olfactory dysfunction. In this study, we retrospectively investigated the effectiveness of modified olfactory training (MOT) for the treatment of COVID-19-induced parosmia. Study Design: This study presents results of MOT performed with 12 odors for 36 weeks in patients with olfactory dysfunction following COVID-19 infection. A total of 75 participants were included in the study (mean age 33 years, range 16–60 years). Methods: The patients were separated into two groups: 1) Treatment group consisted of parosmia patients who received MOT with three sets of four different odors sequentially. 2) Control group consisted of parosmia patients who did not perform any olfactory training. Both groups were matched for age and sex distribution of participants. TDI scores were compared at the time of application and at the end of the 9th month by the Sniffin' Sticks Test. The results of the 0th and 9th months were recorded by applying the parosmia assessment scale to both groups. The results were analyzed statistically, and p < 0.05 was considered significant. Results: When the treatment group and the control group were compared, a significant improvement was observed in both groups at the third, sixth, and ninth month, however the improvement in the treatment group was found to be better than in the control group (P <.001). Extending the treatment from 6 to 9 months in the treatment group was found to be effective in mitigating parosmia complaints and improving discrimination scores (P <.001). Conclusion: This study has shown that modified olfactory training is effective in the treatment of parosmia following COVID-19 infection. Level of Evidence: 3 Laryngoscope, 2022. © 2022 The American Laryngological, Rhinological and Otological Society, Inc.Öğe Olfactory rehabilitation and olfactory bulb volumechanges in patients after total laryngectomy:a prospective randomized study(Elsevier, 2021) Gürbüz, Defne; Kesimli, Mustafa Caner; Bilgili, Ahmet Mert; Durmaz, Hacı ÖmerIntroduction: After total laryngectomy, decreased olfactory function and olfactory bulb volume shrinkage have been reported to occur due to olfactory deprivation caused by nasal airflow interruption. There is evidence that the olfactory system can be modulated by repeated exposure to odors in a procedure called olfactory training. However, it is not known whether any recovery of the lost olfactory bulb volume is possible by eliminating olfactory deprivation via olfactory rehabilitation long after laryngectomy. Objective: This study examined the recovery of olfactory function and the change in olfactory bulb volume via long-term olfactory rehabilitation after total laryngectomy. Methods: Possible causes of olfactory dysfunction in the study participants were evaluated by collecting detailed anamnesis. As olfactory tests, orthonasal butanol threshold and odor discrimination tests were performed. Three-dimensional olfactory bulb volumes were calculated using manual segmentation on T2-weighted coronal magnetic resonance images. In olfactory rehabilitation, four different odors were applied to all patients orthonasally, using a larynx bypass technique for 30 min per day for 6 months. Olfactory tests were performed before the rehabilitation and after 6 months of rehabilitation, and olfactory bulb volume measurements were performed using magnetic resonance images. Results: Eleven patients diagnosed with advanced laryngeal cancer who underwent total laryngectomy and postoperative radiotherapy with a follow-up of 5-10 years were included in the study. All patients were male, and the mean age was 58.18 ± 4.17 years. In total laryngectomized patients, the olfactory bulb volumes measured on magnetic resonance images were 42.25 ± 12.8 mm3 before and 55.5 ± 11.22 mm3 after rehabilitation, and this increase was highly significant. Olfactory test scores were 2.3 ± 1.27 before and 4.39 ± 0.86 after rehabilitation, and this increase was also highly significant. Conclusion: As a result of the olfactory rehabilitation applied by providing orthonasal air flow, the olfactory function lost after total laryngectomy was improved considerably, and the olfactory bulb volume was significantly increased. The increase in olfactory bulb volume in total laryngectomy patients via olfactory rehabilitation to eliminate olfactory deprivation due to nasal airflow interruption was demonstrated for the first time in this prospective longitudinal study.Öğe Oncological and functional outcomes of supracricoid partial laryngectomy(İstanbul Üniversitesi, 2021) Kesimli, Mustafa Caner; Yılmaz, Eren; Yağcı, İbrahim; Aslan, İsmetObjective: The aim of this study is to review the oncological outcomes of T1-T4 glottic or supraglottic tumor patients who underwent supracricoid partial laryngectomy in our clinic. Material and Methods: A total of 43 patients with laryngeal squamous cell carcinoma who underwent supracricoid partial laryngectomy between January 2014 and December 2016 in the Otorhinolaryngology Department of Istinye University Hospital were retrospectively analyzed. Postoperative data of these patients regarding surgical margin, nasogastric feeding tube removal time, decannulation time, postoperative radiotherapy, local regional recurrence, and distant metastases were recorded. Results: Cricohyoidoepiglotopexy was applied to 16 patients by preserving both arytenoids and applied to 7 patients with a single arytenoid; Cricohyoidopexy was applied to 14 patients with both arytenoids preserved, and 6 patients were treated with a single arytenoid.The five-year survival was compared for Cricohyoidopexy/Cricohyoidoepiglotopexy with single arytenoid to double arytenoid preservation and found to be 80%-76% (p=0.56). The mean 5-year survival was 88% in the post-operative radiotherapy group, and 86% in the non- radiotherapy group. The study compared patients with Cricohyoidopexy/Cricohyoidoepiglotopexy with a single arytenoid to those with double arytenoid preservation; the mean decannulation time was 54.23±34.12 to 35.62±27.08 (p=0.05). Postoperative radiotherapy prolonged the decannulation time (51.16±38.5 versus 32.68±20.1; p=0.043). The duration of nasogastric tube placement in the Cricohyoidopexy/Cricohyoidoepiglotopexy with a single arytenoid group was 50.3±14.3 and double arytenoid preservation was 35.17±32.9 (p=0.088). Nasogastric tube removal time was 53.29±50.2 in the post-operative radiotherapy group and was 30.24±16.8 in patients who did not receive post-operative radiotherapy (p=0.040). Conclusion: Supracricoid partial laryngectomy with Cricohyoidoepiglotopexy and Cricohyoidopexy had satisfactory oncological outcomes, and laryngeal function was preserved by rebuilding the neolarynx.Öğe Pediatric nodular fasciitis in the head and neck region(DergiPark, 2021) Kesimli, Mustafa Caner; Yağcı, İbrahim; Yılmaz, Eren; Bayram, Ayel; Ünal, MuratNodular fasciit is a rare benign tumor and may occur anywhere in the body. Pediatric patients constitute approximately 10% of the entire patient group. The disease may show clinical and pathological features resembling malignancy. Therefore, it can be mistaken as sarcoma. This report shows two cases of pediatric nodular fasciitis localized in the parotid region and maxillary sinus.Öğe A simple method for olfactory rehabilitation following total laryngectomy(Springer Link, 2021) Kesimli, Mustafa Caner; Kaya, Deniz; Aydemir, Levent; Durmaz, Haci OmerPurpose: The aim of the study is to demonstrate the effectiveness of spraying odor particles using sinus rinse kits for olfactory rehabilitation in patients with total laryngectomy. Methods: Olfactory rehabilitation was performed by applying four different odorant particles orthonasally using a sinus rinse kit pump for 30 min each day for a duration of 6 months. Olfactory function was evaluated by performing olfactory tests before the rehabilitation and at sixth month after the rehabilitation process. Results: The average CCCRC score prior to olfactory rehabilitation was 2.28 ± 0.79 (between 1.50 and 3.75), while it was 4.46 ± 0.5 (between 3.50 and 5.25) out of a maximum score of 7 after 6 months of olfactory rehabilitation (p value < 0.0001) CONCLUSION: Our results suggest that the use of sinus rinse kits is very simple, inexpensive, easy-to-use, and effective in providing passive olfaction to patients requiring olfactory rehabilitation.
