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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 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 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 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 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.Öğe The efficacy of sustained-release chitosan microspheres containing recombinant human parathyroid hormone on mronj(Sociedade Brasileira de Hematologia e Hemoterapia, 2019) Tayşi A.E.; Cevher E.; Sessevmez M.; Olgaç V.; Tayşi, Nuri Mert; Atalay B.Treatment of patients with bisphosphonate usage is a significant concern for oral surgeons because it interferes with jaw bone turnover and regeneration. In case of adverse effects manifesting related to bisphosphonate use, oral surgeons are usually treating and keep the patient's symptoms under control. In this study, we aimed to investigate a new treatment protocol for medication-related osteonecrosis of the jaw (MRONJ). This treatment protocol consisted of administering human parathyroid hormone (hPTH) loaded chitosan microspheres which were prepared by ionotropic gelation method or/and the prepared microspheres were suspended in a poloxamer gel. After in-vitro optimization studies, the efficacy of the chosen formulations was evaluated in-vivo studies. Zoledronic acid was administered daily to forty-eight adult female Sprague-Dawley rats, divided into four experimental groups, at a daily concentration of 0.11 mg/kg over three weeks to induce the MRONJ model. At the end of this period, maxillary left molar teeth were extracted. In the first group, the subjects received no treatment. In the negative control group, poloxamer hydrogel containing empty microspheres were immediately applied to the soft tissues surrounding the extraction socket. The treatment group-1 was treated with local injections of poloxamer hydrogel containing hPTH. The treatment group-2 was treated with a single local injection of poloxamer hydrogel containing hPTH-loaded chitosan microspheres. Both treatment groups received a total of 7 ?g of hPTH at the end of the treatment protocol. Our study demonstrates successful attenuation of MRONJ through a local drug delivery system combined with hPTH, as opposed to previously attempted treatment strategies. © Sociedade Brasileira de Hematologia e Hemoterapia.
