Browsing by Author "Ayhan KARS"

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A Case of Nasal Myiasis in a Patient with Intestinal Type Sinonasal Adenocarcinoma
(2022-02-01) Sinan KÖYCEĞİZ; Atahan AĞRILI; Ayhan KARS; Fatma ATALAY; Mustafa Sıtkı GÖZELER
Myiasis is an infestation caused by fly, mosquito or midge larvae settling on animals or humans and feeding on dead or living tissues or nutrients digested by them. Myiasis of the nasal cavity is an uncommon entity. It may particularly be encountered in individuals with low socioeconomic levels in need of care or against a background of malignancy, but is very rare in healthy individuals. While there is no clear algorithm, daily endoscopy-guided debridement with saline irrigation will be beneficial in treatment. We report a case of nasal myiasis in an 82-year-old male patient reported as intestinal type sinonasal adenocarcinoma following biopsy taken from a mass completely filling the nasal cavity two years previously, but who had received no treatment during that time.
A Comparison of Pain and Operation Time in Children Undergoing a Tonsillectomy using Different Energy Doses of Bipolar Cautery
(2021-03-01) Ayhan KARS; Fatih BİNGÖL; Korhan KILIÇ
Objective: The aim of the study is to compare the operative time and degree of post-operative pain in children who underwent a tonsillectomy using different energy doses of bipolar cautery and to specify the most appropriate energy dose. Materials and Methods: Patients included in the study were allocated to three groups with 20 in each and each group underwent the operation with 20, 30 and 40 watt energy doses of bipolar cautery. Operative time was recorded for each patient. The Wong-Baker FACES pain rating Scale (WBS) was used in the post-operative period for each patient and the pain severity of the patients was evaluated at post-operative 30th min, 1st, 6th, 24th hours and 10th day. The operative times and pain severity of the patients were compared thereafter. Results: A significant difference was not detected between the groups in which 20, 30 and 40 watt bipolar cautery was used (p>0.05). A significant difference was not detected between groups with regard to pain scores at post-operative 30th min, 1st, 6th, 24th hour and 10th day (p>0.05). Conclusion: We have compared groups with regard to post-operative pain and operative time according to energy dose of bipolar cautery and detected no statistically significant difference in tonsillectomies conducted with different energy doses. Therefore we consider that energy dose should be as low as possible in tonsillectomies conducted with bipolar cautery.
A new marker in inflammatory etiopathogenesis of Bell’s palsy: Immature granulocyte
(2022-01-01) Sedat GÜLTEN; Kübra TOPAL; Fatma ATALAY; Ayhan KARS
Aim: Bell’s palsy (BP) pathogenesis is not fully understood, but is generally idiopathic. Studies investigating the etiopathogenesis of BP suggest have implicated factors such as inflammation, viral infection, microvascular dysfunction, and exposure to acute cold. The purpose of this study was to reveal the effectiveness of immature granulocyte (IG) as an inflammatory marker in the etiopathogenesis of BP. Materials and Methods: The retrospective study was performed September 2019 and January 2021. Thirty-three patients presenting to the our Ear, Nose, and Throat Clinic diagnosed with BP were included in the study. A control group consisting of 50 individuals with similar age and gender distributions to the patient group and presenting for routine examinations was also established. Immature granulocyte count (IGC), and immature granulocyte percentage (IG%) values were calculated from complete blood count (CBC) data. Results: No significant difference was determined between the two groups in terms of age or gender (p > 0.05). IGC values found to differ significantly between the patient and control groups (p=0.004). No significant differences were observed in the IG% (p=0.061). Conclusion: Inflammation is one of the main theories in the context of BP. Higher IGC being determined in patients with BP compared to the healthy control group supports the idea of the role of inflammation in the etiopathogenesis.
A Rare Case Report: Bilateral Choanal Atresia in an Adult Patient
(2020-12-01) Ayhan KARS; Fatma ATALAY; Fatih BİNGÖL
Posterior choanal atresia is rare but is the most common congenital malformation of the nasal cavity. It is characterized by a completely closed choana. Generally, this malformation is observed in newborns as increased respiratory distress during feeding, cyanotic attacks, and relaxation with crying. In contrast to unilateral atresia, bilateral disease is a life threatening condition and is extremely rare in adults. Herein, we presented a case of bilateral membranous choanal atresia detected in an 18-year-old patient. An 18-year-old female patient was admitted to our clinic after complaining of nasal obstruction, nasal discharge, snoring, anosmia, and mouth breathing since she was a child. On endoscopic examination, a right-deviated nasal septum and bilaterally closed choanae were observed. Membranous bilateral choanal atresia was observed on computed tomography (CT). The patient underwent transnasal endoscopic surgery under general anesthesia. Both septoplasty and bilateral coanoplasty surgeries were performed. No complications were observed postoperatively or at one year of follow up. Bilateral choanal atresia is a rare anomaly in adults. The diagnosis can easily be made by endoscopic examination or CT. The transnasal endoscopic surgical technique is an easy, reliable, and effective treatment method.
A RARE COMPLICATION AFTER TONSILLECTOMY: OROPHARYNGEAL STENOSIS DUE TO SYNECHIA BETWEEN THE ANTERIOR PLICA AND THE BASE OF THE TONGUE
(2023-03-31) Abdulkadir ŞAHİN; Ayhan KARS; Mustafa Sıtkı GOZELER
Tonsillectomy is a procedure widely performed in all ear, nose, and throat clinics. Various complications are reported after tonsillectomy. A four-year-old boy who had undergone elective tonsillectomy approximately one year previously was brought to our clinic by his parents due to snoring, difficulty in swallowing, and weight loss developing at some time after surgery and gradually progressing. Oropharyngeal examination revealed a synechia formation between the base of the tongue and the anterior plica. The synechia was released by dissection using bipolar cautery. The operation was completed with no complications. Deep dissection between the base of the tongue and the tonsillar inferior pole during tonsillectomy may makes tissues susceptible to synechia formation by eliminating anatomical barriers.
Efficacy of boric acid therapy in a pseudomonas aeruginosa-induced chronic otitis media model in rats
(2022-09-30) Muhammed Sedat SAKAT; Ayhan KARS; Abdulkadir ŞAHİN; Serkan YILDIRIM; Korhan KILIÇ; Sinan KÖYCEĞİZ
Purpose: Chronic otitis media (COM) is one of the common infectious diseases of the middle ear caused by bacterial or viral pathogens. The purpose of the present study was to investigate the efficacy of boric acid (BA) in the treatment of COM by comparing topical 4% and 8% BA applications with systemic ciprofloxacin in a Pseudomonas aeruginosa (P. aeruginosa) inoculation-induced model of COM in rats. Materials and Methods: Forty-two Sprague Dawley rats were divided into seven equal groups. The COM model was created with P. aeruginosa. Clinical, histopathological and, immunohistochemical comparisons were performed between the control, COM, topical 4% and 8% BA treatment, a systemic ciprofloxacin treatment, and topical 4% and 8% BA contact groups. Results: In the COM model, moderate edema, inflammation, degeneration and moderate tumor necrosis factor-alpha (TNF-α) expression were detected with the application of 4% BA. Mild edema, inflammation, degeneration, and mild TNF-α expression were detected with 8% BA application. Conclusion: Both 4% and 8% BA treatment provided significant clinical, histopathological and immunohistochemical improvement. The application of 8% BA was found to exhibit greater therapeutic efficacy, with no harmful effect on the middle ear mucosa.
Evaluation of Computed Tomography Findings in Revision Endoscopic Sinus Surgery
(2021-03-01) Cömert ŞEN; Ayhan KARS; Berkay ÇAYTEMEL; Meryem Keleş TÜRELİ; Bayram ŞAHİN; Şenol ÇOMOĞLU; Levent AYDEMİR
Objective: To investigate computerized tomography (CT) data of patients who needed revision surgery for chronic rhinosinusitis. Material and Methods: 83 patients who underwent revision endoscopic sinus surgery by the senior author due to recurrent and/or persistent chronic rhinosinusitis were included in this study. The following data were obtained from preoperative CT scans and recorded for each side of every patient: recurrent polyposis, incomplete uncinectomy, retained agger nasi cell, lateralization of middle turbinate, recirculation phenomenon, maxillary antrostomy stenosis, incomplete anterior and posterior ethmoidectomy, scarring at the frontal recess, sphenoid ostium stenosis, or novel onset sphenoid disease. Results: Based on our findings, septal deviation caused inadequate posterior ethmoidectomy, while incomplete uncinectomy increased the risk of frontal sinus disease. Conclusions: We suggest that septum deviation may cause insufficient visualization, while incomplete uncinectomy may prevent adequate intervention to the frontal sinus and these subsequently play a role in ESS failure.
Foreign Bodies in the External Auditory Canal: An Evaluation of 95 Cases
(2022-12-31) Ayhan KARS; Kübra TOPAL; Fatma ATALAY
Objective: The purpose of this study was to examine the demographic characteristics, form of presentation to hospital, the ear in which foreign bodies were observed, and the features thereof, in cases of foreign body in the external auditory canal (EAC) treated in our clinic. Materials and Methods: Ninety-five patients presenting to our hospital due to foreign body in the EAC and treated in the Ear, Nose, and Throat (ENT) Clinic were included in the study. Patients’ medical records were examined, and age, sex, type of presentation to hospital, type of foreign body, and the ear involved were recorded. Results: Sixty-eight (71.5%) of the 95 patients were adults aged 20-85, and 27 (28.5%) were children aged 2-17. Fifty-two (54.7%) patients were male and 43 (45.3%) were female. The foreign body was located in the right ear in 47 (49.5%) cases, the left ear in 45 (47.3%), and in both ears in three (3.2%). Twenty-seven (27.6%) of the foreign bodies consisted of cotton swabs, 14 (14.3%) of insects, 13 (13.2%) of beads, 11 (11.2%) of grass pieces. Conclusion: Foreign bodies in the EAC are a frequent problem in ENT practice. In order to avoid complications, foreign bodies should be removed using appropriate techniques and equipment by professional ENT physicians.
Laryngeal and Sublingual Hematoma Causing Upper Airway Obstruction Due to the Use of Warfarin
(2022-02-01) Ayhan KARS; Fatma ATALAY; Kübra TOPAL
Warfarin is commonly used for the treatment and prophylaxis of thromboembolic diseases. Spontaneous bleeding and hematoma are complications that can occur in warfarin use. When patients will be initiated on warfarin therapy, a careful physical examination should be performed to eliminate the risk of bleeding and additional diseases and other medications used should be evaluated. The patient should be informed about the risks and followed up with regular International Normalized Ratio tests. Although rare, spontaneous laryngeal hematoma must be rapidly diagnosed and treated because it can cause airway obstruction and be life-threatening. In our case, a 61-year-old male patient developed spontaneous sublingual, epiglottic, and arytenoid hematoma due to warfarin use. The patient was monitored and initiated on conservative treatment. In the following days, the patient was discharged with recovery.
Sinonasal Abnormalities on Cranial Magnetic Resonance Imaging in Patients with Tension-Type Headache
(2022-04-01) Zeynep YAVUZ; Birsel KUL; Ayhan KARS; Fatma ATALAY; Kübra TOPAL
Background: Anatomical variations and pathologies in the sinonasal region are a known principal cause or trigger of headaches. The purpose of the present study was to determine the frequency of sinonasal pathologies in patients with tension-type headache and their association with the disease. Methods: Patients presenting to the Kastamonu Training and Research Hospital Neurology Clinic between 2019 and 2021 and diagnosed with a tension-type headache based on the International Headache Society 2018 classification were investigated retrospectively. Patients were examined in terms of cranial magnetic resonance imaging sinonasal anomalies, and the findings were recorded. Sinonasal lesions were classified as septal deviation, inferior turbinate hypertrophy, concha bullosa, and sinus retention cyst. Results: The incidence of septal deviation was significantly higher in the patient group than in the control group (P = .019). The incidence of tension-type headache was 2.2-fold higher among individuals with septal deviation compared to those with no such deviation (95% CI: 1.13-4.39). Comorbid septal deviation and inferior turbinate hypertrophy were observed in 18.1% of the patients in the study, septal deviation and concha bullosa in 1.6%, and septal deviation and sinus retention cyst in 2.1%, but no significant difference was determined in distributions between the patient and control groups. Conclusion: It should be remembered that an accompanying pathology in patients with tension-type headache can further exacerbate existing symptoms or else can be the primary cause of headache. Patients must undergo a detailed ear, nose, and throat examination in terms of identifying mucosal contact points and sinonasal pathologies.
Tularemia in Children: Evaluation of 22 Cases
(2022-03-01) Sinan KÖYCEĞİZ; Ayhan KARS; Pelin Esmeray ŞENOL
Objective: Tularemia is a highly contagious bacterial zoonotic disease de riving from gram-negative Francisella tularensis. The disease is difficult for clinicians, and due to its rarity, a high level of suspicion is required for di agnosis. The purpose of the present study was to retrospectively examine the clinical characteristics, laboratory findings, and responses to treatment of pediatric tularemia cases treated in our clinic. Material and Methods: Pediatric tularemia cases were included in this retrospective study. The medical records of patients with confirmed diag noses were examined, and demographic characteristics such as age and gender, presentation symptoms, and risky contact status were recorded. Factors such as living in rural areas, working in agriculture and animal husbandry, similar disease among friends and family, and drinking water sources were examined. Patients’ physical and laboratory findings, and medical and surgical treatment results were recorded. Results: Twenty-two pediatric cases were included in the study, 15 (68.2%) boys and seven (31.8%) girls. The patients were aged mean 12 ± 2.8 (min max; 3-15 years), and 15 (68.2%) were diagnosed in the fall. The mean time from onset of symptoms to presentation to our hospital was 31.8 ± 20.8 days (min-max; 7-90 days). The most common presentation symptoms were fatigue (54.5%), fever (45.5%), sore throat (%45.5), lack of appetite (40.9%), and abdominal pain-diarrhea (31.8%). Cervical lymphadenopathy (LAP) was determined in all patients at physical examination. Surgical treat ment was applied to 18 (81.8%) patients who did not respond to medical treatment [abscess drainage to 14 (63.6%) and LAP excision to four (18.2%)]. Conclusion: Tularemia must be considered in terms of early diagnosis and treatment in children presenting with cervical LAP in endemic regions and not responding to β-lactam and/or macrolide group antibiotics.