Browsing by Author "Kars A."

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A Comparison of Pain and Operation Time in Children Undergoing a Tonsillectomy using Different Energy Doses of Bipolar Cautery
(2021-01-01) Kars A.; Bingöl F.; Kılıç K.
A Rare Case Report: Bilateral Choanal Atresia in an Adult Patient
(2020-01-01) Kars A.; Bingöl F.; Atalay F.
Analgesic efficacy of Intraoperative lidocaine infusion in patients undergoing thyroidectomy
(2023-01-01) Akgul E.; Gozeler M.S.; Kars A.; Sahin A.; Ates I.
OBJECTIVE: A significant proportion of patients may experience moderate pain requiring treatment in the postoperative first 24 h following thyroidectomy. The aim of this study was to investigate the evaluation of postoperative patient-reported pain from intraoperative intravenous infusion of lidocaine in patients undergoing thyroidectomy surgery. METHODS: A total of 40 patients with American Society of Anesthesiologists physical status classifications I and II, aged 18-65 years, who were scheduled for elective thyroidectomy with the same indications under general anesthesia at the Ataturk University Medical Faculty's Ear, Nose, and Throat Clinic between November 2019 and February 2020, were divided into two equal groups as randomized and double-blind. Before induction of anesthesia, patients in the lidocaine group were given 1.5 mg/kg lidocaine IV bolus infusion during the operation and until the end of the first postoperative hour, followed by a continuous infusion of 1.5 mg/kg/h. Patients in the control group were given 0.9% isotonic solution according to the same protocol. In the postoperative period, 50 mg of dexketoprofen trometamol was administered and repeated every 12 h. Postoperative pain scores, additional analgesia, and side effects were recorded. RESULTS: Postoperative pain scores were significantly lower in the lidocaine group (n=20) compared to the control group (n=20) at 30 min and 1st, 2nd, 4th, 8th, and 12th h postoperatively (p < 0.05). Additional analgesia requirements were also significantly lower in the lidocaine group than in the control group (p<0.05). CONCLUSION: We recommended the use of intravenous lidocaine infusion intraoperatively in thyroidectomy surgery as it reduces pain scores.
Cacosmia and Cacogeusia in Patients with Persistent Anosmia and Ageusia due to COVID-19
(2021-12-01) Topal K.; Atalay F.; Kars A.
Effect of intranasal Merocel packs, silicone splint, and trans-septal suture after septoplasty on Eustachian dysfunction
(2020-12-01) Topal K.; Kars A.; Bingol F.; Kılıc K.; Atalay F.
Objective: In this study, we aimed to compare the effects of nasal obstruction caused by nasal packing, trans-septal suture, and silicon splint after septoplasty on the Eustachian tube functions and middle ear ventilation. Methods: The study included 60 patients who were operated on for septum deviation between January and July 2017. The ages of the patients ranged from 19 to 53 years. A total of 24 patients were female, and 36 patients were male. The patients were divided into three groups. Group 1 comprised patients who received trans-septal suture, Group 2 comprised patients who received silicon splint, and Group 3 comprised patients who received Merocel packing. The preoperative and postoperative tympanometric evaluations were performed for each patient. Results: The middle ear pressures of the patients in the three groups were compared; there was no significant difference between the second and the third groups in the right and left middle ear pressures. The middle ear pressures of the first group were significantly lower in both ears than those of the other groups. We have found that trans-septal suture after septoplasty without using a splint or Merocel packing did not affect the middle ear pressure. Conclusion: Trans-septal U suture application after septoplasty did not increase middle ear pressure and did not affect Eustachian tube functions in comparison with the other alternative methods.
Effect of the COVID-19 pandemic on anxiety, stress, and insomnia in ear, nose and throat physicians
(2021-07-01) Atalay F.; Topal K.; Kars A.
Objective: Health workers are generally the group at highest risk of contagion in pandemics, which result in physical and mental burnout in them. Ear, nose, and throat (ENT) physicians are at severe risk both as patients presenting to ENT clinics are potential carriers of coronavirus disease 2019 (COVID-19) and because of procedures producing aerosols during upper airway examination. In this study, we aimed to examine the effect of the COVID-19 pandemic on anxiety, stress, and insomnia in ENT physicians. Methods: A hundred and three ENT physicians working in various provinces of Turkey were included in the study. The study data were collected using an online questionnaire. In addition to questions involving participants’ demographic characteristics, the questionnaire also contained the Generalized Anxiety Disorder Scale (GAD-7), the Insomnia Severity Index (ISI), and the Perceived Stress Scale (PSS). Results: Anxiety, stress, and insomnia scores were statistically significantly higher in female physicians than in men. No statistically significant variation was observed in terms of physicians’ age groups, possession of children, or presence of chronic disease. Significantly higher anxiety was determined in physicians working for 16–25 years than in those working for one to five years. The physicians’ anxiety levels also highly correlated with insomnia and stress levels. No significant association was observed between insomnia and stress levels. Conclusion: The physicians’ mean scores indicated mild anxiety, clinically insignificant insomnia, and moderate levels of stress. In addition, in agreement with the previous literature, anxiety, insomnia, and stress levels were significantly higher in women than in men.
Effect of thyroidectomy in patients with tracheal compression
(2021-01-01) Koycegiz S.; Mutlu V.; Atalay F.; Kars A.; Topal K.; Yesilyurt M.
OBJECTIVE: Various therapeutic methods are employed to reduce thyroid gland compression of the trachea. Differences in the amount of shrinkage in the thyroid gland, in the amount of amelioration of tracheal compression, and in the amount of fibrosis after treatment may occur with these different methods. Although the compression of the trachea decreases after thyroidectomy, the number of studies showing the extent of this is limited. The purpose of this study was to investigate the effect of thyroidectomy performed due to tracheal compression, to reveal the extent of improvement using magnetic resonance imaging (MRI), and to evaluate our results. METHODS: In total, 30 patients, i.e., 24 women and 6 men, with tracheal compression secondary to thyroid gland enlargement and undergoing total thyroidectomy were included in this study. MRI performed before surgery and 6 months after surgery. The amount of deviation from the tracheal midline and the tracheal lateral and anteroposterior (AP) diameters were measured, compared, and subjected to statistical analysis. RESULTS: Statistical analysis revealed significant differences between pre- and postoperative tracheal deviations, and lateral and AP diameters (p<0.001, p<0.001, and p=0.006, respectively). Histopathologically, benign or malignant pathology caused no significant difference in the postoperative improvement of tracheal anatomy (p=0.348 and p=0.148, respectively). CONCLUSIONS: Thyroidectomy performed due to tracheal compression provides significant improvement in tracheal anatomy. Due to its rapid and effective results, thyroidectomy should be one of the first options considered in the treatment of thyroid diseases with compression findings.
Evaluation of Computed Tomography Findings in Revision Endoscopic Sinus Surgery
(2021-01-01) Aydemir L.; Şen C.; Şahin B.; Çaytemel B.; Kars A.; Çomoğlu Ş.; Türel M.N.K.
Evaluation of effect of septoplasty on nasal mucosal dryness using intranasal Schirmer test
(2022-01-01) Topal K.; Kars A.; Atalay F.; Kılıc K.
Background: Septal deviation causes the air entering the nose to encounter resistance and leads to turbulent flow formation by disrupting laminar air flow. In the literature, the Schirmer test has been recommended to evaluate the moistening of the nasal mucosa. Aims/Objectives: The purpose of this study was to evaluate the degree of nasal humidification using the intranasal schirmer test in patients with septal deviation and to reveal changes in mucosal dryness and humidity in both nasal cavities following septoplasty surgery. Material and Methods: Fifty-three patients with septal deviation detected at endoscopic rhinoscopic examination and scheduled for surgery were enrolled. Schirmer test was performed twice, at a one-month interval, pre- and postoperatively and test records were compared. Results: The Schirmer test value for the deviated side of the septum was significantly lower than that for the contralateral side, for both nasal cavities. Schirmer test values increased significantly on the side of the septal deviation compared to the preoperative values. Conclusions and Significance: Septoplasty surgery performed for septal deviation significantly and reduces nasal mucosa dryness so increases Schirmer test results on the deviated side. We attribute this to septal deviation impairing air flow in the nasal cavity and causing nasal mucosa dryness.
Olfactory Dysfunction Following CoronaVac Coronavirus Disease 2019 Vaccination: A Case Report
(2023-04-01) Kars A.; Topal K.; Atalay F.
Possible Role of Endocannabinoids in Olfactory and Taste Dysfunctions in COVID-19 Patients and Volumetric Changes in the Brain
(2022-10-01) Ergül Z.; Kaptan Z.; Kars A.; Biçer G.; Kılınç Ç.; Petekkaya E.; Çöplü N.
Introduction: COVID-19 infection develops neurologic symptoms such as smell and taste loss. We aimed to determine the volumetric changes in the brain and correlation of possible related biochemical parameters and endocannabinoid levels after COVID-19 recovery. Methods: Brain magnetic resonance images of recovered COVID-19 patients and healthy volunteers, whose olfactory and gustatory scores were obtained through a questionnaire, were taken, and the volumes of the brain regions associated with taste and smell were measured by automatic and semiautomatic methods. Endocannabinoids (EC), which are critical in the olfactory system, and vitamin B12, zinc, iron, ferritin, thyroid-stimulating hormone (TSH), and thyroxine (T4) levels, which are reported to have possible roles in olfactory disorders, were measured in peripheral blood. Results: Taste and smell disorder scores and EC levels were found to be higher in recovered COVID-19 patients compared to controls. EC levels were negatively correlated with bilateral entorhinal cortex (ENT) volumes in the COVID-19 group. Subgenual anterior cingulate cortex volumes showed correlations with gustatory complaints and ferritin in recovered COVID-19 patients. Conclusions: The critical finding of our study is the high EC levels and negative correlation between EC levels and left ENT volumes in recovered COVID-19 patients. Implications: It is possible that ECs are potential neuromodulators in many conditions leading to olfactory disorders, including COVID-19.
Sinonasal Abnormalities on Cranial Magnetic Resonance Imaging in Patients with Tension-Type Headache
(2022-04-01) Atalay F.; Kars A.; Topal K.; Kul B.; Yavuz Z.
Systemic immune inflammation index in differentiated thyroid cancers
(2022-04-01) Kars A.; Sahin A.; Kılıc K.; Sakat M.S.; Bilen A.
Objective. The aim of this study was to investigate the relationship between differentiated thyroid carcinomas (DTCs), histopathological findings and systemic immune-inflammation index (SII) [neutrophil (N) x platelet (P) / lymphocyte (L)] values. Methods. 93 patients with DTC were included. N, P and L levels were measured, and the relationship between the SII and histopathological findings was determined. The results were compared with the values of 33 healthy controls. Results. SII values were significantly higher in the patient group than in the control group (p = 0.000). Tumour pathology diagnosis had no significant effect on SII (p = 0.90). Perineural lymphovascular and capsule invasion and extrathyroidal extension also had no significant effect on SII values. SII was significantly higher in patients with more than one tumour focus (p = 0.01). No significant relationship was determined between tumour diameter and SII. Conclusions. SII is higher in patients with DTC compared to the healthy population. High SII values may be associated with multifocality. According to the results of this study, SII does not affect the histological type, perineural, lymphovascular and capsule invasion, or extrathyroidal extension of DTC.
Systemic immune inflammation index in patients with recurrent aphthous stomatitis
(2022-07-01) Atalay F.; Kars A.; Topal K.; Yavuz Z.
Objectives: Recurrent Aphthous Stomatitis (RAS) a chronic idiopathic oral mucosal disease. But yet the etiology and pathogenesis of RAS are not exactly known, it is thought that inflammation play an important role in the pathogenesis. The aim of this study is to demonstrate the role of systemic inflammation among the possible etiological factors of RAS and to find the possible diagnostic correlation between Systemic Immune Inflammation Index (SII). Methods: Patients who were consulted the otolaryngology outpatient clinic and diagnosed with RAS between 2019–2021 were retrospectively analyzed. Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR) and SII values were calculated based on the results of complete blood count. Demographic and hematological parameters between control and RAS groups were compared. The statistical significance level was considered as <0.05. Results: There was no statistically significant difference between the control and RAS groups in terms of sex and age distributions (p = 0.566 and p = 0.173, respectively). SII, NLR and PLR values were significantly higher in the RAS group compared to the controls (p < 0.001, p < 0.001 and p = 0.001, respectively). A very strong correlation between SII and NLR, moderately strong correlation between SII and PLR and moderate correlation between NLR and PLR values were detected (respectively ρ: 0.813, 0.719, 0.532; p-values <0.001). Conclusion: SII, NLR and PLR has significantly higher levels in the RAS group compared to the control group, that it supports the role of systemic inflammation in the etiopathogenesis of RAS. In addition, the results show that SII is a valuable marker for inflammation. Level of evidence: 4.
Tularemia in Children: Evaluation of 22 Cases
(2022-01-01) Kars A.; Şenol P.E.; Köyceğiz S.
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 treatment 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.