Sureyya Hikmet Kozcu's research while affiliated with Tepecik Training and Research Hospital and other places

Objective: Several studies in literature have reported the effects of septoplasty on postoperative quality of life. However, there is not enough evidence regarding the effect of the chosen type of anesthesia on patient satisfaction and quality of life in patients with septoplasty. In this study, we aimed to evaluate the effect of anesthesia in patients who underwent surgery for nasal septum deviation on their quality of life (QOL) and patient satisfaction. Methods: This prospective, non-randomized, and controlled study was conducted in a third-line reference hospital between July and December 2016. Although no randomization technique was used in the study, the patients included in the study were those on the clinical surgery list and met the inclusion criteria. Fifty patients who underwent septoplasty under general anesthesia (GA) and 50 who underwent septoplasty under local anesthesia (LA) were included. Data were collected using a case report form, World Health Organization-5 (WHO-5) Well-Being Index, Nasal Obstruction Symptom Evaluation (NOSE) form, and patient satisfaction form. Data collection from the completed forms was blinded to the patients and type of anesthesia (day of surgery and post-op 30 th day). Descriptive statistics, Mann-Whitney U test, Pearson's chi-squared test, Wilcoxon marked order test, and Spearman's correlation test were used for data evaluation. Results were evaluated based on 95% confidence interval and p value of < 0.05. Results: There was no difference in sociodemographic characteristics of patients and median WHO-5 and NOSE scores between the groups (p > 0.05). Postoperatively, there was no difference in general health, QOL, and satisfaction (p > 0.05); healthcare satisfaction was higher in patients who had GA (p = 0.000). Conclusion: There was no significant difference in QOL between the patients who underwent septoplasty under GA and LA. In the first month following surgery, patients who underwent septoplasty under GA had higher healthcare satisfaction.

Introduction Adenoidectomy is one of the most frequently performed surgical procedures with different techniques and technologies. Although curettage adenoidectomy (CA) has been practiced conventionally for many years, endoscopic microdebrider adenoidectomy (EMA) has emerged as an innovative surgical method. Comparing physiological effects, efficacy and safety of the endoscopic microdebrider adenoidectomy (EMA) and curettage adenoidectomy (CA) in pediatric population is aimed with this prospective, single-blind, randomized, controlled trial. Methods Sixty pediatric patients with type-A tympanogram according to Jerger classification in both ears before surgery were randomly assigned to receive the CA (n = 30) and the EMA (n = 30). Tympanometry evaluation for each ear was performed the day before surgery firstly and was repeated on days 1, 7 and 14 after surgery. Intraoperative time, complications during and after the operation were recorded. Postoperative pain was also evaluated for 10 days postoperatively. Results Tympanometric evaluation revealed significantly reduced middle ear peak pressure levels with the EMA than with the CA for each ear on day 1 after surgery and for only left ear on day 7 after surgery (P < 0.05). In addition, statistically significant reduced pain scores in postoperative first 3 days were related to the EMA (P < 0.05). There was no significant difference between the methods in terms of duration of surgery and complications. Conclusion According to findings from this study, the EMA procedure may be as safe and rapid as the CA. Furthermore, the EMA may be more controlled and less invasive to the surrounding tissues. Further studies are advised to support these data.

Objective: The risk factors for the development of retention cysts of the maxillary sinuses (RCMs) are not clear, although RCMs are common findings on radiographic images. This study was conducted to evaluate the correlation between RCMs and other nasal-paranasal anomalies and to demonstrate the possible effects of these anomalies on the development of RCMs. Methods: In the study, paranasal sinus computerized tomography (PNsCT) images from 5166 patients were retrospectively reviewed. Correlations between RCMs and osteomeatal complex obstruction, accessory ostium presence, abnormalities of the middle turbinate, and nasal septal deviation were analyzed in the PNsCT images. The paranasal sinus anomalies on the side of the RCMs were compared to the contralateral side. Results: A total of 1880 RCMs were detected in 1429 (27.6%) of 5166 patients. At least one nasal-paranasal sinus anomaly was associated with 88.7% of the RCMs. In the descending order, accessory ostium presence, accessory ostium, middle turbinate anomalies, and nasal septal deviation are pathologies that accompany RCMs. When unilateral RCMs were compared with the normal side, significant correlations were observed between RCMs and osteomeatal complex obstruction, accessory ostium, and middle turbinate anomalies (p=0.001, p=0.016, and p=0.03, respectively). RCMs were commonly found on the same side as osteomeatal complex obstruction (p=0.001), middle turbinate anomalies (p=0.001), and accessory ostium (p=0.052). Conclusions: In this study, the coexistence of osteomeatal complex obstruction, accessory ostium, middle turbinate anomalies, and nasal septum deviation with RCMs was analyzed by investigating PNsCT findings in 5166 patients. The results show that RCMs are associated with pathologies that increase paranasal inflammation, such as osteomeatal complex obstruction, and are good markers for nasal-paranasal sinus anomalies. The presence of incidental RCMs should be a warning sign of nasal-paranasal sinus anomalies.

Objectives: Post-operative haemorrhage remains the most serious complication of tonsillectomy. Recently, several techniques and devices have been developed to minimize intra- and post-operative bleeding, but no optimal method has emerged. In this study, we assessed the effectiveness of z-shaped suture ligation, ensuring haemostasis in paediatric tonsillectomy and preventing post-tonsillectomy haemorrhage in the early and late stages. Methods: Retrospective data were collected from 315 consecutive children who underwent the tonsillectomy procedure with the cold dissection technique and z-shaped suture ligation to obtain haemostasis. Results: No patient experienced post-tonsillectomy haemorrhage. The success rates, in terms of early and late haemostasis, afforded by z-shaped suturing of the tonsillar fossa were thus 100%. Conclusions: The use of z-shaped suturing affords efficient and practical haemostasis in paediatric tonsillectomy. The procedure is inexpensive and requires no special equipment. The anterior and posterior pillars are preserved; thus, functional anatomy is ensured.

Background In order to apply the right treatment for hemostatic disorders in pediatric patients, laboratory data should be interpreted with age-appropriate reference ranges. Objectives The purpose of this study was to determining age-dependent reference range values for prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen tests, and D-dimer tests. Materials and Methods A total of 320 volunteers were included in the study with the following ages: 1 month - 1 year (n = 52), 2 - 5 years (n = 50), 6 - 10 years (n = 48), 11 - 17 years (n = 38), and 18 - 65 years (n = 132). Each volunteer completed a survey to exclude hemostatic system disorder. Using a nonparametric method, the lower and upper limits, including 95% distribution and 90% confidence intervals, were calculated. Results No statistically significant differences were found between PT and aPTT values in the groups consisting of children. Thus, the reference ranges were separated into child and adult age groups. PT and aPTT values were significantly higher in the children than in the adults. Fibrinogen values in the 6 - 10 age group and the adult age group were significantly higher than in the other groups. D-dimer levels were significantly lower in those aged 2 - 17; thus, a separate reference range was established. Conclusions These results support other findings related to developmental hemostasis, confirming that adult and pediatric age groups should be evaluated using different reference ranges.