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Papers by Suleyman Yilmaz

European Archives of Oto Rhino Laryngology and Head Neck, 2010

Our aim was to investigate cisplatin ototoxicity with transient evoked otoacoustic emission (TEOA... more Our aim was to investigate cisplatin ototoxicity with transient evoked otoacoustic emission (TEOAE) test before it is seen with pure tone audiometer. In our study, we compared the hearing of the patients who are receiving 100 mg/m 2 4-cycle cisplatin for lung cancer, with pure tone audiometer and transient evoked otoacoustic emission test in 1,000, 2,000 and 4,000 Hz. We found 55% hearing decrease with pure tone audiometer in patients that are receiving 100 mg/m 2 4-cycle cisplatin for lung cancer. We also established emission amplitude decrease with TEOAE test in 85% of the patients. When we compare the patients' pure tone audiometer in 1,000, 2,000 and 4,000 Hz and TEOAE amplitude changes we did not find statistically significant results (P [ 0.05), but when we compare the patients' TEOAE amplitude changes in 1,000, 2,000 and 4,000 Hz with control group we found statistically significant results (P \ 0.05). Our results show that cisplatin ototoxicity could be find out with TEOAE test before it is seen with pure tone audiometer.

Ferroelectrics, 2004

We report the results of electronic structure calculations for several types of MoO4-clusters in ... more We report the results of electronic structure calculations for several types of MoO4-clusters in the Gd2(MoO4)3 structure in ferroelectric and paraelectric phase by using cluster ab initio restricted Hartree Fock method. The results give a variational approximation to the ground state electron densities of these clusters within the framework of ab initio restricted Hartree Fock (RHF) MO LCAO method.

European Archives of Oto Rhino Laryngology and Head Neck, Feb 1, 2011

Our objective is to evaluate the incidence of unexpected pathologies in routine nasal polyposis s... more Our objective is to evaluate the incidence of unexpected pathologies in routine nasal polyposis specimens and necessity for histopathological evaluation of nasal polyps. A retrospective chart review of all patients who underwent nasal polyposis surgery between January 2004 and June 2010 were reviewed. The patients were divided into two groups. Group 1 consisted of patients with bilateral nasal polyposis. Group 2 consisted of patients with unilateral nasal polyposis. One hundred and seventeen patients (81 male, 36 female) were involved in this study. The mean age was 44.9 § 17.7 years, ranging between 18 and 72 years. Group 1 consisted of bilateral nasal polyposis specimens. Eighty-Wve patients were identiWed with bilateral nasal polyposis. From these 85 patients, no specimens present any evidence of occult pathology on histopathological examination. Group 2 consisted of unilateral nasal polyposis specimens. There were two cases of allergic fungal sinusitis, two of inverting papilloma, one of mucocele, one of plasmacytoma, one of hemangioma, one of esthesioneuroblastoma, and one of schwannoma. Final histopathology of the remaining 23 patients was consistent with inXammation and/or nasal polyposis. We think that in cases of unilateral polyps histopathological examination of the entire material is mandatory. However, routine histological examination of bilateral nasal polyposis may possibly not be necessary in cases where the clinical assessment very clearly has not disclosed any unusual or suspicious signs.

Aim: To review our chronic otitis media surgeries and to investigate the reasons of unsuccess and... more Aim: To review our chronic otitis media surgeries and to investigate the reasons of unsuccess and success of the type 1 tympanoplasty operations. Material and Methods: 68 chronic otitis media patients who underwent type 1 tympanoplasty surgery between 2000 and 2005 years are examined retrospectively. The sex, age, perforation types of the ears (central, marginal, subtotal and total), operation technique

Pneumosinus dilatans is an extremely rare condition which is characterized by gross enlargement o... more Pneumosinus dilatans is an extremely rare condition which is characterized by gross enlargement of the paranasal sinuses. The etiology is not identified. Pneumosinus dilatans refers to an aerated sinus which is abnormally expanded. Anatomical variations of the paranasal sinuses and nasal cavity are important in sinus diseases. We are reporting one patient with pneumosinus dilatans who attended Duzce medical faculty

The Journal of Otolaryngology, 2007

Indian Journal of Otolaryngology and Head & Neck Surgery, 2011

The aim of this study was to determine the prevalence of otitis media with effusion (OME) in prim... more The aim of this study was to determine the prevalence of otitis media with effusion (OME) in primary school children in Rize (Eastern Black Sea Region) and the impact of tobacco smoke exposure in the development of OME in primary school children. This study involved a total of 2960 children who appeal for ENT examination to our department at Rize Training and Research Hospital between November 2007 and April 2009. All children were evaluated with regard to OME and exposure to cigarette smoke. Pure tone audiometry and tympanometry tests and pneumatic otoscopy were performed on the children who were diagnosed with OME by otoscopic examination. The association between the children diagnosed as OME and exposure to cigarette smoke was evaluated. The prevalence of OME in this study was 9.86% (292/2960). Exposure to cigarette smoke was a statistically significant factor in development of OME (P < 0.0001). Environmental factors such as smoking are important in the development of OME. To prevent delayed diagnosis or development of this disease, parents must be informed about the preventable risk factors and symptoms for the development of OME.

Clinical and Experimental Otorhinolaryngology, 2010

Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the maxillary antrum and they... more Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the maxillary antrum and they extend into the choana. They occur more commonly in children and young adults, and they are almost always unilateral. The etiopathogenesis of ACPs is not clear. Nasal obstruction and nasal drainage are the most common presenting symptoms. The differential diagnosis should include the causes of unilateral nasal obstruction. Nasal endoscopy and computed tomography scans are the main diagnostic techniques, and the treatment of ACPs is always surgical. Functional endoscopic sinus surgery (FESS) and powered instrumentation during FESS for complete removal of ACPs are extremely safe and effective procedures. Physicians should focus on detecting the exact origin and extent of the polyp to prevent recurrence.

Gut and Liver, 2012

Endometriosis is an ectopic endometrium, commonplaced in the female. But its occurence in the man... more Endometriosis is an ectopic endometrium, commonplaced in the female. But its occurence in the man is mysterious. In the literature two cases of endometriosis in men have occured following surgery. 1 The present case is the first reported arising in the inguinal region, near the ductus deference.

International Journal of Pediatric Otorhinolaryngology, 2009

Urological Research, 2012

Urinary stone disease (USD) alone can cause much morbidity, but when present in conjunction with ... more Urinary stone disease (USD) alone can cause much morbidity, but when present in conjunction with urinary tract infection, complications and morbidity increase even more. This study investigated the clinical and laboratory findings in patients who had USD with and without infection and evaluated the most suitable diagnostic value for urinary tract infection parameters before urine culture results were available. In a prospective fashion, patients who presented to the emergency department with a complaint of colicky flank pain (with or without hematuria) and who were diagnosed as having urolithiasis with ultrasound were evaluated for 1 year. The gold standard for the diagnosis of urinary tract infection was urine culture. The most suitable diagnostic value for urinary tract infection parameters was determined by receiver operating characteristic (ROC) curves. Logistic regression was used to identify independent variables that predicted a positive urine culture. Of the 192 eligible patients, 177 agreed to participate in the study. Of the clinical and laboratory characteristics analyzed, urine WBC, blood WBC, and fever were significantly different between culture positive and negative patients (p \ 0.001, p = 0.04 p = 0.012, respectively). Using ROC curve analysis, pyuria (over 10 WBCs per HPF), fever over 37.9°C, and leucocytosis over 11,300 were the best predictors of a positive culture result. The logistic regression model for leukocytosis [11,300 (OR 2.1), pyuria (OR 2.8), and temperature [37.9°C (OR 3.1) showed a significantly increased risk of having a positive urine culture (correct class 87.9%). While a single physical examination or laboratory finding cannot predict urinary tract infection in USD patients with complete reliability, the presence of pyruria, fever, and leukocytosis significantly increases the odds of a positive urine culture.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2010

Gastrointestinal (GI) bleeding is considered obscure when it persists or recurs after negative en... more Gastrointestinal (GI) bleeding is considered obscure when it persists or recurs after negative endoscopy. Small bowel lesions account for approximately 1-fourth of cases of obscure GI bleeding. These lack specific clinical symtoms and signs, and tend to be inaccessible to routine examinations. The management of patients with intermittent obscure GI bleeding poses both diagnostic and therapeutic challenges. The aim of this study was to report the importance of laparoscopy in diagnosing and treating small bowel lesions responsible for obscure bleeding in 5 patients with subacute presentations. Data were collected from 2 hospitals' in-patient records and a prospective database. All patients underwent laparoscopic exploration. After the identification of the diseased segments, laparoscopy-assisted segmental resection of the small bowel and enteroentorostomy were carried out in all cases. This approach enabled a successful minimally invasive treatment of the obscure GI bleeding. The overall procedure was safe and our results were satisfactory.

Otolaryngology -- Head and Neck Surgery, 2013

The aim of this study was to find out the efficacy of a polyvinyl alcohol (PVA) sponge (Merocel K... more The aim of this study was to find out the efficacy of a polyvinyl alcohol (PVA) sponge (Merocel Kennedy; Medtronic Xomed, Jacksonville, Florida) sinus pack soaked with levobupivacaine hydrochloride to control postoperative pain and analgesic need following functional endoscopic sinus surgery (FESS). The study was designed as a prospective, double-blind, randomized, controlled study. Forty-one patients who underwent FESS were included in the analysis. Setting A tertiary referral hospital in Turkey. Patients who underwent FESS were divided into 2 groups. The PVA sponge sinus packs were soaked with 5 mL of levobupivacaine hydrochloride (chirocaine 25 mg/10 mL; Abbott, Nycomed Pharma AS, Elverum, Norway) in group I and with 5 mL of saline in group II. Postoperative pain levels were recorded using a visual analog scale (VAS score, 0-100) at 30 minutes and 1, 2, 8, 12, and 24 hours. There were no statistically significant differences between groups regarding age, sex, and American Society of Anesthesiologists status. Postoperative VAS values at 30 minutes and 1, 2, 8, 12, and 24 hours were significantly lower in group I than in group II (P < .05). Supplemental analgesia amount was significantly lower in group I than in group II (P = .003). Using levobupivacaine-soaked PVA sponge sinus packs after FESS is an effective, easy, and quick method to control postoperative pain, and it improves patient comfort and tolerability.

Journal of Oral and Maxillofacial Surgery, 2006

We evaluated the results of the 2-wall and 3-wall orbital decompression in patients with Graves&a... more We evaluated the results of the 2-wall and 3-wall orbital decompression in patients with Graves' disease. In this study, we present a consecutive series of 12 patients (18 orbits) who were submitted to orbital decompression by endoscopic transnasal medial wall combined with transantral inferior wall approach and 7 patients (8 orbits) who were submitted to orbital decompression by endoscopic transnasal medial wall, transantral inferior wall combined with transcutaneous lateral wall approach. The degree of exophthalmos was evaluated with the Hertel exophthalmometer preoperatively and postoperatively in the 24th hour, and first, third, and ninth months. At the end of the third month, the exophthalmos decreased by a mean of 4.38 mm (range, 3 to 7 mm) with the 2-wall decompression and 7.75 mm (range, 5 to 12 mm) with the 3-wall decompression. Visual acuity maintained or improved during the follow-up period. Ocular motility disturbance occurred in 1 patient after 2-wall decompression and in 1 patient after 3-wall orbital decompression. Postoperatively, new-onset diplopia was seen in only 1 patient after 2-wall orbital decompression. The 3-wall (endoscopic transnasal medial wall, transantral inferior wall combined with transcutaneous lateral wall) approach is as safe as the 2-wall approach. Proptosis reduction is much better with the 3-wall orbital decompression.

The Journal of Laryngology & Otology, 1990

Granular cell tumour (GCT) of the larynx is an uncommon laryngeal tumour. It is always benign and... more Granular cell tumour (GCT) of the larynx is an uncommon laryngeal tumour. It is always benign and commonly located in the posterior part of the larynx. Care must be taken to differentiate this lesion from others due to the presence of pseudo-epitheliomatous hyperplasia which overlies the GCT and may occasionally mimic squamous cell carcinoma. Therefore, histological differentiation is important because these tumours are normally managed conservatively. The origin of this tumour is a matter of debate, but most authors believe it to be neural in origin. The rarity of this tumour in the male population prompted reporting this case in the literature.

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2010

The invasiveness of laparoscopic cholecystectomy was further minimized by reducing the number of ... more The invasiveness of laparoscopic cholecystectomy was further minimized by reducing the number of incisions with the introduction of single-incision laparoscopic surgery (SILS) cholecystectomy. In order to solve the challenges posed by SILS cholecystectomy, an increasing number of techniques have been reported with the advent of new surgical instruments and refinements to existing technology. We describe, in this article, two new techniques that utilize existing instrumentations: an access and a retraction technique. A consecutive series of 23 selected patients with symptomatic cholelithiasis underwent SILS cholecystectomy from April 10, 2009 to August 12, 2009. The overall procedure was similar to SILS cholecystectomy described in the literature. Hovewer, the access technique, with small-size arthroscopy cannules, was used to overcome the technical difficulty resulting from the collision of large-size caps of the laparoscopy trocars, and the retraction technique with a tacker was used to suspend the fundus of the gallbladder without taking the risk of gallbladder perforation. All patients were female, and the mean age was 34 years (range, 27-65). The body mass index of all patients was below 30 kg/m(2). The use of arthroscopy cannules provided a wider range of movement, and the retraction of the gallbladder was achieved safely with the tacker. These techniques reduced the operative times considerably. Most of the challenges posed by SILS cholecystectomy can be easily solved with simple technical modifications.

Journal of Anesthesia, 2010

Purpose Pain control after tonsillectomy is still a controversial issue. Topical approaches have ... more Purpose Pain control after tonsillectomy is still a controversial issue. Topical approaches have the advantage of pain control with good patient acceptability. Therefore, this study was conducted to evaluate the effects of topical tramadol on postoperative pain and morbidity in children undergoing tonsillectomy. Methods A prospective, randomized, double-blind, controlled clinical study was designed. Forty children aged between 4 and 15 years, ASA I-II, scheduled for elective tonsillectomy and/or adenoidectomy were randomized into two groups. For patients in Group T (n = 20) swabs soaked with 2 mg/kg tramadol diluted in 10 ml saline were applied to both of their tonsillar fossa for 5 min; in the control group (n = 20) swabs soaked with 10 ml saline were applied. Postoperative pain scores, bleeding, nausea, vomiting, abdominal discomfort, constipation, pain in the throat, painful swallowing, fever, otalgia, trismus, and halitosis were recorded at the first, fifth, thirteenth, seventeenth, twenty-first, and twenty-fourth postoperative hours and the week after tonsillectomy. Results Pain scores were found to be significantly lower at the 21st hour and on postoperative day seven in the tramadol group compared with the control group (p \ 0.05). Mean daily pain scores ranged from Day 1: 0.34 (±0.21) to Day 7: 0.11 (±0.08) in the tramadol group and Day 1: 0.53 (±0.14) to Day 7: 0.42 (±0.15) in the control group. There were no significant differences in morbidity between the groups (p [ 0.05). Conclusion Topical 5% tramadol with its local anesthetic effect seems to be an easy, safe, and comfortable approach for pain management in children undergoing tonsillectomy.

Gynecologic and Obstetric Investigation, 2011

To evaluate the pathological effects of preeclampsia on hearing levels in pregnant women by pure-... more To evaluate the pathological effects of preeclampsia on hearing levels in pregnant women by pure-tone audiometry and brainstem auditory-evoked potentials (BAEPs). Both ears in 30 preeclamptic patients and 38 women with uncomplicated pregnancy matched by maternal age and gestational age were investigated based on BAEPs and pure-tone audiometry. Hearing thresholds were within the normal ranges in all subjects prior to pregnancy. We compared the results of hearing levels and auditory pathway functions between the two groups. Statistically significant differences in pure-tone audiometry results were found between the two groups (p < 0.05). However, these results were not clinically significant because all pure-tone thresholds were lower than 20 dB (normal hearing abilities). The differences between BAEPs were not statistically significant (p > 0.05). This study suggests that preeclampsia does not markedly affect hearing function unless it causes secondary vascular occlusion of microcirculation related to hearing.

Ferroelectrics, 2004

We report the results of electronic structure calculations for several types of MoO4-clusters in ... more We report the results of electronic structure calculations for several types of MoO4-clusters in the Gd2(MoO4)3 structure in ferroelectric and paraelectric phase by using cluster ab initio restricted Hartree Fock method. The results give a variational approximation to the ground state electron densities of these clusters within the framework of ab initio restricted Hartree Fock (RHF) MO LCAO method.

Ferroelectrics, 2002

A calculation procedure for obtaining the complete set of scattering coefficients and incident, s... more A calculation procedure for obtaining the complete set of scattering coefficients and incident, scattered and internal electric fields in terms of the vector spherical harmonics for a multilayered nonlinear structure (as model of polydomain ferroelectric) is proposed by using the T-matrix method.

European Archives of Oto Rhino Laryngology and Head Neck, 2010

Our aim was to investigate cisplatin ototoxicity with transient evoked otoacoustic emission (TEOA... more Our aim was to investigate cisplatin ototoxicity with transient evoked otoacoustic emission (TEOAE) test before it is seen with pure tone audiometer. In our study, we compared the hearing of the patients who are receiving 100 mg/m 2 4-cycle cisplatin for lung cancer, with pure tone audiometer and transient evoked otoacoustic emission test in 1,000, 2,000 and 4,000 Hz. We found 55% hearing decrease with pure tone audiometer in patients that are receiving 100 mg/m 2 4-cycle cisplatin for lung cancer. We also established emission amplitude decrease with TEOAE test in 85% of the patients. When we compare the patients' pure tone audiometer in 1,000, 2,000 and 4,000 Hz and TEOAE amplitude changes we did not find statistically significant results (P [ 0.05), but when we compare the patients' TEOAE amplitude changes in 1,000, 2,000 and 4,000 Hz with control group we found statistically significant results (P \ 0.05). Our results show that cisplatin ototoxicity could be find out with TEOAE test before it is seen with pure tone audiometer.

Ferroelectrics, 2004

We report the results of electronic structure calculations for several types of MoO4-clusters in ... more We report the results of electronic structure calculations for several types of MoO4-clusters in the Gd2(MoO4)3 structure in ferroelectric and paraelectric phase by using cluster ab initio restricted Hartree Fock method. The results give a variational approximation to the ground state electron densities of these clusters within the framework of ab initio restricted Hartree Fock (RHF) MO LCAO method.

European Archives of Oto Rhino Laryngology and Head Neck, Feb 1, 2011

Our objective is to evaluate the incidence of unexpected pathologies in routine nasal polyposis s... more Our objective is to evaluate the incidence of unexpected pathologies in routine nasal polyposis specimens and necessity for histopathological evaluation of nasal polyps. A retrospective chart review of all patients who underwent nasal polyposis surgery between January 2004 and June 2010 were reviewed. The patients were divided into two groups. Group 1 consisted of patients with bilateral nasal polyposis. Group 2 consisted of patients with unilateral nasal polyposis. One hundred and seventeen patients (81 male, 36 female) were involved in this study. The mean age was 44.9 § 17.7 years, ranging between 18 and 72 years. Group 1 consisted of bilateral nasal polyposis specimens. Eighty-Wve patients were identiWed with bilateral nasal polyposis. From these 85 patients, no specimens present any evidence of occult pathology on histopathological examination. Group 2 consisted of unilateral nasal polyposis specimens. There were two cases of allergic fungal sinusitis, two of inverting papilloma, one of mucocele, one of plasmacytoma, one of hemangioma, one of esthesioneuroblastoma, and one of schwannoma. Final histopathology of the remaining 23 patients was consistent with inXammation and/or nasal polyposis. We think that in cases of unilateral polyps histopathological examination of the entire material is mandatory. However, routine histological examination of bilateral nasal polyposis may possibly not be necessary in cases where the clinical assessment very clearly has not disclosed any unusual or suspicious signs.

Aim: To review our chronic otitis media surgeries and to investigate the reasons of unsuccess and... more Aim: To review our chronic otitis media surgeries and to investigate the reasons of unsuccess and success of the type 1 tympanoplasty operations. Material and Methods: 68 chronic otitis media patients who underwent type 1 tympanoplasty surgery between 2000 and 2005 years are examined retrospectively. The sex, age, perforation types of the ears (central, marginal, subtotal and total), operation technique

Pneumosinus dilatans is an extremely rare condition which is characterized by gross enlargement o... more Pneumosinus dilatans is an extremely rare condition which is characterized by gross enlargement of the paranasal sinuses. The etiology is not identified. Pneumosinus dilatans refers to an aerated sinus which is abnormally expanded. Anatomical variations of the paranasal sinuses and nasal cavity are important in sinus diseases. We are reporting one patient with pneumosinus dilatans who attended Duzce medical faculty

The Journal of Otolaryngology, 2007

Indian Journal of Otolaryngology and Head & Neck Surgery, 2011

The aim of this study was to determine the prevalence of otitis media with effusion (OME) in prim... more The aim of this study was to determine the prevalence of otitis media with effusion (OME) in primary school children in Rize (Eastern Black Sea Region) and the impact of tobacco smoke exposure in the development of OME in primary school children. This study involved a total of 2960 children who appeal for ENT examination to our department at Rize Training and Research Hospital between November 2007 and April 2009. All children were evaluated with regard to OME and exposure to cigarette smoke. Pure tone audiometry and tympanometry tests and pneumatic otoscopy were performed on the children who were diagnosed with OME by otoscopic examination. The association between the children diagnosed as OME and exposure to cigarette smoke was evaluated. The prevalence of OME in this study was 9.86% (292/2960). Exposure to cigarette smoke was a statistically significant factor in development of OME (P < 0.0001). Environmental factors such as smoking are important in the development of OME. To prevent delayed diagnosis or development of this disease, parents must be informed about the preventable risk factors and symptoms for the development of OME.

Clinical and Experimental Otorhinolaryngology, 2010

Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the maxillary antrum and they... more Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the maxillary antrum and they extend into the choana. They occur more commonly in children and young adults, and they are almost always unilateral. The etiopathogenesis of ACPs is not clear. Nasal obstruction and nasal drainage are the most common presenting symptoms. The differential diagnosis should include the causes of unilateral nasal obstruction. Nasal endoscopy and computed tomography scans are the main diagnostic techniques, and the treatment of ACPs is always surgical. Functional endoscopic sinus surgery (FESS) and powered instrumentation during FESS for complete removal of ACPs are extremely safe and effective procedures. Physicians should focus on detecting the exact origin and extent of the polyp to prevent recurrence.

Gut and Liver, 2012

Endometriosis is an ectopic endometrium, commonplaced in the female. But its occurence in the man... more Endometriosis is an ectopic endometrium, commonplaced in the female. But its occurence in the man is mysterious. In the literature two cases of endometriosis in men have occured following surgery. 1 The present case is the first reported arising in the inguinal region, near the ductus deference.

International Journal of Pediatric Otorhinolaryngology, 2009

Urological Research, 2012

Urinary stone disease (USD) alone can cause much morbidity, but when present in conjunction with ... more Urinary stone disease (USD) alone can cause much morbidity, but when present in conjunction with urinary tract infection, complications and morbidity increase even more. This study investigated the clinical and laboratory findings in patients who had USD with and without infection and evaluated the most suitable diagnostic value for urinary tract infection parameters before urine culture results were available. In a prospective fashion, patients who presented to the emergency department with a complaint of colicky flank pain (with or without hematuria) and who were diagnosed as having urolithiasis with ultrasound were evaluated for 1 year. The gold standard for the diagnosis of urinary tract infection was urine culture. The most suitable diagnostic value for urinary tract infection parameters was determined by receiver operating characteristic (ROC) curves. Logistic regression was used to identify independent variables that predicted a positive urine culture. Of the 192 eligible patients, 177 agreed to participate in the study. Of the clinical and laboratory characteristics analyzed, urine WBC, blood WBC, and fever were significantly different between culture positive and negative patients (p \ 0.001, p = 0.04 p = 0.012, respectively). Using ROC curve analysis, pyuria (over 10 WBCs per HPF), fever over 37.9°C, and leucocytosis over 11,300 were the best predictors of a positive culture result. The logistic regression model for leukocytosis [11,300 (OR 2.1), pyuria (OR 2.8), and temperature [37.9°C (OR 3.1) showed a significantly increased risk of having a positive urine culture (correct class 87.9%). While a single physical examination or laboratory finding cannot predict urinary tract infection in USD patients with complete reliability, the presence of pyruria, fever, and leukocytosis significantly increases the odds of a positive urine culture.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2010

Gastrointestinal (GI) bleeding is considered obscure when it persists or recurs after negative en... more Gastrointestinal (GI) bleeding is considered obscure when it persists or recurs after negative endoscopy. Small bowel lesions account for approximately 1-fourth of cases of obscure GI bleeding. These lack specific clinical symtoms and signs, and tend to be inaccessible to routine examinations. The management of patients with intermittent obscure GI bleeding poses both diagnostic and therapeutic challenges. The aim of this study was to report the importance of laparoscopy in diagnosing and treating small bowel lesions responsible for obscure bleeding in 5 patients with subacute presentations. Data were collected from 2 hospitals' in-patient records and a prospective database. All patients underwent laparoscopic exploration. After the identification of the diseased segments, laparoscopy-assisted segmental resection of the small bowel and enteroentorostomy were carried out in all cases. This approach enabled a successful minimally invasive treatment of the obscure GI bleeding. The overall procedure was safe and our results were satisfactory.

Otolaryngology -- Head and Neck Surgery, 2013

The aim of this study was to find out the efficacy of a polyvinyl alcohol (PVA) sponge (Merocel K... more The aim of this study was to find out the efficacy of a polyvinyl alcohol (PVA) sponge (Merocel Kennedy; Medtronic Xomed, Jacksonville, Florida) sinus pack soaked with levobupivacaine hydrochloride to control postoperative pain and analgesic need following functional endoscopic sinus surgery (FESS). The study was designed as a prospective, double-blind, randomized, controlled study. Forty-one patients who underwent FESS were included in the analysis. Setting A tertiary referral hospital in Turkey. Patients who underwent FESS were divided into 2 groups. The PVA sponge sinus packs were soaked with 5 mL of levobupivacaine hydrochloride (chirocaine 25 mg/10 mL; Abbott, Nycomed Pharma AS, Elverum, Norway) in group I and with 5 mL of saline in group II. Postoperative pain levels were recorded using a visual analog scale (VAS score, 0-100) at 30 minutes and 1, 2, 8, 12, and 24 hours. There were no statistically significant differences between groups regarding age, sex, and American Society of Anesthesiologists status. Postoperative VAS values at 30 minutes and 1, 2, 8, 12, and 24 hours were significantly lower in group I than in group II (P < .05). Supplemental analgesia amount was significantly lower in group I than in group II (P = .003). Using levobupivacaine-soaked PVA sponge sinus packs after FESS is an effective, easy, and quick method to control postoperative pain, and it improves patient comfort and tolerability.

Journal of Oral and Maxillofacial Surgery, 2006

We evaluated the results of the 2-wall and 3-wall orbital decompression in patients with Graves&a... more We evaluated the results of the 2-wall and 3-wall orbital decompression in patients with Graves' disease. In this study, we present a consecutive series of 12 patients (18 orbits) who were submitted to orbital decompression by endoscopic transnasal medial wall combined with transantral inferior wall approach and 7 patients (8 orbits) who were submitted to orbital decompression by endoscopic transnasal medial wall, transantral inferior wall combined with transcutaneous lateral wall approach. The degree of exophthalmos was evaluated with the Hertel exophthalmometer preoperatively and postoperatively in the 24th hour, and first, third, and ninth months. At the end of the third month, the exophthalmos decreased by a mean of 4.38 mm (range, 3 to 7 mm) with the 2-wall decompression and 7.75 mm (range, 5 to 12 mm) with the 3-wall decompression. Visual acuity maintained or improved during the follow-up period. Ocular motility disturbance occurred in 1 patient after 2-wall decompression and in 1 patient after 3-wall orbital decompression. Postoperatively, new-onset diplopia was seen in only 1 patient after 2-wall orbital decompression. The 3-wall (endoscopic transnasal medial wall, transantral inferior wall combined with transcutaneous lateral wall) approach is as safe as the 2-wall approach. Proptosis reduction is much better with the 3-wall orbital decompression.

The Journal of Laryngology & Otology, 1990

Granular cell tumour (GCT) of the larynx is an uncommon laryngeal tumour. It is always benign and... more Granular cell tumour (GCT) of the larynx is an uncommon laryngeal tumour. It is always benign and commonly located in the posterior part of the larynx. Care must be taken to differentiate this lesion from others due to the presence of pseudo-epitheliomatous hyperplasia which overlies the GCT and may occasionally mimic squamous cell carcinoma. Therefore, histological differentiation is important because these tumours are normally managed conservatively. The origin of this tumour is a matter of debate, but most authors believe it to be neural in origin. The rarity of this tumour in the male population prompted reporting this case in the literature.

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2010

The invasiveness of laparoscopic cholecystectomy was further minimized by reducing the number of ... more The invasiveness of laparoscopic cholecystectomy was further minimized by reducing the number of incisions with the introduction of single-incision laparoscopic surgery (SILS) cholecystectomy. In order to solve the challenges posed by SILS cholecystectomy, an increasing number of techniques have been reported with the advent of new surgical instruments and refinements to existing technology. We describe, in this article, two new techniques that utilize existing instrumentations: an access and a retraction technique. A consecutive series of 23 selected patients with symptomatic cholelithiasis underwent SILS cholecystectomy from April 10, 2009 to August 12, 2009. The overall procedure was similar to SILS cholecystectomy described in the literature. Hovewer, the access technique, with small-size arthroscopy cannules, was used to overcome the technical difficulty resulting from the collision of large-size caps of the laparoscopy trocars, and the retraction technique with a tacker was used to suspend the fundus of the gallbladder without taking the risk of gallbladder perforation. All patients were female, and the mean age was 34 years (range, 27-65). The body mass index of all patients was below 30 kg/m(2). The use of arthroscopy cannules provided a wider range of movement, and the retraction of the gallbladder was achieved safely with the tacker. These techniques reduced the operative times considerably. Most of the challenges posed by SILS cholecystectomy can be easily solved with simple technical modifications.

Journal of Anesthesia, 2010

Purpose Pain control after tonsillectomy is still a controversial issue. Topical approaches have ... more Purpose Pain control after tonsillectomy is still a controversial issue. Topical approaches have the advantage of pain control with good patient acceptability. Therefore, this study was conducted to evaluate the effects of topical tramadol on postoperative pain and morbidity in children undergoing tonsillectomy. Methods A prospective, randomized, double-blind, controlled clinical study was designed. Forty children aged between 4 and 15 years, ASA I-II, scheduled for elective tonsillectomy and/or adenoidectomy were randomized into two groups. For patients in Group T (n = 20) swabs soaked with 2 mg/kg tramadol diluted in 10 ml saline were applied to both of their tonsillar fossa for 5 min; in the control group (n = 20) swabs soaked with 10 ml saline were applied. Postoperative pain scores, bleeding, nausea, vomiting, abdominal discomfort, constipation, pain in the throat, painful swallowing, fever, otalgia, trismus, and halitosis were recorded at the first, fifth, thirteenth, seventeenth, twenty-first, and twenty-fourth postoperative hours and the week after tonsillectomy. Results Pain scores were found to be significantly lower at the 21st hour and on postoperative day seven in the tramadol group compared with the control group (p \ 0.05). Mean daily pain scores ranged from Day 1: 0.34 (±0.21) to Day 7: 0.11 (±0.08) in the tramadol group and Day 1: 0.53 (±0.14) to Day 7: 0.42 (±0.15) in the control group. There were no significant differences in morbidity between the groups (p [ 0.05). Conclusion Topical 5% tramadol with its local anesthetic effect seems to be an easy, safe, and comfortable approach for pain management in children undergoing tonsillectomy.

Gynecologic and Obstetric Investigation, 2011

To evaluate the pathological effects of preeclampsia on hearing levels in pregnant women by pure-... more To evaluate the pathological effects of preeclampsia on hearing levels in pregnant women by pure-tone audiometry and brainstem auditory-evoked potentials (BAEPs). Both ears in 30 preeclamptic patients and 38 women with uncomplicated pregnancy matched by maternal age and gestational age were investigated based on BAEPs and pure-tone audiometry. Hearing thresholds were within the normal ranges in all subjects prior to pregnancy. We compared the results of hearing levels and auditory pathway functions between the two groups. Statistically significant differences in pure-tone audiometry results were found between the two groups (p < 0.05). However, these results were not clinically significant because all pure-tone thresholds were lower than 20 dB (normal hearing abilities). The differences between BAEPs were not statistically significant (p > 0.05). This study suggests that preeclampsia does not markedly affect hearing function unless it causes secondary vascular occlusion of microcirculation related to hearing.

Ferroelectrics, 2004

We report the results of electronic structure calculations for several types of MoO4-clusters in ... more We report the results of electronic structure calculations for several types of MoO4-clusters in the Gd2(MoO4)3 structure in ferroelectric and paraelectric phase by using cluster ab initio restricted Hartree Fock method. The results give a variational approximation to the ground state electron densities of these clusters within the framework of ab initio restricted Hartree Fock (RHF) MO LCAO method.

Ferroelectrics, 2002

A calculation procedure for obtaining the complete set of scattering coefficients and incident, s... more A calculation procedure for obtaining the complete set of scattering coefficients and incident, scattered and internal electric fields in terms of the vector spherical harmonics for a multilayered nonlinear structure (as model of polydomain ferroelectric) is proposed by using the T-matrix method.