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Biomedical subjects

Burhan Dadas

Publications and source records attributed to Burhan Dadas.

15 recordsLinked to original sources

The effects of the incision types in myringoplasty operations on cosmesis.

There is no study based on objective measurements about the cosmetic results of myringoplasty operation in medical literature. This study aims to show the differences in the auriculomastoid angle between the operations which were done with postauricular and endaural incisions. The auriculomastoid angle of 20 patients having had postauricular myringoplasty operation were measured both preoperative and postoperative periods. The auriculomastoid angles of 17 patients having had endaural myringoplasty operation were also measured in both preoperative and postoperative periods. Also, the patients were asked whether there was a change in the shape of their ears. It was observed that the increase of the auriculomastoid angles of the patients who had myringoplasty by postauricular incision was statistically significant when compared to the ones having had the operation by endaural incision. Also, the patients who had myringoplasty operation by postauricular incision realized the change in their ears significantly when compared to the other group. In this study, esthetically better results were observed in the myringoplasty operations done by endaural incision than the ones done by postauricular incision. When deciding on the incision type, this should be considered.

Adolescent↗

Blood gas changes in patients undergoing laryngeal microsurgery.

BACKGROUND: The aim of this prospective, single-blind study was to assess the variations in the blood levels of PaO(2), PaO(2)/FiO(2), PaCO(2), and acid-base balance of patients undergoing laryngeal microsurgery under general anesthesia using small-bore endotracheal tubes. METHODS: 25 male patients were intubated with endotracheal tubes of 5.5-mm-inner diameter and fifteen female patients were intubated with endotracheal tubes of 5-mm-inner diameter during surgery. PaO(2)/FiO(2), PaO(2), PaCO(2), percentage saturation of O(2) and HCO(3), and pH levels were monitored before surgery and at 15-min intervals during laryngeal microsurgery. Respiratory function's values (dead space, peak inspiratory pressure (PIP) and dynamic compliance) were recorded every 15 min throughout laryngeal microsurgery. RESULTS: No significant differences were observed between the pre- and intra-operative values of percentage saturation of O(2), PaO(2)/FiO(2) and HCO(3) until 120th min. There was no significant difference in respiratory function's values intraoperatively. Under anesthesia, PaO(2) levels significantly increased when compared with preoperative values. Another significant increase was observed in PaCO(2) levels after the 60th min. However, compared with preoperative values, pH levels significantly decreased under anesthesia at the 105th and 120th min. CONCLUSION: Laryngeal microsurgery under general anesthesia can be performed using small-bore endotracheal tubes. This is not likely to have any adverse effects on a patient's blood gases and acid-base balance unless the operation lasts longer than 105 min.

Acid-Base Equilibrium↗

Basaloid squamous cell carcinoma of the larynx.

Basaloid squamous cell carcinoma (BSCC) is a rare tumor with distinct morphological and biological features that differentiate it from the common form of squamous cell carcinoma (SCC) in the head and neck region. It is mostly seen in the supraglottic larynx, hypopharynx and a base of the tongue. We present two cases of BSCC of the larynx; both being transglottic tumors. Both of the patients underwent primary surgery including bilateral neck dissections. None of the patients had cervical metastases at histopathological examination. Both patients received radiotherapy after surgery. They were alive and free of disease at 24 and 27 months, respectively.

Adult↗

Lymphoepithelial carcinoma of the larynx.

Lymphoepithelial carcinoma (LEC) of the larynx is a rare neoplasm; with a review of the literature having disclosed only 34 documented cases. This neoplasm seems to behave in a fashion reminiscent of nasopharyngeal carcinoma. In contrast to nasopharyngeal carcinoma, most cases have not been associated with Epstein-Barr virus (EBV). The diagnosis often requires immunohistochemistry or electron microscopy for confirmation. We describe a case of this tumor involving the supraglottis. The patient was treated with supraglottic laryngectomy and bilateral modified neck dissection. The histopathological study of the surgical specimen revealed an undifferentiated carcinoma with aspects of lymphoeptihelioma. The patient underwent radiotherapy and his 2-year follow-up showed no evidence of local or distant metastasis.

Carcinoma, Squamous Cell↗

Arteriovenous malformation of the nasopharynx: a case report.

Arteriovenous malformation (AVM) of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent itself truly as a lethal benign disease. We present here an unusual case of an AVM with the size of 1.5 cm x 0.8 cm at the adenoid tissue found in an 8-year-old boy, which is not previously reported in the literature where we treated the patient with surgery alone. Although bleeding is a common presentation with vascular malformations, we have not seen any bleeding in our case. After the surgery, paranasal sinus and neck CT were undertaken. They showed no other AVM.

Adenoidectomy↗

Comparison of diced cartilage graft wrapped in surgicell and diced cartilage graft wrapped in fascia: an experimental study.

HYPOTHESIS: This study was conducted to compare diced cartilage grafts wrapped in fascia and diced cartilage grafts wrapped in surgicell with respect to their resorption. STUDY DESIGN: Experimental study. METHODS: Eight male Wistar Albino rats were used. After general anesthesia, two different subcutaneous pockets (upper and lower pocket) were prepared in the rat's abdomen. Surgicell-wrapped homograft that was taken from the ear was placed into the upper subcutaneous pocket. Fascia-wrapped homograft which was taken from the ear was placed into the lower subcutaneous pocket. All the rats were killed at the end of 2 months, and the samples were collected to be examined histopathologically. Cartilage mass, foreign body reaction, fibrosis, chronic inflammation, and vascularization were researched. RESULTS: Diced cartilage wrapped surgicell stained negative for glial fibrillary acidic protein (GFAP). Diced cartilage wrapped in fascia stained positive for GFAP. There was a significant difference between two groups with respect to fibrosis, chronic inflammation, and cartilage mass. There was no significant difference between the two groups regarding vascularization. CONCLUSIONS: This study suggests that diced cartilage graft wrapped in surgicell was absorbed, whereas diced cartilage graft wrapped in fascia was not.

Absorption↗

Isolated maxillary sinus Ewing's sarcoma.

Extraskeletal Ewing's sarcoma is rarely found arising in the head and neck region. Only six cases of extraskeletal Ewing's sarcoma invading the nasal cavity or paranasal sinuses have been reported in the literature. The first described case of that Ewing's sarcoma located in isolated maxillary sinus extending into the orbita without involving the nose is presented. A 16-year-old woman presented with swelling in her right cheek. The nasal examination was normal. A computed tomography (CT) and magnetic resonance imaging (MRI) of the sinuses revealed a large mass in the right maxillary sinus with extension to the orbita. Under general anesthesia biopsies were taken. Based on histopathological analysis, a diagnosis of extraskeletal Ewing's sarcoma was made. The patient did not accept the surgical therapy. The patient was treated with combined chemotherapy and radiotherapy. The patient has done without evidence of recurrence or metastasis for one year.

Adolescent↗

Changes occurring in the nasal mucociliary transport in patients with one-sided septum deviation.

Septum deviation is the most commonly seen nasal pathology. Mucociliar activity can be affected by septum deviation that can be detected in many nasal pathologies. This study was aimed to compare the changes occurring in the mucociliary activities in both the nasal cavities of 20 patients with one-sided septal deviation and 20 healthy young individuals without septal deviation. The mucociliary activity of the right nasal cavity in healthy human beings and the mucociliary activity of the concave and convex sides of nasal cavities in patients with septal deviation were measured. Mucociliary clearance was measured by means of the rhinoscintigraphy technique. The mucociliary transport speed on the concave side was found to be significantly increased compared to the convex side and the control group. As a result, the mucociliary activity was within normal limits in patients with septum deviation who didn't have a nasal mucosal disease. Furthermore, the mucociliary activity was found to be increased on the concave side where the airflow was higher.

Adolescent↗

Short-term evaluation of over-under myringoplasty technique.

Over-under tympanoplasty is a technique aimed at eliminating the disadvantages of the two classical techniques of overlay and underlay myringoplasty, which are employed in repairing the tympanic membrane. In this retrospective study, a total of 104 patients underwent myringoplasty, which was performed by means of the underlay technique in 46 patients and over-under technique in 58 patients. The mean follow-up period was 11 months. In the first group of patients, the underlay technique was performed; the grafted membrane was placed medial to the remaining drum and the manubrium of the malleus. In the second group, the over-under technique was performed; the grafted membrane was placed under the remaining drum and over the malleus. The rate of success in the first group of 46 patients was 91.5%, and that of atelectasis was 19.5%. The rate of success in the second group of 58 patients was 94.9% and 12%, respectively. Lateralization of the graft was not observed in either of the groups. In the patients operated on by means of the underlay technique, the air-bone gap decreased by 16.55 dB this rate was 16.96 dB in those operated on by the over-under technique. The authors consider over-under tympanoplasty to be superior to the other two classical methods not only because of its effectiveness, but also because of the results achieved by this technique.

Adolescent↗

Efficacy of anti-adhesive barriers in secondary thyroidectomy: an experimental study.

HYPOTHESIS: This study was conducted to compare the effectiveness of two anti-adhesive barriers (Seprafilm and Interceed) for reducing adhesions after thyroidectomy in a rat model. The anti-adhesive barriers are suggested for use in repeated surgeries in general and the gynecologic fields in particular. STUDY DESIGN: Controlled, randomized study. METHODS: Twenty-eight male Wistar Albino rats that underwent right subtotal thyroidectomy were randomly assigned to three groups. One group received Seprafilm (n = 10), and the other received Interceed (n = 10) as anti-adhesive barriers. The third group was the control group (n = 8). At postoperative day 14, the rats were killed under general anesthesia, and the surgical fields were evaluated for the adhesion formation. The extent of the adhesion formation is scored from 0 (no adhesions) to 2 (fibrous adhesions that required sharp dissection). Histopathologically, chronic inflammation, histiocyte, fibroblast, fibrosis, collagen, vascularization, granuloma, giant cell, and fat necrosis were examined. RESULTS: All the subjects in the control group, 7 of 10 in the Interceed group, and 4 of 10 in the Seprafilm group needed to be dissected bluntly or sharply. There was significant difference between the Seprafilm and the control group (P < .05) whereas there was no significant difference between the Interceed group and the control group (P > .05). When examined histopathologically, the criteria showing adhesion, such as fibrosis, fibroblast, and collagen were higher in the control group compared with the Seprafilm and Interceed groups. There was no significant difference between the Seprafilm and Interceed groups, whereas a significant difference was found between these two groups and the control group. CONCLUSION: This study suggests that both Seprafilm and Interceed decrease the incidence of posthyroidectomy adhesions in a rat model. Both agents showed no foreign body reaction.

Animals↗

Determination of the changes in the hypoglossal nerve function after suspension laryngoscopy with needle electromyography of the tongue.

The purpose of this study was to determine changes in the hypoglossal nerve function after suspension laryngoscopy with needle electromyography of the tongue. This study also attempted to determine the possible relationship between the predictive factors of intubation difficulty by using the intubation difficulty scale, which was introduced by Adnet et al., duration of suspension laryngoscopy and changes in hypoglossal nerve function after suspension laryngoscopy. The study was performed on 39 patients who underwent suspension laryngoscopy for benign glottic pathology. Pre-operative airway assessment was evaluated by the intubation difficulty scale and the duration of suspension laryngoscopy was recorded. Needle electromyography of the tongue was performed three or four weeks after the suspension laryngoscopy. After needle electromyography of the tongue, increased polyphasia was found in 13 patients (33 per cent), bilaterally in three of them. The interference pattern was reduced in two of these 13 patients. There was no statistically significant difference in predictive factors of intubation difficulty and the duration of the operation between these 13 patients with increased polyphasia and the remaining 26 patients with completely normal electromyography findings. These findings show that, in spite of normal clinical tongue function, subclinical changes can be detected by needle electromyography of the tongue after suspension laryngoscopy.

Adolescent↗

The evaluation of the effects of lateral osteotomies on the lacrimal drainage system after rhinoplasty using active transport dacryocystography.

The lacrimal drainage system (LDS) is vulnerable to surgical trauma during rhinoplasty. We aimed to investigate the possible effects of the low lateral osteotomies on the LDS during rhinoplasty using active transport dacryocystography (ATD) at the late postoperative stage. Twenty patients who underwent open rhinoplasty were evaluated by ATD between the sixth and seventh postoperative months. Presence of the LDS dehiscence and the absence of the passage of the contrast material into the inferior meatus were noted as signs of injury to the LDS in ATD. The proximity of the osteotomy site to the LDS was measured using three different measurements in ATD. The distance from the lacrimal fossa to the lateral osteotomy site, the distance from the inferior meatus to the lateral osteotomy site and the distance from the middle point of the lacrimal fossa and inferior meatus to the lateral osteotomy site were measured. The anatomic integrity of the bone structure around the LDS was preserved in all patients and free drainage of contrast media from the fossa lacrimalis to inferior meatus was observed in ATD evaluation of all patients. The average distance from the LDS to the lateral osteotomy site was found to be between 7-8.8 mm. In conclusion, the low lateral osteotomy is a safe method in order to avoid trauma to the LDS, and ATD seems an appropriate diagnostic technique in evaluation of the LDS after rhinoplasty.

Adult↗

Level of vocal folds as projected on the exterior thyroid cartilage.

OBJECTIVE: This study aims to identify the level of the vocal folds as projected on the exterior thyroid cartilage. STUDY DESIGN: Anatomic study of human cadaver larynges. METHODS: The study includes 83 fresh larynges harvested at autopsy from 62 male and 21 female cadavers. The larynges were excised and divided in the midline posteriorly. One needle was inserted at the level of anterior commissure from endolarynx, and the other was inserted at the thyroid ala just anterior to the vocal process along the superior surface of the right vocal cord. Measurements of vocal cord projections on the thyroid ala were done with a caliper. RESULTS: The mean value of the ratio of the distances from the superior thyroid notch to anterior commissure and the midline height from thyroid notch to the inferior border of thyroid cartilage was found to be 0.41 in males and 0.38 in females. No statistical differences were observed between these two groups (P =.062). We found that the distance from the anterior commissure to the inferior thyroid border in midline "c" was longer than the distance from the posterior border of the vocal cord to the inferior border of the inferior tubercle of the thyroid ala "d" in 44 (71%) males and in 7 (33%) females. On the other hand, "d" was longer than "c" in 8 (12.9%) males and in 8 (38.1%) females. These two distances were equal in 10 (16.1%) males and in 6 (28.6%) females. CONCLUSION: In this study, we found that the anterior commissure lies approximately at the juncture of the upper two fifths and lower three fifths of the midline height of thyroid cartilage in the majority of the larynges of the male and female cadavers. The position of the posterior border of the vocal cords was found to be at a lower level than anterior commissure in two thirds of males and in one third of females. This means that the vocal cords slope downward posteriorly in the majority of the larynges of the males. This may be one of the causes of failure of some type I thyroplasties.

Adolescent↗