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  • Küçük Resim
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    Comparison of nasal mucociliary clearance in adenoid hypertrophy with or without otitis media with effusion
    (Elsevier, 2014) Yazıcı, Haşmet; Soy, Fatih Kemal; Kulduk, Erkan; Doğan, Sedat; Dündar, Rıza; Sakarya, Engin Umut; Haberal Can, İlknur
    Objective: To investigate pre- and postoperative mucociliary clearance in patients with adenoid hypertrophy or combined with otitis media with effusion. Methods: Patients were divided into two groups: Group 1-patients with adenoid hypertrophy (AH), and Group 2 patients with AH and otitis media with effusion (AHOME). In all patients, AH size was recorded, and the Andersen saccharin and methylene blue tests were conducted before and 1 month after surgery to obtain mucociliary clearance time (MCT). Nasal cavity length was measured intraoperatively to establish mucociliary clearance velocity (MCV). Patients with allergic rhinitis, active infection, and history of nasal or ear surgery were excluded. Results: This study included 64 patients with a mean age of 8.34 +/- 2.98 years (range: 3-18 years). Pre- and postoperative MCT were 14.60 +/- 4.83 and 9.48 +/- 2.63 min in Group 1 and 16.03 +/- 4.31 and 12.12 +/- 3.78 mm-in Group 2, respectively. Pre- and postoperative MCV were 0.77 +/- 0.30 and 1.16 +/- 0.42 mm/min in Group 1 and 0.67 +/- 0.16 and 0.89 +/- 0.28 mm/min in Group 2, respectively. MCT and MCV were significantly improved postoperatively in both groups (p < 0.001). In addition, the postoperative MCT and MCV of Group 1 were significantly better than those of Group 2(p < 0.001). Exposure to cigarette smoking and adenoid size had negative correlations with mucociliary clearance. Conclusions: Otitis media was associated with impaired mucociliary clearance and further studies should be performed to demonstrate the causes of this deficiency.
  • Küçük Resim
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    Uncinatotomy: Performing endoscopic sinus surgery without an uncinectomy
    (Lippincott Williams and Wilkins, 2015) Yazıcı, Haşmet; Soy, Fatih Kemal; Kulduk, Erkan; Doğan, Sedat; Dündar, Rıza; Haberal Can, İlknur
    Background: The results of endoscopic sinus surgery performed for chronic rhinosinusitis are controversial. For a better surgical outcome, different surgical techniques involving an uncinectomy as the primary step of the operation have been proposed. The surgery should resolve the pathophysiologic problems caused by the disease and preserve the normal anatomy and physiology. We developed a technique to remove the pathology localized to isolated maxillary and anterior ethmoid cells, without excising the uncinate process. The infundibular area was exposed with medialization of the uncinate with a bipedicle flap prepared 1.5 cm from the insertion of the uncinate to the nasal wall, and then the sinus pathology was removed. At the end of the surgery, the uncinate was returned to its original position. Methods: We performed this new technique to 3 patients and evaluated postoperative results. Results: Primary disease was eradicated, and no complication was noted. Conclusions: With this technique, it is possible to perform all steps of sinus surgery without excising any anatomic structure.