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    Association of Frontal and Maxillary Bone Fractures and Concomitant Craniocerebral Injuries in Patients Presenting with Head Trauma
    (2022) Orhan Kubat, Gözde; Şahin, C.; Özen, Ö.
    Background: Maxillofacial fractures and craniocerebral injuries are common in patients with head trauma. These are injuries with high mortality and morbidity. Therefore, patients with head trauma should be evaluated early with a multidisciplinary approach. Aim: The association between frontal and maxillary bone fractures and concurrent craniocerebral injuries were investigated in patients presenting with head trauma in this study. The data of the patients were analyzed retrospectively. Methods and material: Age and gender distributions were evaluated in frontal and maxillary fractures. Concomitant craniocerebral injuries were investigated. Craniocerebral injuries were grouped as pneumocephalus, extra-axial, intra-axial injuries and brain edema. Craniocerebral injuries in frontal and maxillary fractures were compared statistically. Results: Frontal bone and maxillary bone fractures were detected in 24% and 95% of the patients. Coexistence of pneumocephalus and intra-axial injuries in frontal bone fracture was statistically significant. The association of frontal posterior wall fractures with pneumocephalus and parenchymal contusion was found to be statistically significant. In addition, the association of craniocerebral injuries were evaluated and statistically significant ones were determined. Conclusion: The presence of maxillofacial fractures in patients presenting with head trauma increases mortality and morbidity. Craniocerebral injuries can be life-threatening and delay the treatment of facial fractures. Upper facial bone fractures are significantly more common in craniocerebral injuries.
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    Frontal Recess Morphology and Frontal Sinus Cell Pneumatization Variations on Chronic Frontal Sinusitis
    (2023) Orhan Kubat, Gözde; Özen, Özkan
    Objective: The morphology and anatomical structure of the frontal sinus and recess are quite complex. The assessment of sinus ventilation is important in understanding the pathophysiology of chronic frontal sinusitis. The present study investigates the effects of frontal recess morphology, frontal beak thickness, and frontal sinus cell pneumatization variations on chronic frontal rhinosinusitis and examines the role of frontal beak thickness in frontal sinusitis. Methods: Frontal recess morphology, frontal sinus anatomy and pneumatization variations, and frontal beak thickness were analyzed with paranasal sinus-computed tomography scans, and the findings of the participants with and without frontal sinusitis were examined through logistic regression analysis. Results: Frontal beak thickness was greater in the chronic frontal rhinosinusitis group, while the frontal sinus ostium width and frontal recess width were greater in the control group (P < .001). The incidence of frontal air cells was statistically significantly higher in the chronic frontal rhinosinusitis group than in the control group (P < .05). Conclusion: The findings of our study reveal the narrowing of the frontal recess is an important factor in the development of chronic frontal sinusitis. Accordingly, frontal recess and frontal sinus anatomical structures should be assessed in detail in cases of chronic frontal sinusitis, and changes in these structures should be taken into consideration for treatment. The lack of any significant correlation between bone density and sinusitis suggests that chronic frontal sinusitis does not cause histopathological changes in the bony structure of the frontal beak.
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    Laryngopharyngeal lesion awareness of physicians performing upper gastrointestinal endoscopy: Survey study
    (2022) Orhan Kubat, Gözde; Kubat, Mehmet; Demirtaş, Mahmut; Özgürsoy, Ozan Barış
    Introduction: Early diagnosis of cancers in the laryngeal and pharyngeal (LF) region is important for minimally invasive treatment and prolongation of survival. In the practice of otolaryngology diseases, hypopharyngeal cancers are mostly diagnosed in the late period. The aim of this study is to evaluate the approaches of gastroenterology and general surgery specialists to LF region lesions during upper gastrointestinal (UGI) endoscopic procedures. Materials and Methods: Endoscopist physicians who agreed to participate in our study and performed UGI endoscopy were asked to fill out the online questionnaire and the results were evaluated. Survey results; It is based on demographic information, professional experience and characteristics of the procedure, endoscopy evaluation criteria, whether anatomical regions are evaluated and laryngeal and hypopharyngeal region lesions can be defined. Results: It was observed that 88% of the 100 participants who participated in the survey evaluated the LF region, and 71% encountered lesions in the hypopharynx, 62% with lesions obstructing the esophagus entrance, and 52% with laryngeal lesions. It was determined that 23.7% of the physicians who encountered hypopharyngeal lesions and 11.5% of the physicians who encountered laryngeal lesions took biopsies from the lesions in these regions. As the endoscopic experience increased, the identifiability of the lesions increased statistically significantly (p<0.05). The identifiability of the lesions was found to be statistically significantly lower in the group who thought that the education received during their residency was insufficient (p<0.05). Conclusion: With the routine evaluation of LF structures during endoscopy of the UGI, it is possible to diagnose lesions in this region at an early stage. In this age, where minimally invasive and organ-preserving endoscopic treatments are at the forefront, routine evaluation of LF regions should be included in the UGI endoscopy training required to increase the accuracy of diagnostic approaches. To increase the early diagnosis rate, endoscopists should be informed about the examination of anatomical regions in detail, and they should be encouraged to take biopsies in suspicious cases. In this period, the percentage of biopsy should be increased by performing simultaneous otolaryngology consultation.