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    Changes in Epistaxis in Different Climatic Conditions: A Comparison Between the East Black Sea and Central Anatolia
    (2023) Yücedağ, Fatih; Sevil, Ergun; Çevik, İsmail; Sezgin, Arife; Kulaksız, Betül Değer
    Background: This study is the first to have been assessing epistaxis cases in respect of the geographic and seasonal variations in 2 distinct cities 900 km apart in 2 different regions of Turkey, whereas most studies in the literature about this entity had evalu- ated patients in the same residential area. The purpose of this study was to compare seasonal and regional variations in the presentations of patients with epistaxis in the regions of Central Anatolia, which has a continental climate, and the Eastern Black Sea, which has a marine climate. Methods: This retrospective study was conducted in Karaman Training and Research Hospital and Trabzon Kanuni Training and Research Hospital throughout 2019, a total of 2141 cases (Central Anatolia: 1247; Eastern Black Sea: 894). The data of patients who presented with epistaxis were scanned retrospectively from patient records. Weather parameter data on the day of admission to hospital were obtained from the Regional Institutes of Meteorology. Results: The number of cases (1247 vs. 894, P < .001) was significantly higher in the Central Anatolia than in the Eastern Black Sea, in which higher results of mean humid- ity, air pressure, rainfall, and wind speed were recorded. A weak positive correlation was determined between the number of cases and mean temperature (r = 0.397) and a weak negative correlation between the number of cases and air pressure (r = ?0.261) and rainfall (r = ?0.288). Conclusion: The study results suggest that the meteorological parameters of mean temperature, rainfall, and air pressure could have a significant effect on epistaxis.
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    Changes in Epistaxis in Different Climatic Conditions: A Comparison Between the East Black Sea and Central Anatolia
    (Aves, 2023) Yucedag, Fatih; Sevil, Ergun; Cevik, Ismail; Sezgin, Arife; Kulaksiz, Betul Deger
    Background: This study is the first to have been assessing epistaxis cases in respect of the geographic and seasonal variations in 2 distinct cities 900 km apart in 2 different regions of Turkey, whereas most studies in the literature about this entity had evaluated patients in the same residential area. The purpose of this study was to compare seasonal and regional variations in the presentations of patients with epistaxis in the regions of Central Anatolia, which has a continental climate, and the Eastern Black Sea, which has a marine climate. Methods: This retrospective study was conducted in Karaman Training and Research Hospital and Trabzon Kanuni Training and Research Hospital throughout 2019, a total of 2141 cases (Central Anatolia: 1247; Eastern Black Sea: 894). The data of patients who presented with epistaxis were scanned retrospectively from patient records. Weather parameter data on the day of admission to hospital were obtained from the Regional Institutes of Meteorology. Results: The number of cases (1247 vs. 894, P <.001) was significantly higher in the Central Anatolia than in the Eastern Black Sea, in which higher results of mean humidity, air pressure, rainfall, and wind speed were recorded. A weak positive correlation was determined between the number of cases and mean temperature (r = 0.397) and a weak negative correlation between the number of cases and air pressure (r = -0.261) and rainfall (r = -0.288). Conclusion: The study results suggest that the meteorological parameters of mean temperature, rainfall, and air pressure could have a significant effect on epistaxis.
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    ERİŞKİN HASTALARDA TONSİLLEKTOMİ SONRASI GÖRÜLEN KANAMALARIN RETROSPEKTİF ANALİZİ
    (2022) Yücedağ, Fatih; Çevik, İsmail; Sevil, Ergun
    AMAÇ: Bu çalışmada tonsillektomi sonrası kanayan hastaların özelliklerini belirlemek ve bu hastalara yaklaşımlarımızı araştırmak amaçlanmıştır.GEREÇ VE YÖNTEM: Bu çalışmamızda tonsillektomi sonrası kanama ile kliniğimize başvuran 29 hastanın kayıtları geriye dönük incelendi. Hastaların yaş, cinsiyet, ameliyattan sonra kaçıncı gün kanadığı, laboratuvar parametreleri, kanama sebepleri, uygulanan cerrahi teknik ve kanama müdahale yöntemleri araştırıldı.BULGULAR: Hastaların 11 (%37,9)’i kadın, 18 (%62,06)’i erkek olup yaş ortalaması 26,8 (18-45) yıl idi. 25 hastaya soğuk bıçak yöntemi ile, 4 hastaya ise bipolar koter yardımı ile tonsillektomi yapıldı. Ameliyattan sonra kanama nedeni ile ortalama başvuru süresi 7,3 (1-19) gün idi. Altı (%20,6) hastada kanama nedeni tespit edilebildi. İki hastaya konservatif tedavi yöntemleri uygulandı, hastaların 14’üne (%48,2) lokal, 13’üne (%44,8) ise genel anestezi altında kanama müdahalesi yapıldı.SONUÇ: Tonsillektomi sonrası kanamalara erişkin hastalarda sık rastlanmakta ve bu durum hayatı tehdit edici sonuçlar doğurmaktadır. Yeni tedavi yöntemleri ve kanama sonrası erken müdahale ile olası komplikasyonların önüne geçilebilir.
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    Long-Term Results of Tragal Cartilage Type 1 Tympanoplasty
    (2023) Yücedağ, Fatih; Sevil, Ergun; Çevik, İsmail
    Aim: Tympanoplasty is one of the most frequently performed operations by ear, nose, and throat specialists. Surgical treatment of tympanoplasty aims to obtain a healthy ear membrane and minimise hearing loss. The purpose of this study was to evaluate the success of the graft and functional hearing outcomes of patients applied with tragal cartilage type 1 tympanoplasty operation in our clinic. Materials and Methods: This study included 43 patients who underwent tragal cartilage type 1 tympanoplasty operation between January 2016 and November 2020. A retrospective evaluation was made of the preoperative pure tone audiometry (PTA) values and the operative findings. In the follow-up examination, the graft status and PTA results were recorded. The graft success and improvements in hearing were evaluated in all the patients. Results: A total of 43 patients were evaluated, comprising 24 males and 19 females with a mean age of 31.2 years (range, 13-58 years). The operation was performed on the right ear of 22 patients and the left ear of 21. The tympanoplasty operation was performed with an endaural approach in 6 cases and a postauricular approach in 37. The mean follow-up period was 20.8 months (range, 12-39 months). The rate of graft success of all the patients was 88.4%. The mean air conduction threshold, air-bone gap, and bone conduction threshold values at 500, 1000, 2000, and 4000 Hz were determined to have statistically significantly decreased postoperatively in comparison with the preoperative values (p<0.05). Conclusion: In tragal cartilage type 1 tympanoplasty operations, high rates of graft success were obtained and a dramatic gain in hearing postoperatively. 
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    Prognostic Value of Early Treatment Response in Idiopathic Sudden Sensorineural Hearing Loss Treated with Hyperbaric Oxygen
    (Aves, 2024) Sevil, Ergun; Cebi, Gamze
    Background: The aim of this study is to evaluate the value of early treatment response in predicting the prognosis of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) who received hyperbaric oxygen (HBO) treatment. Methods: A total of 226 patients were available for evaluation and met the inclusion criteria. The patients were separated into 3 groups according to the degree of hearing loss: mild to moderate hearing loss <60 dB, severe hearing loss between 61 dB and 80 dB, and profound hearing loss >= 81 dB. An improvement of >= 10 dB in the pure tone audiogram (PTA) performed after the first 5 sessions compared to the pre-treatment audiogram was considered an early treatment response positive (ETR-P). No improvement or an improvement of <10 dB was considered an early treatment response negative (ETR-N). Results: After the first week of HBO treatment, a total of 119 patients (52.6%) showed ETR-N and 107 patients showed (47.3%) ETR-P. A significant association was found between the degree of hearing loss and ETR-P and ETR-N (Chi(2)= 7.24, P = .02). Patients in the ETR-N group received significantly more HBO sessions than those in the ETR-P group (17.6 +/- 3.4 vs. 13.3 +/- 4.1, P = 0.02). The pure tone average after treatment of the ETR-N patients (60.3) was higher than that of the ETR-P patients (45.2). There was a significant difference between pure tone average after treatment and ETR-P and ETR-N (U = 4110, z = - 4.59, P = .000). Conclusion: Patients who did not achieve sufficient treatment success in the first week of HBO therapy did not achieve good final hearing results.
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    Transoral robotic supraglottic laryngectomy: Long-term functional and oncologic outcomes
    (W B Saunders Co-Elsevier Inc, 2024) Muderris, Togay; Sevil, Ergun; Gul, Fatih
    Objectives: Minimally invasive transoral organ preservation surgeries are being increasingly used for supraglottic tumors. This study investigates the long-term functional and oncologic outcomes of transoral robotic supraglottic laryngectomy (TORS-SGL).Materials and methods: Twenty-three patients with supraglottic laryngeal cancer who underwent TORS-SGL be-tween 2012 and 2015 at a tertiary referral hospital were retrospectively analyzed with at least 5 years of follow-up. The head and neck tumor council and the multidisciplinary oncological board decided whether the patients were suitable for robotic surgery, and the necessity of adjuvant radiotherapy or chemotherapy. Inclusion criteria was histopathological diagnosis of squamous cell carcinoma of the larynx.Results: Twenty-one patients with T1-T3 supraglottic squamous cell carcinoma were included in this study. Mean follow-up was 48.8 months. Local control was 94.4 % at 2 years and 85.9 % at 5 years. Disease-free survival and overall survival were 85.7 % and 81 % at 2 years and 69.3 % and 57.1 % at 5 years, respectively. There was no permanent tracheostomy or prolonged swallowing dysfunction among patients. Age, perineural and lympho-vascular invasion were found to be risk factors affecting overall survival.Conclusion: TORS-SGL is a feasible, safe and reliable approach with excellent functional results for T1, T2, and selected T3 supraglottic tumors, providing acceptable long-term oncologic results when compared to alternative treatment modalities.