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    A Comparison of Pain and Operation Time in Children Undergoing a Tonsillectomy using Different Energy Doses of Bipolar Cautery
    (Istanbul University Press, 2021) Kars, Ayhan; Bingöl, Fatih; Kılıç, Korhan
    Objective: The aim of the study is to compare the operative time and degree of post-operative pain in children who underwent a tonsillectomy using different energy doses of bipolar cautery and to specify the most appropriate energy dose. Materials and Methods: Patients included in the study were allocated to three groups with 20 in each and each group underwent the operation with 20, 30 and 40 watt energy doses of bipolar cautery. Operative time was recorded for each patient. The Wong-Baker FACES pain rating Scale (WBS) was used in the post-operative period for each patient and the pain severity of the patients was evaluated at post-operative 30th min, 1st, 6th, 24th hours and 10th day. The operative times and pain severity of the patients were compared thereafter. Results: A significant difference was not detected between the groups in which 20, 30 and 40 watt bipolar cautery was used (p>0.05). A significant difference was not detected between groups with regard to pain scores at post-operative 30th min, 1st, 6th, 24th hour and 10th day (p>0.05). Conclusion: We have compared groups with regard to post-operative pain and operative time according to energy dose of bipolar cautery and detected no statistically significant difference in tonsillectomies conducted with different energy doses. Therefore we consider that energy dose should be as low as possible in tonsillectomies conducted with bipolar cautery. © 2021, Istanbul University Press. All rights reserved.
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    A Rare Case Report: Bilateral Choanal Atresia in an Adult Patient
    (AVES, 2020) Kars, Ayhan; Bingöl, Fatih; Atalay, Fatma
    Posterior choanal atresia is rare but is the most common congenital malformation of the nasal cavity. It is characterized by a completely closed choana. Generally, this malformation is observed in newborns as increased respiratory distress during feeding, cyanotic attacks, and relaxation with crying. In contrast to unilateral atresia, bilateral disease is a life threatening condition and is extremely rare in adults. Herein, we presented a case of bilateral membranous choanal atresia detected in an 18-year-old patient. An 18-year-old female patient was admitted to our clinic after complaining of nasal obstruction, nasal discharge, snoring, anosmia, and mouth breathing since she was a child. On endoscopic examination, a right-deviated nasal septum and bilaterally closed choanae were observed. Membranous bilateral choanal atresia was observed on computed tomography (CT). The patient underwent transnasal endoscopic surgery under general anesthesia. Both septoplasty and bilateral coanoplasty surgeries were performed. No complications were observed postoperatively or at one year of follow up. Bilateral choanal atresia is a rare anomaly in adults. The diagnosis can easily be made by endoscopic examination or CT. The transnasal endoscopic surgical technique is an easy, reliable, and effective treatment method. © Author(s).
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    Effect of intranasal Merocel packs, silicone splint, and trans-septal suture after septoplasty on Eustachian dysfunction
    (Aves, 2020) Topal, Kubra; Kars, Ayhan; Bingol, Fatih; Kilic, Korhan; Atalay, Fatma
    Objective: In this study, we aimed to compare the effects of nasal obstruction caused by nasal packing, trans-septal suture, and silicon splint after septoplasty on the Eustachian tube functions and middle ear ventilation. Methods: The study included 60 patients who were operated on for septum deviation between January and July 2017. The ages of the patients ranged from 19 to 53 years. A total of 24 patients were female, and 36 patients were male. The patients were divided into three groups. Group 1 comprised patients who received trans-septal suture, Group 2 comprised patients who received silicon splint, and Group 3 comprised patients who received Merocel packing. The preoperative and postoperative tympanometric evaluations were performed for each patient. Results: The middle ear pressures of the patients in the three groups were compared; there was no significant difference between the second and the third groups in the right and left middle ear pressures. The middle ear pressures of the first group were significantly lower in both ears than those of the other groups. We have found that trans-septal suture after septoplasty without using a splint or Merocel packing did not affect the middle ear pressure. Conclusion: Trans-septal U suture application after septoplasty did not increase middle ear pressure and did not affect Eustachian tube functions in comparison with the other alternative methods.