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Cingi C.,Eskiehir Osmangazi University | Sayin I.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital | Civelek S.,Sisli Etfal Teaching and Research Hospital
Expert Review of Medical Devices | Year: 2010

Powered instruments have been introduced into otorhinolaryngology practice over the last decade. These instruments were accepted immediately by many institutions, and continuing development has led to the current use of microdebriders in a variety of surgical procedures in otorhinolaryngology. In clinical rhinology, they were first used in endoscopic sinus surgery to facilitate working on deep planes, but have subsequently been adopted in various conditions. This article presents an evaluation of the use of microdebriders in common rhinological disorders. © 2010 Expert Reviews Ltd. Source


Sayin I.,ENT Clinic | Kaya K.H.,ENT Clinic | Ekizoglu O.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital | Erdim I.,ENT Clinic | Kayhan F.T.,ENT Clinic
European Archives of Oto-Rhino-Laryngology | Year: 2013

The objective was to compare the outcomes of spontaneous closure and hyaluronic acid (HA) ester patching (Epifilm®) in subjects with traumatic tympanic membrane (TM) perforation. This was a prospective, controlled study performed at a tertiary teaching and research hospital. During 6-month period, subjects were divided into spontaneous closure (group A) and HA ester patch-Epifilm® (group B) group. Demographic data, presenting symptoms, closure rate, closure time and audiometric data were evaluated and compared between groups. In total, 155 subjects were evaluated. Group A consisted of 62.6 % (n = 97) of the subjects, whereas group B consisted of 37.4 % (n = 58) of the subjects. Group B had significantly shorter closure times when compared with group A (6.61 ± 4.59 vs. 10.60 ± 5.23 weeks, p = 0.001). When the closure time was evaluated according to perforation size both grade 1 and 2 perforations have significantly shorter closure times when compared with group A (6.33 ± 4.54 vs. 10.80 ± 5.69 weeks, for grade 1 and 6.650 ± 2.07 vs. 10.30 ± 4.32 weeks for grade 2 perforations). Closure rates were not significant between groups (85.6 % for group A and 94.8 % for group B). When the closure rate was evaluated according to perforation size no significant difference exists for grade 1, 2 and 3 perforations between groups. Both air conduction and air-bone gap were significantly improved in both groups. HA ester patch (Epifilm®) is a non-toxic material that can be used in traumatic tympanic membrane perforations. In this study, use of HA ester patching was resulted with earlier closure time but not resulted with higher closure rates. © 2012 Springer-Verlag Berlin Heidelberg. Source


Guraslan H.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital | Dogan K.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2016

Objective To evaluate the malignancy potential of large unilocular and multilocular ovarian cysts in postmenopausal women and to discuss their appropriate management. Study design This retrospective study included 204 postmenopausal patients who underwent surgery for simple adnexal cysts or cysts with isolated septal structures at the Gynecology and Obstetrics Clinic of Bakirkoy Dr Sadi Konuk Training and Research Hospital. Data obtained from patient and computer records included patient age, follow-up period, ultrasonography reports, surgery information, histopathological evaluation results, and cancer antigen-125 (CA-125) levels at diagnosis and during follow-up. The Kruskal-Wallis test was used to compare three or more groups. The Chi-square test or Fisher's exact test was used to compare qualitative parameters, while relationships between parameters were analyzed by using Spearman's correlation analysis. Results A total of 236 cysts were identified in 204 postmenopausal women who underwent surgery. The cysts were categorized as having unilocular cyst morphology or complex structures without morphological abnormalities other than septa in 182 (77.1%) and 54 cases (22.9%), respectively. The mean cyst diameter was 6.6 ± 3.1 cm (range, 2.7-30 cm) with diameters ≥5 cm in 176 cysts (75%). The median cyst volume was 88.5 cm3 (range, 10-2636; interquartile range: 81) and the mean morphology index was 1.2 (range, 1-6), with 16 cysts (6.8%) ≥5. No malignancy or borderline histology was observed in any patient. Conclusions Among postmenopausal women, cysts that are unilocular or contain isolated septa, have a low-risk of malignancy even when they are larger than 5 cm. Rather than undergoing emergency surgery, these patients may be followed up conservatively with intermittent transvaginal ultrasonography. © 2016 Elsevier Ireland Ltd. All rights reserved. Source


Ekin M.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital | Cengiz H.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital | Ayag M.E.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital | Kaya C.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital | And 2 more authors.
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2013

Objectives: We hypothesized that treatment of adenomyosis with the levonorgestrel-releasing intrauterine system (LNG-IUS) can concurrently improve urinary incontinence along with irritative and obstructive symptoms and thus positively affect the patients' quality of life. Study design: Sixty-five patients suffering from heavy prolonged menstrual bleeding (menorrhagia) with dysmenorrhea diagnosed with uterine adenomyosis by ultrasound were enrolled in this study. LNG-IUS was inserted in the outpatient department for the treatment of the uterine adenomyosis. The patients filled out two validated questionnaires, the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7), before and 6 months after the insertion of the LNG-IUS. The before and after scores were compared using the non-parametric Mann-Whitney U test. Results: The mean (±SD) age of the patients was 44.5 ± 6.5 years. Both UDI and IIQ scores were significantly lower at 6 months after treatment with the LNG-IUS (P < 0.0001). UDI scores revealed improvement rates of 14.3%, 35.7%, and 22.7% for urinary incontinence, irritative symptoms, and obstructive symptoms, respectively. Moreover, improvements in irritative and obstructive symptoms were significantly correlated with improvements in menorrhagia and dysmenorrhea (P < 0.04). IIQ scores demonstrated improvement rates of 18.9%, 14.6%, 19.7%, and 18.5% for physical activity, travel, social relations, and emotional health, respectively. Conclusions LNG-IUS used for treating menorrhagia and dysmenorrhea improved urinary incontinence along with irritative and obstructive symptoms in patients with adenomyosis. © 2013 Elsevier Ireland Ltd. All rights reserved. Source


Cengiz H.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital | Dagdeviren H.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital | Kaya C.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital | Yesil A.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital | Caypinar S.S.,Bakirkoy Dr Sadi Konuk Teaching and Research Hospital
Archives of Gynecology and Obstetrics | Year: 2014

Purpose: Almost 50 % of the patients experience moderate-to-severe pain during endometrial biopsy. The study aimed to examine the effectiveness of intrauterine lidocaine for relieving pain during endometrial biopsy. Methods: A randomised trial was conducted in 120 patients undergoing endometrial biopsy. Sixty-seven women were assigned to the paracervical block group and 53 were assigned to the intrauterine lidocaine group. The main outcome measure was pain intensity, measured using the visual analogue scale, during and after the procedure. Results: The groups were similar with regard to age, body mass index, gravidity, total number of previous vaginal deliveries, menopausal status, and uterine depth. The pain scores immediately after the procedure were similar in the groups (p = 0.079). However, the pain scores 30 min after the procedure were significantly lower in the intrauterine group than in the paracervical group (p = 0.0001). Conclusions: Compared to paracervical block, intrauterine lidocaine may be the preferred anaesthesia for endometrial biopsy, and it does not cause any serious complications. © 2013 Springer-Verlag Berlin Heidelberg. Source

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