Filtreler
Does preincisional injection of levobupivacaine with epinephrine have any benefits for children undergoing tonsillectomy? An intraindividual evaluation

Tas E. | Hanci V. | Ugur M.B. | Turan I.O. | Yigit V.B. | Cinar F.

Article | 2010 | International Journal of Pediatric Otorhinolaryngology74 ( 10 ) , pp.1171 - 1175

Objective: To evaluate the effects of peritonsillar injection of levobupivacaine with epinephrine in children undergoing adenotonsillectomy, through an intraindividual study. Patients and methods: 20 children (age 6-13 years) undergoing elective tonsillectomy with or without adenoidectomy were enrolled in this prospective, randomized, intraindividual trial. After entubation and just prior to incision, 3. ml of 0.25% levobupivacaine with epinephrine was injected into one peritonsillar region while 0.9% saline was being used for the contralateral side. Amount of intraoperative blood loss, duration of tonsillectomy, postoperative pain, . . . otalgia and hemorrhage were assessed for each side separately. Visual analog scale was used for postoperative pain assessment. Heart rate and mean arterial pressure during and after operation were also observed. The follow-up period after surgery was 10 days. Results: Median visual analog scale values for the levobupivacaine with epinephrine injected side was significantly lower than the saline injected side, during the first postoperative 16. h (p< 0.05). There were also significant differences between the intraoperative blood losses of the two sides (p< 0.05). However; no significant differences were observed with respect to duration of surgery, postoperative otalgia and hemorrhage (p> 0.05). Conclusion: Preincisional injection of levobupivacaine with epinephrine decreases early postoperative pain and intraoperative blood loss as well. © 2010 Elsevier Ireland Ltd Daha fazlası Daha az

Cervical lymphadenopathies in children: A prospective clinical cohort study

Bozlak S. | Varkal M.A. | Yildiz I. | Toprak S. | Karaman S. | Erol O.B. | Yekeler E.

Article | 2016 | International Journal of Pediatric Otorhinolaryngology82 , pp.81 - 87

Aim: Cervical lymphadenopathy (LAP) is a common sign and may raise fears about serious illnesses. The aim of our study was to evaluate the patients with cervical LAPs in a general pediatrics clinic setting, and to evaluate follow-up results for potential causes and risk factors for malignancies. Material and methods: Two hundred-eighteen patients aged between 79.4 ± 46.7 months with LAP were enrolled in this prospective cohort study. The patients were examined in terms of demographics, clinical, radiologic and serologic aspects like Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus B19. A lymph node biopsy was performed in . . . selected patients. The patients were followed-up for 8 weeks and risk factors for malignancy were evaluated. Results: Seventy patients (41.3%) had specific etiology and 6 (2.7%) had malignant causes. The causes were as follows: 27% (n = 59) infections; 2.7% (n = 6) malignancies; 11.4% (n = 25) other causes. EBV was responsible for 27% of infectious causes. The other common infectious etiologies were CMV 4.3%, parvovirus B-19 2.9%, and group-A beta-hemolytic streptococcus (GAS) 10.8%. Four of the six malignancies were lymphomas. Predictive factors for malignancy were having LAP larger than 30 mm, rubbery lymph node, high serum CRP and LDH values, no hilum in ultrasonography, and enlargement of lymph node in follow-up. High uric acid levels and leucopenia were also common in the malignancy group. Conclusion: Etiology of cervical LAPs was diagnosed in 41.3% patients. Infectious causes were the most common cause with 27%. Malignancy was diagnosed in 2.7% and lymphoma was the most common malignancy. © 2016 Elsevier Ireland Ltd Daha fazlası Daha az

Effects of intramuscular and peritonsillar injection of tramadol before tonsillectomy: A double blind, randomized, placebo-controlled clinical trial

Ugur M.B. | Yilmaz M. | Altunkaya H. | Cinar F. | Ozer Y. | Beder L.

Article | 2008 | International Journal of Pediatric Otorhinolaryngology72 ( 2 ) , pp.241 - 248

Background/aims: Our objective was to investigate the efficacy of intramuscular injection and peritonsillar infiltration of tramadol to prevent pain in children undergoing tonsillectomy. Methods: In a double-blinded trial, 45 children were randomized into three groups: infiltration anesthesia with tramadol (2 mg kg-1) to the peritonsillar area (INF group, n = 15), intramuscular analgesia with tramadol (2 mg kg-1) (IM group, n = 15), and the placebo controls (PL group, n = 15). Visual analog scale (VAS) scores for pain assessment, heart rate (HR) and mean arterial pressure (MAP) during and after anesthesia were recorded. Results: Mea . . .n HR values were higher in INF than PL group at 10th, 20th, and 30th minutes of operation (P < 0.05). Nine children required analgesics within the first hour after surgery in PL compared to 1 child in INF group (P = 0.036). VAS scores on awakening were significantly better in INF than PL group (P = 0.015). The difference between IM and PL groups was not significant for any of the parameters. Conclusion: Peritonsillar infiltration with tramadol provided good intraoperative analgesia, less postoperative pain on awakening and lower analgesic requirement within the first hour after surgery. © 2007 Elsevier Ireland Ltd. All rights reserved Daha fazlası Daha az

Beneficial effects of Ebselen on corrosive esophageal burns of rats

Ocakci A. | Coskun O. | Tumkaya L. | Kanter M. | Gurel A. | Hosnuter M. | Uzun L.

Article | 2006 | International Journal of Pediatric Otorhinolaryngology70 ( 1 ) , pp.45 - 52

Aim: This study was evaluated to investigate the efficacy of Ebselen, which is an organoselenium compound and glutathione peroxidase mimic, on the prevention of stricture development after esophageal caustic injuries in the rat. Methods: Thirty healthy male Wistar albino rats were utilized in this study. The rats were randomly allotted into one of three experimental groups: group A (sham) animals were uninjured. Caustic esophageal burn was created by applying 1 ml of 37.5% NaOH to the distal esophagus. Group B rats were injured but untreated. Group C rats were injured and received Ebselen (10 mg/kg/day) via the oral route. Blood and . . . tissue samples for the biochemical and histopathological analysis were taken all rats at the end (28th day) of the experiment. Oxidative stress is believed to play a role in the pathogenesis of corrosive esophageal burns. To assess changes in the cellular antioxidant defense system, we measured the activities of antioxidant enzymes (such as glutathione peroxidase (GSHPx), superoxide dismutase (SOD), and catalase (CAT)) in esophagus homogenates. We also measured esophageal tissue malondialdehyde (MDA) levels, a marker of lipid peroxidation, to determine whether there is an imbalance between oxidant and antioxidant status. Efficacy of the treatment was assessed by measuring the stenosis index and histopathologic damage score and biochemically by determining tissue hydroxyproline content, lipid peroxidation and antioxidant enzyme levels. Results: The stenosis index in group B was significantly increased compared with group A and C (P < 0.05). The hydroxyproline level was significantly increased in group B compared with group A and C (P < 0.05). In group B, the histopathologic damage score was significantly higher than in group C (P < 0.05). Treatment with Ebselen decreased tissue hydroxyproline levels, histological damage, and the stenosis index. Caustic esophageal burn increased the lipid peroxidation and also decreased the antioxidant enzyme levels in group B. Ebselen treatments for 28 days decreased the elevated lipid peroxidation and also increased the reduced antioxidant enzyme levels. Live weights of the rats was significantly decreased in group B compared with group A and C (P < 0.05). Conclusion: It is concluded that Ebselen has a preventive effect in the development of fibrosis and decrease the lipid peroxidation, and increase the antioxidant defense system activity in an experimental model of corrosive esophagitis in rats. © 2005 Elsevier Ireland Ltd. All rights reserved Daha fazlası Daha az

Effect of positional change and inhalant anesthesia on parameters of acoustic reflectometry

Ugur M.B. | Kemaloglu Y.K. | Ceylan A. | Boynuegri S. | Babacan A. | Goksu N.

Article | 2003 | International Journal of Pediatric Otorhinolaryngology67 ( 9 ) , pp.943 - 946

Objective: Purpose of this study was to find out the effect of positional change and inhalant anesthesia on acoustic reflectometry (AR) parameters (reflectivity and curve angle). Method: AR parameters were measured on 58 ears with otitis media in sitting position before anesthesia and in supine position under inhalant anesthesia, subsequently. Results: Under anesthesia, ears with effusion disclosed more changes in reflectivity (Chi-squared analysis, ?2-test; P<0.05) and curve angle (P>0.1) than those without effusion. Further, inhalant anesthesia caused more changes in the false negative ears (63.63%) than in those with effusi . . .on having positive test before anesthesia (12.90%) (P<0.001). Conclusions: From the data of this study, it could be said that reflectivity shows changes according to the amount of effusion which is in contact with the tympanic membrane under anesthesia, and that curve angle becomes more sensitive to detect effusion when anesthetic gas diffuses into the middle ear with effusion, probably due to the pushing of effusion towards the tympanic membrane. © 2003 Elsevier Science Ireland Ltd. All rights reserved Daha fazlası Daha az

Could radiofrequency myringotomy be an alternative to incisional myringotomy?

Cinar F. | Ugur M.B. | Uzun L.

Article | 2008 | International Journal of Pediatric Otorhinolaryngology72 ( 10 ) , pp.1493 - 1496

Objective: To evaluate the usefulness of radiofrequency myringotomy (RFM) and the closure time of the myringotomy site in comparison to incisional myringotomy (IM). Methods: We performed conventional surgical myringotomy on the right ears and RFM on the left ears of 40 rabbits. In order to investigate the effect of the power of energy delivered on the patency period we arranged the animals into two groups: three power grade in RFM group 1 (RFMg1; n: 20) and six power grade in RFM group 2 (RFMg2; n: 20). The follow-up of the myringotomy procedure was performed on days 5, 8, 11, 14 and 17 with examination under the operating microscop . . .e. Results: At the first examination on day 5 after the procedure, all IM openings were found to be closed while seven and eight (36 and 44%) of the tympanic membranes in the radiofrequency groups 1 and 2 remained open, respectively. In these remaining ears, RFM site was patent up to days 11 and 14, respectively in the two RFM groups. None of the RFMs was patent on study day 17. The difference between the closure time of myringotomy sites of the radiofrequency and IM groups was statistically significant (p < 0.05). In comparison of the two RFM groups, we found approximately equal rates regarding the myringotomy patency (p > 005; ?2 yates: 0.02). The complication rates were 5 and 2% for the IM and RFM groups, respectively. Conclusions: Radiofrequency myringotomies last longer than incisional myringotomies. With the low complication rate, it is possible to perform this bloodless RF procedure in an office setting. Increased power grade of radiofrequency has no effect on prolonging the myringotomy patency. RFM appears to be a safe and simple procedure that can be used as an alternative to IM. © 2008 Elsevier Ireland Ltd. All rights reserved Daha fazlası Daha az

Risk factors for otitis media effusion in children who have adenoid hypertrophia

Eliçora S.Ş. | Öztürk M. | Sevinç R. | Derin S. | Dinç A.E. | Erdem D.

Article | 2015 | International Journal of Pediatric Otorhinolaryngology79 ( 3 ) , pp.374 - 377

Objective: Many studies have shown that children with adenoid hypertrophy (AH) are more likely to have chronic otitis media with effusion (COME). However, not every child with AH has COME. In this study, we investigated the socio-demographic risk factors of children who underwent surgery for AH, including a subgroup with COME. Our aim was to identify the factors involved in the development of COME. Methods: The study population consisted of 170 pediatric patients (118 males, 52 females) who underwent adenoidectomy between 2005 and 2008. The patients were divided into two groups, those with AH alone and those with AH and COME (AH. +. . . . COME). Major factors such as age, gender, breast-milk feeding, bottle-feeding, tobacco smoke exposure, familial predisposition, allergies, congenital diseases, and school attendance were compared between the two groups. Results: AH alone was detected in 102 of the patients, 68% of whom were male, and AH. +. COME in the remaining 68, of whom 72% were male. The mean age was 6.5 years in the AH group and 5.3 years in the AH. +. COME group. There were no significant differences between the two groups with respect to breast-feeding, bottle-feeding, familial predisposition, tobacco exposure, and allergies. However, the relationships between COME and male sex, congenital diseases, and school attendance were significant. Conclusions: COME is seen in young children with AH. Among the socio-demographic features examined in this study, only male sex, congenital diseases, and school attendance were statistically significant risk factors for COME development. © 2015 Elsevier Ireland Ltd Daha fazlası Daha az

Tympanometry and acoustic reflectometry in ears with chronic retraction without effusion

Kemaloglu Y.K. | Beder L. | Şener T. | Göksu N.

Article | 2000 | International Journal of Pediatric Otorhinolaryngology55 ( 1 ) , pp.21 - 27

Objective: Purpose of this study was to find out test accuracy and predictivity of tympanometry (TYMP) and parameters (reflectivity and curve angle) of acoustic reflectometry (AR) in the ears with prior clinic and otoscopic evidences of effusion in which no effusion was detected by myringotomy, by comparing with the data found in normal ears and in those with effusion. Methods: While study group included 31 ears with chronic retraction in which no effusion was detected by myringotomy, control group included 150 fully normal ears and 150 ears with effusion confirmed by myringotomy. B tracings in TYMP, and values of reflectivity highe . . .r than 5 and curve angle lower than 75°in AR were accepted as indicators of effusion; in the combined test, the ears with non-B tracings in which curve angle higher than 75°were accepted as those without effusion. Results: False positivity values of TYMP, reflectivity and curve angle and the combined test found in the ears with chronic retraction without effusion (29, 23, 19 and 35% respectively; ?2-test, P > 0.1) were significantly higher than normal ears (?2-test, P < 0.001), but lower than those of effusion (?2-test, P < 0.0001). Further, although negative predictivity values of TYMP, reflectivity and curve angle were found to be lower in these ear, compared to normal ears (?2-test, P < 0.01), the combined test reached to a perfect negative predictivity, as much as in normal ears. On the other hand, positive predictivity values were decreased in the ears with chronic retraction without effusion by only reflectivity. Conclusions: By both TYMP and AR alone, it is more difficult to find out the ears without effusion among the ears clinically and otoscopically diagnosed as otitis media than to find out normal ears. Therefore, in clinical work, false positivity of these devices were higher, and their specificity and negative predictivity were lower; although the combined test solved problem of low negative predictivity, high number of false positive ears in clinical work, that is lower specificity, continues to be an unsolved problem by either TYMP or AR alone, or both together. (C) 2000 Elsevier Science Ireland Ltd Daha fazlası Daha az

Otoacoustic emissions and effects of contralateral white noise stimulation on transient evoked otoacoustic emissions in diabetic children

Ugur A.K. | Kemaloglu Y.K. | Ugur M.B. | Gunduz B. | Saridogan C. | Yesilkaya E. | Bideci A.

Article | 2009 | International Journal of Pediatric Otorhinolaryngology73 ( 4 ) , pp.555 - 559

Objective: In this study, our aim was to determine presence of dysfunction in the efferent auditory system of children with type-I diabetes mellitus (DM) presenting no evidence of symptomatic neuropathy. Methods: Thirty children with type-I DM (DM group) and 31 age matched healthy children (control group) with normal hearing and middle ear function were entered to the study. Distortion product otoacoustic emissions (DPOAE), transiently evoked otoacoustic emissions (TEOAE), and spontaneous otoacoustic emissions (SOAE) measurements were performed. Then, the TEOAE recording was repeated while a continuous broadband white noise (bandwid . . .th: 50-8000 Hz) presented at 40 dB SL was delivered to the contralateral ear for efferent auditory system suppression. Results: We found that contralateral stimulation (CS) with white noise resulted in significantly more pronounced suppression of the TEOAE response amplitude in healthy controls compared to DM group at 2000 and 4000 Hz frequencies. Further, a relatively higher percentage of the controls had suppression in at least three frequencies compared to DM group. SOAE prevalence was found to be higher in the DM group. Conclusions: Our findings suggest presence of a dysfunction in medial olivocochlear efferent system in diabetic children. This may be regarded as an early central manifestation of diabetic neuropathy. © 2008 Elsevier Ireland Ltd. All rights reserved Daha fazlası Daha az

Role of caffeic acid phenethyl ester, an active component of propolis, against NAOH-induced esophageal burns in rats

Ocakci A. | Kanter M. | Cabuk M. | Buyukbas S.

Article | 2006 | International Journal of Pediatric Otorhinolaryngology70 ( 10 ) , pp.1731 - 1739

Objectives: This study was evaluated to investigate the efficacy of caffeic acid phenethyl ester (CAPE), which is a natural honeybee product exhibits a spectrum of biological activities including anti-microbial, anti-inflammatory, antioxidant and anti-tumoral actions, on the prevention of stricture development after esophageal caustic injuries in the rat. Methods: Thirty healthy male Wistar albino rats were utilized in this study. The rats were randomly allotted into one of three experimental groups: group A (sham) animals were uninjured. Caustic esophageal burn was created by applying 1 ml 37.5% NaOH to the distal esophagus. Group . . .B rats were injured but untreated. Group C rats were injured and received CAPE (10 µmol/kg/day i.p. for 28 days). Efficacy of the treatment was assessed by measuring the esophageal transit time, stenosis index, histopathologic damage score and biochemically by determining tissue hydroxyproline content, lipid peroxidation and antioxidant enzyme activities. Results: The esophageal transit time, the stenosis index, histopathologic damage score and the hydroxyproline level were significantly increased in the untreated group compared with the sham and CAPE-treated groups. Treatment with CAPE decreased tissue hydroxyproline levels, histological damage, and the stenosis index, but except the esophageal transit time. Caustic esophageal burn also increased the lipid peroxidation and decreased the antioxidant enzyme activities in the untreated group. CAPE treatments decreased the elevated lipid peroxidation and also increased the reduced antioxidant enzyme activities. In corrosive esophageal burn group with no treatment, the most consistent findings were degenerative changes and increased in submucosal collagen content, and the luminal narrowing. CAPE treatment protected esophagus. Nevertheless, there was the slight increase in submucosal collagen. Conclusions: It is concluded that CAPE has a preventive effect on the stricture development after esophageal caustic injuries in the rat. © 2006 Elsevier Ireland Ltd. All rights reserved Daha fazlası Daha az

A study on the prevalence of accessory auricle anomaly in Turkey

Beder L.B. | Kemaloglu Y.K. | Maral I. | Serdaroglu A. | Bumin M.A.

Article | 2002 | International Journal of Pediatric Otorhinolaryngology63 ( 1 ) , pp.25 - 27

Objective: Accessory auricular anomaly is a small elevation of skin containing a bar of elastic cartilage localized most commonly just anterior to the tragus or ascending crus of the helix. The anomaly may exist isolated or may be associated with other congenital anomalies of the first arch. The purpose in this study is to detect prevalence of accessory auricle in Turkey and find out whether it is associated with other craniofacial anomalies or hearing loss. Methods: The study was performed on 850 children from the age of 7 to 9 during a screening program in primary schools. Complete otolaryngologic examination and acoustic reflecto . . .metry measurements were performed on all the children. Full physical examination, tympanometric and audiometric evaluation and EEG measurements were added to the cases with accessory auricle anomaly. Results: Among 850 children examined, four had accessory auricle anomaly and prevalence of the anomaly was calculated as 0.47% (95% confidence interval (CI), 0.13-1.20%). Children were developmentally normal, and no other congenital craniofacial or systemic anomaly was detected in any of the cases. Further, tympanometric, audiometric evaluations and EEG tests were in normal limits. Conclusions: In this study, the prevalence rate of the condition was calculated as 0.47%. Although one study from China reported this prevalence as 0.22%, the difference between the reported prevalances was not statistically significant. Further, although external ear anomalies may present together with cranifacial anomalies and neurologic disorders like epilepsy, neuromotor retardation and EEG disorders, in our cases, mental and motor development was normal and epilepsy history or abnormal EEG patterns do not exist. On the other hand, no hearing loss was found to be associated with accessory auricles. Copyright © 2002 Elsevier Science Ireland Ltd Daha fazlası Daha az

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