M. Akif Kilic

Outcome of Surgery for Crooked Nose: An Objective Method of Evaluation

Objectives:The aim of this study was to report the authors’ surgical results, and to present their method of angle measurement using the Scion Image computer program to evaluate surgical results for crooked noses.Methods:The study included 27 patients with crooked noses: classified as C-type and 14 classified as I-type. Deviation angles were measured by using the Scion Image computer program on frontal views before and at least 3 months after the operation. Correction of the crooked nose was performed through an open approach with the patients under general anesthesia.Results:Significant correction was achieved for both types of crooked noses (p < 0.05). The results for the I-type crooked noses were closer to the ideal angles than those for the C-type, but the difference was not significant. The findings showed that 66.7% of the patients with crooked noses, had good or excellent results after surgery: 53.8% of those with the C-Type and 78.6% of those with the I-type.Conclusion:It is difficult to achieve satisfactory results in the correction of crooked noses. The angle measurement method using the Scion Image computer program may be helpful in evaluating the effectiveness of different surgical techniques.

Bacteraemia during tonsillectomy

The aim of this study was to determine the incidence of bacteraemia during tonsillectomy and investigate the effect of the timing of culture sampling on the incidence of bacteraemia associated with it. Sixty-four consecutive patients who had been admitted for elective tonsillectomy were included in the study. Patients were randomly classified into two groups. Blood cultures as well as tonsillar surface and deep tissue cultures were obtained from all patients before tonsillectomy and 60 minutes after tonsillectomy. In addition, blood cultures were taken within two minutes following tonsillectomy for group 1 and 15 minutes after tonsillectomy for group 2. In group 1, the cultures obtained within two minutes were positive in nine patients, while only two of the blood cultures taken post-operatively were positive in group 2. The difference between the two groups was statistically significant (p < 0.05). The results of this study suggest that a transient bacteraemia occurs frequently in association with tonsillectomy, but the timing of culture sampling for its detection is important.

Bacteremia during open septorhinoplasty

Background In this study, we aimed at determining the incidence of bacteremia during septoplasty and open septorhinoplasty. Methods The study included 60 patients (30 septoplasties and 30 open septorhinoplasties). Preoperative nasal cultures from the nasal cavity and vestibule were taken by using swabs, and blood cultures were obtained from peripheral veins preoperatively, intraoperatively, and postoperatively. Blood cultures were evaluated by using the BACTEC method. Results Neither the blood cultures taken preoperatively nor those obtained postoperatively was positive for any organisms. On the other hand, although the bacterial growth was observed in only one of the blood cultures (3.3%) taken intraoperatively during septoplasty, it was observed in four blood cultures (13.3%) obtained intraoperatively during open septorhinoplasty. Conclusion Our data indicate that a transient bacteremia occurs during open septorhinoplasty. Although this bacteremia is transient and it has not led to any clinical manifestations in our patients, the possibility of bacteremia during this surgery should be kept in mind and necessary precautions should be taken preoperatively in patients with a high risk of cardiovascular infection.

Effect Of N-Acetylcysteine on Carboplatin-Induced Ototoxicity and Nitric Oxide Levels in a Rat Model

Objective: The aim of the present study is to investigate the effect of N‐acetylcysteine (NAC) given 30 minutes before carboplatin administration on carboplatin‐induced ototoxicity and nitric oxide (NO) levels in a rat model.

Malondialdehyde Level and Adenosine Deaminase Activity in Nasal Polyps

OBJECTIVES: Although there are many reports on adenosine deaminase (ADA) activities in different tissues, no information is available about the enzyme activity in nasal mucosa and polyp tissues. Whereas ADA is related to the production of free radicals by neutrophils, malondialdehyde (MDA) is an indicator of lipid peroxidation that is a general mechanism of tissue damage by free radicals. This study is aimed at determining and comparing the ADA activity and MDA level in nasal polyps and normal mucosa. STUDY DESIGN AND SETTING: Twenty-three patients with nasal polyps and a control group consisting of 14 patients with septal deviation and lower turbinate hypertrophy were included in the study. Tissue MDA level was measured by the method of Okawa with modification and tissue ADA activity by the method of Giusti. RESULTS: In patients with nasal polyp, mean tissue MDA level and ADA activity were 2.43 ± 0.38 nmol/mg protein (Pr) and 0.235 ± 0.055 U/mg Pr, respectively, which were significantly higher than those of control nasal mucosa (1.03 ± 0.41 nmol/mg protein and 0.056 ± 0.011 U/mg Pr, respectively) (P < 0.05). In addition, tissue MDA level was positively correlated to ADA activity in nasal polyps (r = 0.701, P < 0.001). CONCLUSIONS: The present study showed the presence of detectable ADA activity in nasal mucosa, and also significant increases in both tissue MDA level and ADA activity in NP tissue when compared to normal turbinate tissue. EBM rating: B-2b

Bacteremia during adenoidectomy

OBJECTIVE Although adenoidectomy is one of the most commonly performed surgical procedures in children, there is no satisfactory information about the risk of bacteremia during adenoidectomy and necessity of antibiotic use. The aim of this study was to determine the incidence of bacteremia during adenoidectomy and identify the organisms leading to bacteremia. METHODS Thirty two patients who had undergone adenoidectomy at ENT Clinic of Sutcu Imam University were included in the study. They had received no antimicrobial therapy for at least 20 days before surgery. Adenoidal surface and deep tissue cultures were taken and venous blood samples were obtained for cultures before and immediately after adenoidectomy in which adenoid was removed with a curette. RESULTS While none of the blood cultures taken preoperatively was positive for any organisms, the cultures obtained postoperatively were positive in only two of 32 patients included in the study. CONCLUSION The results of this study suggest that there is an extremely low incidence of bacteremia during adenoidectomy. As a result, it may be concluded that the use of prophylactic antibiotics to prevent bacteremia or its complications is unnecessary unless the patient has a predisposing factor for cardiac infection like prosthetic valve replacement.

Malondialdehyde level and adenosine deaminase activity in adenoid tissue of patients with OME and obstructive adenoid hypertrophy

OBJECTIVE The aim of our study was to determine and compare adenosine deaminase (ADA) activity and malondialdehyde (MDA) level in adenoid tissue of patients with or without otitis media with effusion (OME). METHODS The study included 30 patients undergoing adenoidectomy due to obstructive adenoid hypertrophy (OAH) or OME. Tissue MDA level was measured by the method of Okawa with modification and tissue ADA activity by the method of Giusti. We measured, superoxide dismutase (SOD) and catalase (CAT) activities as well. RESULTS In patients with OAH, mean tissue MDA level and ADA activity were 4.13 ± 0.90 nmol/mg Pr and 0.39 ± 0.04 U/mg Pr, respectively, which were significantly higher than those of OME group (1.43 ± 0.41 nmol/mg Protein and 0.22 ± 0.04 U/mg Pr, respectively) (P<0.05). SOD and CAT activities were found to be increased in patients with OAH when compared to the OME group but they did not reach statistically significant level (P=0.06 and 0.05 respectively). CONCLUSIONS The present study showed the presence of measurable ADA activity in adenoid tissue, and also significant increases in both tissue MDA level and ADA activity in OAH tissue when compared to adenoid tissue of the patient with OME. However, the significance of changes in MDA and ADA activation in the pathogenesis of OAH requires further study.