Browsing by Author "Ozden, S"

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    A Double-Layered, Stepped Spreader Graft for the Deviated Nose
    Seyhan, A; Ozden, S; Gungor, M; Celik, D
    Background: In deviated noses, a beveled hump resection is recommended to preserve the shorter nasal wall. Even with this precaution, in some patients, the shorter wall does not reach the planned dorsal level when the lateral wall is transposed toward the midline after the lateral osteotomy. Method: A double-layered, stepped spreader graft was used on the shorter wall side to construct symmetrical lateral nasal walls. The composite graft was constructed by fixing a smaller cartilage graft to the side of the dorsal border of a slightly larger than normal standard spreader graft. The smaller graft component adds height to the shorter lateral wall while the larger one functions as a usual spreader graft. Results: Stepped spreader grafts were used in 4 primary and 2 secondary rhinoplasty cases. All compound grafts were harvested from the septal cartilage except for one of the secondary cases, in which auricular cartilage was used. Two patients received a usual spreader graft on the contralateral side. Postoperatively, none of the patients exhibited significant recurrent deviation, and acceptable symmetrical dorsal esthetic lines were obtained in all patients. Conclusion: This technique should be considered whenever the height of the lateral wall is shorter than desired after centralization of a deviated nose. Reconstruction of the shorter wall by adding height with a stepped spreader graft results in a more stable dorsum that resists relapse. Dorsal esthetic lines can also be reconstructed at the same time.
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    Three-dimensional modeling of nasal septal deviation
    Seyhan, A; Ozaslan, U; Sir, E; Ozden, S
    Background: Some deviated nasal septa can never be straightened completely due to their 3-dimensional (3-D) nature. Based on a Study of models and clinical cases, a basic classification and treatment strategy was proposed for 3-D septal deviations. Methods: basic types of 3-D septal L struts were crafted from pieces of thick plastic sheeting. By a carefully placed through-and-through incision in the angle area and overlapping the resultant segments, the models became 2 dimensional (2-D). We used this technique intraoperatively, in some cases resecting the overlapping area of septal tissue, along with a septal extension graft, in 11 patients who were followed up for more than 6 months. Results: External nasal deviation due to a deviated septum was obvious in 5 cases, and all were relieved postoperatively. Preoperative breathing difficulties were improved in 7 of 8 patients. Conclusion: Correction of 3-D septal L deformity can be successfully performed by constructing 2-D L struts by making a full-thickness incision of the angle area and then overlapping the segments. This approach is especially beneficial in those having a septal extension graft that need a perfectly straight caudal septum upon which to fix the extension graft.
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    A simplified use of septal extension graft to control nasal tip location
    Seyhan, A; Ozden, S; Ozaslan, U; Sir, E
    Background: For defining the shape and projection of the nasal tip, the bilateral and symmetric batten-type septal extension grafts proposed by Byrd and colleagues have drawbacks. The main problems are stiffness of the nasal tip and thickening of the septum in the nasal valve area. Methods: Since 1998, unilateral single-batten grafts, and more frequently, bilateral asymmetric batten grafts as compared with Byrd's bilateral symmetric application, have been used for 72 patients in our facility. Results: At the 6-month postoperative follow-up assessment, tip projection was found to be satisfactory in 61 patients. Less than desired projection occurred in three cases and overprojection in two cases. Nasal lobule deviation was evident in one patient. The loss of the columellar break point was evident in five cases. Conclusion: Unilateral or asymmetric bilateral batten grafts facilitate adjustment of the nasal tip intraoperatively. This technique results in a more pliable nasal tip in the horizontal plane. Construction of a three-layered cartilage in the nasal valve area is not needed, and the nasal airway is preserved. With this modification, a reliable and predictable nasal tip location is obtained with a minimum of graft usage.
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    A 46-year-old male with an ulcerated linear lesion on his neck
    Yoleri, L; Ozden, S; Kandiloglu, A
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    Socioeconomic status has direct impact on asthma control: Turkish adult asthma registry
    Arslan, B; Türk, M; Hayme, S; Aydin,Ö; Gokmen, D; Buhari, GK; Sozener, ZC; Gemicioglu, B; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Niksarlioglu, EYO; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Oguzulgen, IK; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Cetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Ozturk, AB; Sevinc, C; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Celik, GE; Uysal, MA
    BackgroundAsthma is one of the most common causes of chronic respiratory disease, and countries with low socioeconomic status have both a high prevalence of asthma and asthma-related death.ObjectiveIn this study, we aimed to determine socioeconomic levels of asthmatic patients according to a national database and investigate the effects of social markers on disease control in our region.MethodsThis is an analysis of data from 2053 adult asthma patients from a multicentre chart study in Turkey. Socioeconomic status (SES) data were collected from questionnaires and this form was sent to the patients via e-mail. Parameters related to social status and poor disease control were analyzed.ResultsIlliteracy (OR:2.687 [95% CI: 1.235-5.848]; p = 0.013) and lower household income (OR:1,76 [95% CI: 1.002-3.09]; p = 0.049) were found as independent risk factors for hospitalization in the multivariate logistic regression analysis. Therewithal, being aged between 40 and 60 (OR: 1.435 [95% CI: 1.074-1.917]; p = 0.015), illiteracy (OR: 2.188 [95% CI: 1.262-3.795]; p = 0.005) and being employed (OR: 1.466 [95% CI: 1.085-1.847]; p = 0.011) were considered as independent risk factors for systemic corticosteroid use at least 3 days within last 1 year.ConclusionAs a result of our national database, education level, household income and working status briefly socioeconomic status have impacts on asthma control. Identification of social markers in asthma and better recognition of risk factors based on the population gives us clues to provide better asthma control in the future.
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    Picturing asthma in Turkey: results from the Turkish adult asthma registry
    Celik, GE; Aydin, O; Gokmen, D; Buhari, GK; Sozener, ZC; Gemicioglu, B; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EY; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Oguzulgen, IK; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Turk, M; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Arslan, B; Cetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Ozturk, AB; Sevinc, C; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A
    IntroductionNational data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention.MethodsCase entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes.ResultsThe registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3-5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions.ConclusionThe picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery.
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    Factors influencing the prescription of add-on long-acting muscarinic antagonists in real-world asthma management: Insights from a national registry
    Gemicioglu, B; Gokmen, D; Can, A; Sevinc, C; Oguzulgen, IK; Soyyigit, S; Yakut, T; Havlucu, Y; Aydin, O; Buhari, GK; Sozener, ZC; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EYO; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, A; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Turk, M; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Donmez, H; Arslan, B; Cetin, GP; Kara, BY; Dursun, AB; Karakis, GP; Kendirlinan, R; Ozturk, AB; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Çelik, GE
    Current guidelines recommend adding long-acting muscarinic antagonists (LAMAs) in patients with uncontrolled asthma, despite the use of moderate to high doses of inhaled steroid-long-acting beta agonists (ICS/LABA). This study aims to analyze the factors related to the prescription of add-on LAMA in clinical practice for asthma patients, shedding light on physicians' preferences. This study included adult asthma patients on add-on LAMA and ICS/LABA monitored for at least one year in a national registry comprising 2053 asthmatics. Patients' characteristics and disease profiles were analyzed to identify factors associated with the prescription of add-on LAMA across the entire cohort. A comparative analysis was performed among three groups: MART (ICS/formoterol as a maintenance and reliever therapy) plus LAMA, Conventional (ICS/LABA as a maintenance and short-acting beta agonist as reliever) plus LAMA and Triple (ICS/ LABA/LAMA single inhaler). LAMAs were added to ICS/LABA in 11.7 % of patients in the national registry. Logistic regression analysis revealed that older age, low FEV1 (%), Asthma Control Test (ACT) scores less than 20, and severe exacerbation were the main factors influencing the initiation of LAMA in our registry. However, demographic characteristics of asthma, control status, pulmonary function test results were similar among the three groups of LAMA users (p > 0.05). Physicians used LAMAs without phenotyping based on allergic status or eosinophil levels (p > 0.05). Mepolizumab was added after LAMA in all patients, while omalizumab was initiated before LAMA in 16.9 % of the patients receiving LAMA along with biologics. Add-on LAMAs were predominantly prescribed for older, uncontrolled, and exacerbated asthma patients with low FEV1.
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    Asthma patients with obesity have a unique phenotype: a subanalysis of the Turkish adult asthma registry
    Celebi Sozener, Z; Oguzulgen, IK; Ozalp Ates, FS; Baccioglu, A; Argun Baris, S; Ediger, D; Gunaydin, FE; Sevinc, C; Seker, U; Yilmaz Kara, B; Beyaz, S; Mungan, D; Aydin, O; Gokmen, D; Buhari, GK; Gemicioglu, B; Bulut, I; Orcen, C; Kepil Ozdemir, S; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Alan Yalim, S; Yilmaz, I; Koca Kalkan, I; Uysal, MA; Ozgun Niksarlioglu, EY; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Akkor Gelincik, A; Dirol, H; Goksel, O; Karaoglanoglu, S; Oner Erkekol, F; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Basyigit, I; Yilmazel Ucar, E; Erdogan, T; Polatli, M; Turk, M; Pur, L; Yegin Katran, Z; Sekibag, Y; Aykac, EF; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Polat Yulug, D; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Arslan, B; Cetin, GP; Soyyigit, S; Pasaoglu Karakis, G; Dursun, AB; Kendirlinan, R; Ozturk, AB; Omeroglu Simsek, G; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Cadalli Tatar, E; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Celik, GE
    Objective: The obese-asthma phenotype has gradually increased in the last few years. We aimed to assess the differences between obese and non-obese patients with asthma. Methods: This research is a subanalysis of the Turkish Adult Asthma Registry (TAAR). Clinical presentation, disease control, severity, and demographics of obese and non-obese (normal-weight, overweight) patients were compared. Results: The obesity rate in TAAR was 32.2% (n=619/1919; 18-83years; 527F/92 M). Patients with asthma and obesity had higher rates of childhood obesity, longer symptom duration, later onset of asthma, and more severe asthma. These patients were more likely to be female, older, less educated, and live in rural areas. Patients with obesity had more scheduled visits and emergency visits compared with non-obese patients, but similar asthma control, oral corticosteroid use, hospitalizations, intensive care unit admissions, and unscheduled visits. They also had a higher frequency of T2-high but lower frequency of possible T2-low phenotypes compared with normal-weight asthmatics. The risk of severe asthma in patients with obesity was 6.04 times higher for allergic than non-allergic patients and 3.58 times higher for the T2-high phenotype than for possible T2-low phenotypes. A one-unit increase in the asthma control test reduced the risk of severe asthma by 22%. Conclusions: A good definition of this phenotype is important to ensure that appropriate treatment strategies are implemented to achieve the control goal. We also believe that prevention of childhood obesity is an effective and pivotal strategy to achieve the goal of asthma control.