Polypropylene mesh (PPM) is widely used in ventral hernia repair, however is also associated with visceral adhesions when the mesh is exposed to intraabdominal organs. In this study, a composite mesh [ePTFE (expanded polytetrafluoroehylene) + PPM] and sodium hyaluronate/carboxymethyl cellulose (NaHA/CMC) membrane laid under PPM are evaluated in terms of adhesion formation in a rat model of ventral hernia repair. In this experimental study, a 2 × 1 cm of peritoneum and underlying muscle defect was created at the right side of the anterior abdominal wall of 37 male Wistar albino rats. These defects were repaired with 2.5 × 2 cm PPM in group 1 (n = 13), with composite mesh in group 2 (n = 12) and with PPM+NaHA/CMC in group 3 (n = 12). Rats were sacrificed after 14 days and the prosthetic materials were examined for the calculation of surface area percentage covered by adhesions, for organ involvement in the adhesions and for histological evaluation. There was a reduction in the adhesion-covered area in group 2 and group 3. Organ involvement was predominantly seen in group 1. Neoperitoneum was perfect in group 2. Fibrosis and inflammation were higher in group 1. All groups showed adhesiogenic potential to some extent. This potential was maximum with PPM. Both ePTFE and NaHA/CMC displayed similar effects in preventing adhesion formation.
Amaç: Bu çalışmada, nazal septum deviyasyonu tanısı konulmuş hastalarda yaşam kalitesinin septoplasti öncesi ve sonrasında değerlendirilmesi, ayrıca akustik rinometri ve rinomanometri yöntemlerinin cerrahi başarının objektif olarak ortaya konulmasındaki yeri ve öneminin gösterilmesi amaçlandı.
Hastalar ve Yöntemler:Bu çalışma septoplasti ameliyatı uygulanan 44 hasta üzerinde yapıldı. Hastaların ameliyat öncesi yakınmaları Nazal Obstrüksiyon Semptom Değerlendirme (NOSE) skalası ile değerlendirildi. Hastaların eş zamanlı olarak dekonjesyon öncesi ve sonrası akustik rinometri ve rinomanometri verileri kaydedildi. Septal cerrahi yöntemi olarak Cottle septoplastisi uygulanan hastalar, ameliyattan bir ay sonra NOSE skalası, akustik rinometri ve rinomanometri ile tekrar değerlendirildi ve bulgular ameliyat öncesi verilerle karşılaştırıldı.
Bulgular:Hastaların ameliyat öncesine göre NOSE skoru değerlerinde anlamlı azalma (p<0.05); akustik rinometri ile ölçülen minimal kesitsel alan (MKA1, MKA2) ve hacim değer-lerinde anlamlı artış (p<0.05) ve rinomanometri ile ölçülen nazal direnç değerlerinde anlamlı azalma (p<0.05) görüldü. Hastaların ameliyat öncesi ve sonrası NOSE skoru değerleri arasında meydana gelen değişim ile akustik rinometri ve rinomanometri verilerindeki değişim arasında anlamlı ilişki bulunmadı (p>0.05).Sonuç: Kanıta dayalı tıp uygulamalarının giderek önem kazandığı günümüzde, ameliyat başarısının objektif değer-lendirilmesi amacıyla akustik rinometri ve rinomanometri kullanılabilir yöntemlerdir.Anahtar Sözcükler: Akustik rinometri; Nazal Obstrüksiyon Semptom Değerlendirme skalası; rinomanometri; septoplasti.
Objectives:In this study we aimed to evaluate the quality of life during before, and after septoplasty in patients who were diagnosed with nasal septal deviation and also to demonstrate the role and importance of acoustic rhinometry and rhinomanometry methods in objectively demonstrating surgical success.
Patients and Methods:This study was carried out in 44 patients undergoing septoplasty surgery. Patients' preoperative complaints were evaluated by Nasal Obstruction Symptom Evaluation (NOSE) scale. The pre-and postdecongestion acoustic rhinometry and rhinomanometry data of the patients were recorded simultaneously. One month after Cottle's septoplasty performed as the septal surgery method, patients were re-evaluated by NOSE scale, acoustic rhinometry and rhinomanometry and the findings were compared with the preoperative data.
Results:Compared to the patients' preoperative values, a significant decrease in NOSE scores (p<0.05); a significant increase in the minimal cross-sectional area (MCA1, MCA2) and volume values measured by acoustic rhinometry (p<0.05) and a significant decrease in the nasal resistance values measured by rhinomanometry (p<0.05) were observed. No significant relationship was found between the change in patients' preand postoperative NOSE score values and the change in their acoustic rhinometry and rhinomanometry data (p>005).
Conclusion:Nowadays, evidence-based medical practices a...
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