Person: DEMİR, UYGAR LEVENT
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DEMİR
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UYGAR LEVENT
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Publication A novel approach to crooked nose in rhinoplasty: Asymmetric level osteotomy combined with unilateral spreader graft(Lippincott Williams & Wilkins, 2019-07-01) Demir, Uygar Levent; DEMİR, UYGAR LEVENT; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz ve Baş Boyun Cerrahisi Anabilim Dalı; CNQ-7672-2022The crooked nose is certainly among the most difficult to treat deformities for rhinoplasty surgeons. This deformity is a complex problem because each structural nasal component can be effected and they may be asymmetric bilaterally. Despite the use of sophisticated techniques and an additional effort, unfortunately the long-term aesthetic results may not be perfect with some minor flaws. Here in this study, the authors introduce a new technique that is used to correct crooked nose deformity. Sixteen consecutive patients who underwent open approach rhinoplasty by the same senior author between January 2015 and January 2018 with the diagnosis of C-shaped, reverse C-shaped, and I-shaped crooked nose deformity were included. The authors performed low-to-low lateral osteotomy with transverse root osteotomy to concave side (wider side) and low-to-high osteotomy to convex side (narrower side) combined with a unilateral spreader graft to concave side. Frontal images were taken preoperatively and 6 months postoperatively to use for further assessments. The authors compared the preoperative deviation angle values at rhinion (RDA) and at nasal tip (tip deviation angle) with postoperative values. In the study group, RDA value showed significant decrease after surgery; the preoperative RDA value was 6.2 degrees (1.66 degrees-16.39 degrees) and it was calculated as 2.44 degrees (0.7 degrees-5.77 degrees) with P<0.001 postoperatively. The changes at tip deviation angle were also significant (P<0.001) and tip deviation was successfully decreased from a value of 5.08 degrees (2.8 degrees-10.62 degrees) to 2.13 degrees (0.5 degrees-6.6 degrees) postoperatively. In conclusion, this study offers a new and effective technique to correct crooked nose deformity that can be used safely with satisfying aesthetic results.Publication Treatment outcomes for primary retromolar trigone carcinoma: A single institution experience(Galenos Yayıncılık, 2020-04-09) Demir, Uygar Levent; Yanaşma, Halide Öztürk; DEMİR, UYGAR LEVENT; ÖZTÜRK YANAŞMA, HALİDE; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz Anabilim Dalı.; 0000-0002-9590-1420; 0000-0001-8544-6674; CNQ-7672-2022; EFV-2180-2022Objective: Retromolar trigone (RMT) is a rare location for oral cavity cancers. RMT cancers are aggressive malignancies that mostly present at an advanced stage. In this study, we aimed to evaluate treatment outcomes in patients who underwent initial radical surgical resection and postoperative radiotherapy or chemoradiotherapy with a diagnosis of primary RMT squamous cell carcinoma in our institution.Methods: The study included 20 primary RMT tumor patients out of 191 oral cavity cancer cases treated from January 2010 through December 2019. We retrospectively analyzed treatment details, histopathology reports, postoperative clinical course and survival outcomes.Results: The mean age at presentation was 59.4 years. Eighty percent of all patients were either stage 3 or stage 4. We performed mandibular resection in 14 patients (70%) and partial maxillectomy in eight patients (40%). Nineteen patients (95%) underwent unilateral neck dissection. The incidence of metastatic cervical lymph node was 13/20 (65%). Overall survival (OS) and disease-free survival (DFS) rates during follow-up (mean 26.3 months) were 60% and 75%, respectively. There was statistical significance between presence of multilevel metastatic lymph nodes and OS (p=0.013). DFS and OS of early stage and advanced stage groups were 100% vs 75% and 100% vs 50%, respectively, with no statistical significance (p=0.189 and p=0.084).Conclusion: The survival of advanced stage RMT cancer is poor despite appropriate treatment. Bone involvement that necessitates resection is common due to the proximity of the tumor to the mandible and the maxilla. Multilevel positive cervical lymph nodes and advanced stage are poor prognostic factors.Publication Comparison of clinical results in nasal tip augmentation either via face to face or back to back technique with autogenous auricular conchal cartilage(Lippincott Williams & Wilkins, 2015-06-28) Şahin, Murat Sertan; Kasapoğlu, Fikret; Demir, Uygar Levent; Özmen, Ömer Afşin; Coşkun, Hakan; Basut, Oğuz; Sahin, Murat Sertan; KASAPOĞLU, FİKRET; DEMİR, UYGAR LEVENT; ÖZMEN, ÖMER AFŞIN; COŞKUN, HAMDİ HAKAN; BASUT, OĞUZ İBRAHİM; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz Cerrahisi Anabilim Dalı.; 0000-0002-4718-0083; 0000-0002-9698-0546; 0000-0002-0881-1444; A-1452-2019; AAI-3877-2021; BBC-2978-2021; CNQ-7672-2022; DVC-7511-2022; CFJ-8210-2022Objective:To compare the objective and subjective findings between patients who underwent nasal tip augmentation surgery via two different methods using autogenous auricular conchal cartilage.Materials and Methods:This study included the data of 21 patients who underwent nasal tip augmentation surgery. The patients were randomly divided in two groups according to the technique used to form a double layer columellar strut graft; either face to face (group 1) and back to back (group 2). All patients were assessed via nasal obstruction symptom evaluation scale (NOSE) and via acoustic rhinometry and rhinomanometry at preoperative and postoperative 1st and 6th months.Results:There was statistically significant improvement in symptom score in both patient groups with no difference inbetween. Total nasal resistance decreased nonsignificantly at the end of 6th month in both groups; 13.1Pa/cm(3) to 8.6Pa/cm(3) and 10.3Pa/cm(3) to 9.5Pa/cm(3) respectively. There was no significant increment in MCA values for both groups except left MCA1.Conclusions:We achieved good results in tip augmentation via both techniques. An autogenous conchal cartilage is a good alternative to replace lacking caudal septal cartilage. It provides safe and stable support to the nasal tip. However, further comprehensive studies with larger sample size and long follow-up are required to elucidate any difference between these two techniques.Publication The efficiacy of sternocleidomastoid muscle flap on frey's syndrome via a novel test: Galvanic skin response(Springer India, 2014-01-01) Demirci, Uğur; Basut, Oğuz; Noyan, Behzat; Demir, Uygar Levent; Özmen, O. Afşin; Kasapoğlu, Fikret; Coşkun, H. Hakan; Onart, Selçuk; Demirci, Uğur; BASUT, OĞUZ İBRAHİM; Noyan, Behzat; DEMİR, UYGAR LEVENT; ÖZMEN, ÖMER AFŞIN; KASAPOĞLU, FİKRET; COŞKUN, HAMDİ HAKAN; Onart, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Fizyoloji Anabilim Dalı.; 0000-0002-9698-0546; A-1452-2019; AAI-3877-2021; GWW-4604-2022; CFJ-8210-2022; FRE-9096-2022; EQK-3127-2022; FQP-9099-2022; CNQ-7672-2022The aim of this study was to evaluate the effects of sternocleidomastoid (SCM) muscle flap on preventing Frey's syndrome by using, Galvanic skin responses (GSR). Fourty-three patients who underwent superficial parotidectomy were randomly divided into two groups and their GSR were recorded. SCM muscle flap was applied over the surgical area only in one group. Six months after the surgery, GSRs were remeasured. In addition, the patients completed a questionnaire regarding their complaints about clinical Frey's syndrome. Four patients had symptoms of clinical Frey's syndrome. Postoperative GSR measurements revealed no significant difference between two sides in flap group (p = 0.426) but higher in without flap group (p = 0.003). The patients with clinical Frey syndrome had significantly higher GSR values than the remaining patients. The SCM muscle flap was an effective method in preventing Frey's syndrome. Moreover, GSR test was highly sensitive and specific for diagnosis.Publication Is there a change in the treatment of T1 glottic cancer after CO₂ laser? A comparative study with cold steel(Galenos Yayıncılık, 2018-06-01) Demir, Uygar Levent; Çevik, Turgut; Kasapoğlu, Fikret; DEMİR, UYGAR LEVENT; ÇEVİK, TURGUT; KASAPOĞLU, FİKRET; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz Anabilim Dalı.; AAI-3877-2021; CNQ-7672-2022; ERB-8467-2022Objective: Carbon dioxide (CO2) laser provides high local control and disease-specific survival rates with minor morbidity and good quality of life in transoral cordectomy. We aimed to compare the oncological outcome and survival between cold steel and CO2 laser in the treatment of early glottic cancer.Methods: In this retrospective study, the participants were divided into two groups. The first group comprised patients who were operated upon between 2001 and 2007 using cold steel (group 1, n=38), and the second group comprised patients who were operated upon between 2008 and 2016 using CO2 laser (group 2, n=88). Both groups were compared regarding age, gender, pathological grade, T stage, type of cordectomy, margin status, anterior commissure involvement, follow-up, locoregional recurrence, and disease- free survival (DFS).Results: The overall survival rate and DFS were similar between the two groups (94.7% vs. 98.9% and 100% vs. 98.9%, respectively), and no association was found between surgical margin positivity and local recurrence. However, a significant association between the presence of anterior commissure involvement and recurrence was found in all 126 patients (p=0.016). Local recurrence was significantly higher in the group 2 (p=0.024), but it did not affect overall survival and DFS in these patients (100% vs. 94.1%).Conclusion: Although CO2 laser excision is considered to be superior to cold steel regarding surgical time and bleeding control, the local recurrence rates were found to be higher with the laser than the cold steel. Thus, we argue that cases should be selected more carefully concerning the anterior commissure, depth of tumor invasion lateral to vocal muscle, difficulty at endoscopic exposure for lesions with anterior commissure involvement, and reliability of surgical margins at frozen sections.Publication Mixed fungal infection in early period after kidney transplantation: A case report(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2015-01-01) Işıktaş Sayılar, Emel; Ersoy, Alparslan; ERSOY, ALPARSLAN; Akalın, Halis; AKALIN, EMİN HALİS; Ayar, Yavuz; Girgin, Nermin Kelebek; KELEBEK GİRGİN, NERMİN; CEYLAN, İLKAY; DEMİR, UYGAR LEVENT; Ener, Beyza; ENER, BEYZA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; 0000-0003-4607-9220; 0000-0001-7530-1279; 0000-0003-3306-3107; AAU-8952-2020; AAH-5054-2021; O-9948-2015; AAH-7250-2019; GSE-0029-2022; AGF-0767-2022; AAG-8523-2021Invasive fungal infections have a rapid and frequently fatal course in patients with solid organ transplantations. Mostly Aspergillus spp., Mucorales spp., Candida spp. and Cryptococcus neoformans are causal pathogens for opportunistic infections. Aspergillus spp. and Mucorales spp. especially lead to invasive fungal infections at rhino-cerebral area; they show similar radiological and clinical signs and they lead to invasive fungal co-infections. In case of any doubt about invasive fungal infections, antifungal treatment should be initiated as soon as possible and immunosuppressive treatment should be considered. This case presentation is about a patient at 51 years of age who developed invasive rhino-cerebral mixed fungal infection in 4 weeks following renal transplant.Publication The effects of tumour thickness and size on cervical lymph node metastasis in tongue cancer(Derman Medical Publ, 2015-02-01) Demir, Uygar Levent; Akça, Mehmet Ege; Saraydaroğlu, Özlem; DEMİR, UYGAR LEVENT; Akça, Mehmet Ege; SARAYDAROĞLU, ÖZLEM; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz Anabilim Dalı. 2Patoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; AAO-2435-2020; AAH-9701-2021; CNQ-7672-2022Aim: To evaluate the association between cervical lymph node metastasis and histopathological parameters related with tumour in oral tongue cancer patients. Material and Method: Thirty-six patients who underwent glossectomy combined with either unilateral or bilateral neck dissection with the diagnosis of anterior 2/3 tongue cancer were enrolled in the study. Data regarding tumour size, tumour thickness, perineural invasion, degree of differentiation, pathological cervical lymph node and extracapsular spread were retrieved from patients' files. Subsequently, we analyzed the association between these parameters and nodal metastasis. Results: There were 16 (44.4%) patients with nodal metastasis. There was no significance between tumour size (T) and nodal metastasis (p=0.702). Pathological lymph node incidence increased in accordance with tumour thickness. The percentage of lymph node metastasis was 20% in patients with tumor thickness <= 5mm and it was found 27.2% in those with thickness >5mm and <= 10mm. We showed that if the tumour thickness was > 10mm, <= 20mm or >20mm then the incidence of metastasis found higher as 58.3% and 62.5% respectively. However, we did not find a cut-off value for tumour thickness. There was no significance between perineural invasion and nodal metastasis (p=0.478). Discussion: Tongue cancer shows high risk of cervical lymph node metastasis even at early stages. We suggest to perform neck dissection in all patients who have high risk of occult metastasis inrelation with poor prognosis.