Polipli kronik sin\u00fczitin endoskopik sin\u00fcs cerrahisi (ESC) ile tedavisinde ba\u015far\u0131 oran\u0131 %70-98 aras\u0131nda rapor edilmektedir. Ast\u0131ml\u0131 olgularda bu ba\u015far\u0131 oran\u0131 %50\u2019ye kadar d\u00fc\u015fmektedir.<\/p>\n
Ameliyat sonras\u0131 6. ay sonu\u00e7lar\u0131n\u0131 kar\u015f\u0131la\u015ft\u0131ran bir \u00e7al\u0131\u015fmaya g\u00f6re pediatrik ya\u015f grubundaki ba\u015far\u0131 oranlar\u0131 eri\u015fkin ve geriatrik ya\u015f gruplar\u0131na g\u00f6re anlaml\u0131 derecede d\u00fc\u015f\u00fckt\u00fcr. Bir ba\u015fka \u00e7al\u0131\u015fmaya g\u00f6re ise 6 ya\u015f alt\u0131ndaki ba\u015far\u0131 anlaml\u0131 derecede k\u00f6t\u00fcd\u00fcr. Bunun nedenleri olarak \u00e7ocuklarda s\u0131k kar\u015f\u0131la\u015f\u0131lan \u00fcst solunum yolu enfeksiyonlar\u0131 nedeniyle olu\u015fan sin\u00fcs mukozas\u0131nda \u00f6dem, dar cerrahi saha ve poliklinik \u015fartlar\u0131nda postoperatif d\u00f6nemdeki pansuman g\u00fc\u00e7l\u00fc\u011f\u00fcd\u00fcr. Poole gibi baz\u0131 yazarlar 7 ya\u015f alt\u0131nda cerahi yap\u0131lmamas\u0131n\u0131 dahi savunmaktad\u0131r.<\/p>\n
Eri\u015fkinlerde yap\u0131lan \u00e7al\u0131\u015fmalar cerrahiden yakla\u015f\u0131k 1,5 y\u0131l sonra iyi epitelizasyon olu\u015ftu ise nadiren rek\u00fcrrens g\u00f6r\u00fclece\u011fi y\u00fcn\u00fcndedir ve bu s\u00fcre standart postoperatif takip s\u00fcresi olarak kabul edilmektedir. \u00c7ocukluk \u00e7a\u011f\u0131 sin\u00fczitinde farkl\u0131 patolojik durumlar s\u00f6z konusu oldu\u011fundan, bu ya\u015f grubu i\u00e7in do\u011fru postoperatif takip s\u00fcresinin ne oldu\u011funu saptamak amac\u0131yla bu \u00e7al\u0131\u015fma planlanm\u0131\u015ft\u0131r.<\/p>\n
Retrospektif olarak planlanan \u00e7al\u0131\u015fma ile CT g\u00f6r\u00fcnt\u00fcleri ve endoskopik bulgular de\u011ferlendirlerek \u00e7ocuklarda ESC sonras\u0131 ideal takip s\u00fcresi belirlenmeye \u00e7al\u0131\u015f\u0131lm\u0131\u015ft\u0131r.<\/p>\n
5-15 ya\u015f aras\u0131 88 olgu \u00e7al\u0131\u015fmaya dahil edilmi\u015ftir.<\/p>\n
37 olguda tek tarafl\u0131 sin\u00fczit ve antrokoanal polip mevcuttur (USP grubu).<\/p>\n
51 olguda iki tarafl\u0131 sin\u00fczit ve polip mevcuttur (BSP grubu).<\/p>\n
85 olgu ilk kez ameliyat olmu\u015ftur. Kistik fibrozisli olgu bulunmamaktad\u0131r.<\/p>\n
33 adet eri\u015fkin iki tarafl\u0131 sin\u00fczit ve polibi olan olgu kontrol grubu olarak kullan\u0131lm\u0131\u015ft\u0131r (Eri\u015fkin grubu).<\/p>\n
T\u00fcm ameliyatlar genel anestezi alt\u0131nda ayn\u0131 cerah taraf\u0131ndan uygulanm\u0131\u015ft\u0131r.<\/p>\n
BSP grubunda uygulanacak cerrahiye hastan\u0131n ya\u015f\u0131na g\u00f6re karar verilmi\u015ftir:<\/p>\n
10 ya\u015f\u0131n alt\u0131ndaki olgulara polipektomi,<\/p>\n
10 ya\u015f\u0131n \u00fczerindekilere anterior tmoidektomi ile osteomeatal kompleks a\u00e7\u0131lm\u0131\u015f + fontanel ve nazofrontal kanal a\u00e7\u0131lmas\u0131,<\/p>\n
13 ya\u015f \u00fczerine ise total sin\u00fcsektomi yap\u0131lm\u0131\u015ft\u0131r.<\/p>\n
Tek tarafl\u0131 sin\u00fczit ve antrokoanal polip olgular\u0131nda sadece polipektomi yap\u0131l\u0131rsa rek\u00fcrrens ihtimali \u00e7ok y\u00fcksek oldu\u011fundan ya\u015flar\u0131na bak\u0131lmaks\u0131z\u0131n maksiller sin\u00fcs\u00fcn membran\u00f6z k\u0131sm\u0131 a\u00e7\u0131lm\u0131\u015f ve polibin taban\u0131n\u0131 i\u00e7erecek \u015fekilde maksiller sin\u00fcs mukozas\u0131 al\u0131nm\u0131\u015ft\u0131r (anterior etmoidektomi yap\u0131lm\u0131\u015f ve fontanel a\u00e7\u0131lm\u0131\u015ft\u0131r).<\/p>\n
Postoperatif d\u00f6nemde 3 ay s\u00fcreyle d\u00fc\u015f\u00fck doz makrolid teavisi verimi\u015ftir. Alerjik olgulara antialerjik ila\u00e7lar ve topikal steroidler de verilmi\u015ftir.<\/p>\n
Klinik de\u011ferlendirme CT bulgular\u0131na, rinoskopik bulgulara ve alerij fakt\u00f6rlerine g\u00f6re yap\u0131lm\u0131\u015ft\u0131r. Ayr\u0131ca nazal belirtiler de\u011ferlendirilmi\u015ftir.<\/p>\n
BSP grubunda cerrahiden sonraki 1 y\u0131lda hastalar\u0131n yaln\u0131zca %50\u2019sinin daha iyi oldu\u011fu tespit edilmi\u015ftir. Takip s\u00fcresi uzad\u0131\u011f\u0131nda iyile\u015fen hasta oran\u0131n\u0131n artt\u0131\u011f\u0131 g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Postoperatif 4 y\u0131ll\u0131k bir periyodun sonunda istatistiksel olarak anlaml\u0131 derecede iyile\u015fme g\u00f6r\u00fclmektedir. Benzer \u015fekilde 12 ya\u015f ve daha b\u00fcy\u00fck \u00e7ocuklarda durumu de\u011fi\u015fmeyen ve k\u00f6t\u00fcle\u015fen olgular\u0131n y\u00fczdesi anlaml\u0131 derecede d\u00fc\u015fmektedir. Bunun nedeni, \u00e7ocuklarda tekrarlayan enfeksiyonlar\u0131n s\u0131k olmas\u0131 ve sin\u00fcs mukozas\u0131n\u0131n stabilizasyonu i\u00e7in daha uzun s\u00fcreye gereksinim duymas\u0131 olabilir.<\/p>\n
USP grubunda postoperatif 1. y\u0131l sonunda, BSP grubuna g\u00f6re anlaml\u0131 derecede daha fazla iyile\u015fme g\u00f6r\u00fclmektedir.<\/p>\n
Semptomlar a\u00e7\u0131s\u0131ndan bak\u0131ld\u0131\u011f\u0131nda, %90 olguda genel olarak semptomlarda iyile\u015fme mevcut iken, kafada a\u011f\u0131rl\u0131k hissi ve burun t\u0131kan\u0131kl\u0131\u011f\u0131 %95 olguda d\u00fczelmektedir. Burun ak\u0131nt\u0131s\u0131 ise %70 olguda d\u00fczelmektedir. Ba\u015fka bir \u00e7al\u0131\u015fma, \u00e7ocuklarda rinit oran\u0131n\u0131n %40 oldu\u011funu bildirmektedir. Burun ak\u0131nt\u0131s\u0131n\u0131n devam\u0131n\u0131n nedeni bu olabilir.<\/p>\n
Eri\u015fkin olgularda \u00e7o\u011fu olguda postoperatif 1. y\u0131l sonunda anlaml\u0131 derecede daha fazla iyile\u015fme g\u00f6r\u00fclmektedir.<\/p>\n
Bu yaz\u0131lar www.haldunoguz.com adresinden al\u0131nm\u0131\u015ft\u0131r.<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
Pediatrik polipli kronik sin\u00fczit tedavisinde endoskopik sin\u00fcs cerrahisinin uzun d\u00f6nem de\u011ferlendirmesi Konu hakk\u0131nda detayl\u0131 ve g\u00fcncel bilgiler i\u00e7in bu makaleyi okuyun<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[40,50,58,66,37],"class_list":["post-1932","post","type-post","status-publish","format-standard","hentry","category-kulak-burun-bogaz","tag-calisma","tag-sinus","tag-sinuzit","tag-sure","tag-yas"],"_links":{"self":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/1932","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/comments?post=1932"}],"version-history":[{"count":1,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/1932\/revisions"}],"predecessor-version":[{"id":1933,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/1932\/revisions\/1933"}],"wp:attachment":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/media?parent=1932"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/categories?post=1932"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/tags?post=1932"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}