Tuesday, October 6, 2020

What is Fibroid? What are the Symptoms? What is the treatment?

Myoma is abnormal smooth muscle proliferation in the uterus and is one of the most common female diseases. We can define fibroids as benign tumors. Fibroids that can show different locations in the uterus such as intramural, subserus, intracavitary and pedunculated can be seen at any age. However, it is also known to be more common between the ages of 30 and 40. These tumors, which can be affected by the hormonal state of the body, tend to shrink after the menopause period.

Fibroids, which tend to grow after menopause, must be followed up regularly because of the possibility of turning into malignant. In general, the probability of these tumors becoming cancerous is 1 in 1000. However, it is very important to have regular follow-ups due to the risk of cancer, even if it is low.

Meanwhile, there is a risk of recurrence of fibroids. The probability of recurrence in the first 5 years after the removal of fibroids with surgery is around 20% to 25%. All visible tumors can be cleared during treatment. However, those in microscopic dimensions that are not yet visible to the eye can grow over time as they cannot be cleaned.

Why Does Myoma Occur?

The probability of being seen in women in the reproductive period is around 20%. Of course, when diagnosed, women also wonder why these tumors occur. However, it should be noted that the cause of fibroids is not yet known. Genetic factors are effective in this formation and therefore the family history of the patients is also important in diagnosing fibroids. However, these tumors also have a hormone-dependent feature. Their tendency to shrink after menopause suggests that they are highly affected by the estrogen hormone.

According to the researches, fibroids are more common in obese women and women who have never given birth before. Its dimensions can be different for each patient. We can also say that fibroids can pose some risks depending on their size and where they are located in the uterus. For example, fibroids that are large and put pressure on the cavity cavity in the uterus can cause infertility. However, we can say that they can cause problems such as miscarriage or recurrent pregnancy loss, as well as premature birth.

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What are the Symptoms of Myoma?

When patients have fibroids, the ability of the uterus to contract can also be negatively affected. Accordingly, menstrual irregularity may occur. Most of the women learn that they have uterine fibroids when they apply to the gynecologist and obstetrician with the complaint of long and severe menstrual bleeding. Due to severe bleeding, anemia may also occur. Anemia is usually seen in women who think that severe and prolonged menstrual bleeding is normal and who do not consult a doctor for a long time.

Myoma, which reaches large sizes, manifests itself with the following symptoms:

  • Swelling and pain in the abdominal area
  • Constipation
  • Complaints about degassing
  • Some kidney problems
  • Frequent urination

Healthy fibroids in the cavity can manifest themselves with different symptoms. For example, we can say that stalked fibroids can go outside the uterine cavity. Symptoms such as bleeding and infection after sexual intercourse can also be seen. Depending on the infection, malodorous vaginal discharge may also occur.

Dr. Ismet Yildirim says ...

Myoma is a benign tumor arising from the uterine muscle layer seen in 2 out of every 5 women after the age of 35. The cause is usually genetic, if it is present in the mother, it is likely to be in her daughter and siblings. It causes complaints depending on the location in the uterus.

While those who settle in the inner layer of the uterus bleed excessively, those placed in the muscle layer cause pain. In case of excessive growth, it can damage the surrounding organs and cause trouble for conception. There is no drug treatment. If it causes conditions such as anemia, rapid growth and pain, it is appropriate to be removed by surgery. There are different types of surgery. Fibroids that do not complain are followed up. Fibroids may regress on their own in women who enter menopause. Regular periodic check-ups in women ensure early diagnosis.

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Is There a Treatment for Myoma?

Before proceeding to the treatment phase, myoma must be diagnosed in the uterus and myoma must be examined. Since it is possible to diagnose with pelvic examination and ultrasound imaging, it is not absolutely necessary to perform very advanced examinations. However, depending on the location of the myoma, the age and complaints of the patient, three-dimensional USG, MRI and tomography may be required.

After the diagnosis of myoma is made, treatment options are evaluated considering the age of the patient, symptoms, the size of the myoma and the location where it is located. If there is a very sudden growth or transformation into a malignant tumor, it may be necessary to perform surgical intervention and evacuate the fibroid formation from the body immediately.

However, it may be possible for fibroids to cause infertility, as we mentioned before. Fibroids located in a place that prevents fertilization may also need to be surgically removed to eliminate the infertility problem. In short, it is possible to treat fibroids with medical and surgical treatment methods. The most ideal treatment option will be applied by the gynecologist and obstetrician by evaluating the patient's condition.

Myoma Surgery In The Womb

First of all, in case of uterine fibroids, the patient does not necessarily need surgery. When the decision of surgery is made, the surgical intervention is performed with the most appropriate technique for the patient. Surgery can be performed using open, closed, BAE or hysteroscopy methods. 

Whether the patient wants to have children or not is also important in determining the surgical intervention technique. Because, as an alternative to evacuating fibroids from the body, it may be preferable to completely remove the uterus. However, in this case, the patient also loses fertility and cannot get pregnant again.

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This method of myoma surgery is applied by entering and removing fibroids that cause severe pain or severe bleeding in the patient. In this method, a special imaging system is used and fibroids located under the uterus or inside the uterus can be imaged.

Closed Surgery

Surgery can be performed by laparoscopic or robotic surgery method. If the uterine fibroids are larger than 4-5 cm, the myoma is removed from the uterine bed. Then, bleeding in this area can be intervened.

Open Surgery

Other surgical techniques can be inconvenient in cases such as the large size of myomas and their progress to the upper part of the belly. Therefore, surgical intervention should be done with an open technique. The operation is completed with the application of stitches after the incision is applied to the patient and the removal of myomas. The recovery time of the patient is longer in operations performed with open technique. Therefore, it is preferred to perform the surgery with other techniques unless it is necessary.

Uterine Artery Embolization (UAE)

In very rare cases, interventional radiological techniques can be used. The veins that feed the myoma are closed with the help of catheter entering through the inguinal vein. In this way, the growth of myoma can be prevented and even shrinkage of myoma can be achieved. When this method is applied, it is observed that the symptoms are reduced by 90%.

Does Myoma Cause Much Pain?

In case of uterine fibroids in women, there is often no severe pain. However, some patients may experience pain that can disturb daily life, especially during menstrual periods. At the same time, although it is rare, some patients may also experience back pain.

It may also be possible to experience pain during or after sexual intercourse. Therefore, fibroids is a condition that can cause pain. Factors such as which part of the uterus is located, its size, and the tissues that it puts pressure on in the uterus can also determine whether it causes pain or how much pain it causes.

Does Myoma Bleed?

Since the most typical symptom of fibroids is bleeding, women who have fibroids in the uterus may experience severe bleeding during their menstrual periods. At the same time, these tumors can cause the menstrual period to take longer. This is because women experience problems such as anemia and fatigue due to severe and prolonged menstrual bleeding.

Myoma that causes excessive bleeding complaints should be removed by surgical intervention. Because different health problems may arise due to severe bleeding. You can write your questions on the subject in the comment section.

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Friday, October 2, 2020

What Is A Wound In The Cervix? (Servical Erosion) How Is It Treated?

cervicitis often develops due to infection and can be defined as inflammation of the cervical tissue. It can also occur after irritation or trauma and is commonly manifested by vaginal discharge. Treatment can be done with simple surgical interventions, and after a short recovery period, it is possible for the patient to return to his daily life. We can state that all women with active sex lives are suitable candidates for this ailment.

Cervical Erosion

Is There Really A Wound In The Cervical Mouth?

Wound in the cervix, which is common in the society, is among the problems frequently encountered by gynecologists and obstetricians. What is called "wound" among the people is actually the formation of a red and rough appearance in this area. The squamous epithelial cells of the vagina change due to various reasons such as irritation, trauma or infection, and this change causes a rough surface appearance in the cervix. Sometimes, the cervix can be bloody and velvety.

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Why Does Cervical Wound (Cervicitis) Occur?

It is still not known exactly which factors cause scar formation in the cervix. However, it should be noted that infection is an extremely active factor. This problem often arises as a result of infections that develop in the cervical region due to various factors. Generally, 3 microorganisms can cause cervicitis. These;

  • Chlamydia
  • Gonorrhea
  • Trichomonas

However, we can state that frequent sexual intercourse is among the causes of cervicitis. The hormonal changes in the body can also lead to such a result. In recent years, it has been understood that some chemical factors also cause scar formation in the cervix. This discomfort can occur in women, especially due to the chemical substances on the condom. As a result of the allergic reactions of the body to some substances, sores can occur in the cervix area.


What Symptoms Does Cervical Sore Cause?

What Symptoms Does Cervical Sore Cause

First of all, it should be noted that the symptoms of the wound in the cervix do not have specific features. Since symptoms that can occur in many different conditions are observed, it can only cause discharge in the patient. Because it does not cause a different complaint, it is sometimes diagnosed during routine control examinations.

Because discharge is not a symptom that patients take too seriously. Since the discharge that occurs after the menstrual period is often not considered as a disease precursor, patients do not need to consult a doctor. This situation turns into an important obstacle to early diagnosis in many diseases. However, vaginal discharge is the most important symptom of cervicitis.

Although there are no symptoms in mild cases, we can list the symptoms of cervicitis in general as follows:

  • Bleeding during or after sexual intercourse if the wound is large
  • Bleeding in the form of spotting outside the menstrual period
  • A burning sensation during urination
  • Itching in the vaginal area

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Who Is The Cervical Wound More Common?

Wound in the cervix, which can be seen at any age, can also occur due to genetic factors. A wound is expected in women with a wound on their mother. Especially in young girls who have never had intercourse, the presence of wounds suggests genetic factors. It can be mentioned that it is more common in women who have frequent vaginal infections or have more than one delivery. This problem may occur more commonly in women with cervical irritation for various reasons and women who have frequent sexual intercourse.

The use of birth control pills, on the other hand, can cause the cells that make secretion in the cervical canal to proliferate and increase the risk of wound formation in the cervix, even indirectly. We can state that this disorder is more common in women who use contraceptive pills or have spirals.


How To Treat Wounds In The Cervical Mouth? How Long Does It Take To Heal?

Burning the problematic area with electrocautery or freezing with cryotherapy are minor surgical methods used in the treatment of wounds in the cervix. Let us state that the healing time can vary depending on which treatment is applied and the size of the wound in the cervix. 

The most common treatment protocol is obtaining heat with a pen-like device and burning this area with heat. This treatment is the oldest treatment method and there may be very mild pain during the procedure. However, the patient can return to his life immediately after the procedure.

After the wound treatment in the cervix, which is applied by burning the wound with a cautery device, the complaint of discharge can continue for up to 15 days and this is medically quite normal. Slight burning may continue for a while. It takes 10 to 15 days for the tissues to fully heal, and sexual intercourse should not be made during this period. Because sexual intercourse can cause the wound to recur.

With cryotherapy, recovery occurs faster in the freezing process. The procedure takes about 5 minutes and the patient can return to his daily life immediately. After the cervical wound treatment applied with this method, only a mild groin pain can be experienced. It should be underlined that the probability of recurrence after this job is also lower.


Does The Cervical Wound Go On Itself?

Does The Cervical Wound Go On Itself

If it is a simple irritant substance that causes wound formation in the cervix, the problem may disappear if this substance is not used. In a sense, we can say that this ailment does not always require treatment. However, the smear test must be done beforehand and the test result must be evaluated by the gynecologist and obstetrician.

If the patient has an infection and the development of cervicitis is observed due to the infection, it will be beneficial to apply the treatment procedure. In addition, in case of wound in the cervix, the factor that causes the wound may need to be eliminated and it may be waited for a while. If there are no signs of improvement during this period, the appropriate treatment option may be preferred.

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What Happens If Uterine Wound Is Not Treated?

In case of a wound in the cervix, you should definitely consult with the gynecologist and obstetrician and be examined. If the wound condition is of a size that requires treatment and is not treated, it can become chronic in a short time. At the same time, the wound can deepen and spread over a wider area. In this case, the patient's complaints will also increase and the quality of daily life will be negatively affected by these complaints.

You should also know that the treatment may take longer and may be more difficult in the future. We can say that untreated cervical wounds cause infertility, premature birth, miscarriage and even cervical cancer. If it is not treated, changes occur in the flora of the vagina due to frequent discharge and vaginal inflammation occurs.


Does Cervical Wound Cause Cancer?

First of all, we need to mention that cervical wound and cervical cancer are very different conditions. Wound in the cervix does not necessarily mean that the patient will have cervical cancer. But not treating the wound can significantly increase the risk of cancer. It is also important whether cervicitis is ulcerated or not. In the case of an ulcerating wound, it is necessary to scan for the presence of the HPV virus immediately.

Because this virus progresses and spreads very quickly in the area with wound formation. It should not be forgotten that HPV virus alone is the cause of cervical cancer. As a result, although cervicitis is not a single cause of cancer, it is a condition that is indirectly related to cervical cancer.

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Monday, September 28, 2020

Dry Nose and Treatment

Dry Nose TreatmentThe precautions to be taken and general treatment principles in case of dryness in the nose can be summarized as follows. There are a variety of symptoms that can indicate an extremely dry nose. Nasal functions such as sniffing and cleaning air before it enters the body may be impaired. The skin in the nasal passage can crack due to aching cracks. There may be blistering of the skin and mucus inside and outside the nose. This can lead to bacterial infections that can make your crusting symptoms worse. An extremely dry nose can sometimes be caused by a side effect of a drug such as an antihistamine. While effective for a runny nose, antihistamine sprays and medications often contain atropine, and atropine can dry the nasal passage. Environmental factors such as temperature and lack of moisture can contribute to dry nose.

What Are The Factors That Cause Dry Nose?

Environmental factors; Dry nose occurs due to the decrease in humidity at air temperature. In addition, hot and humid environments can cause nasal dryness.

Taking antihistamine group drugs is also among the causes of dryness.

Nasal inflammation (rhinitis) is a runny nose disease, but sometimes it can cause nasal dryness.

Some bacteria and germs can cause dry nose.

Nasal sprays given for nasal discharge can also cause dryness in long-term use.

Consumption of water below the required amount can cause dry mouth as well as dry nose.

Sjögren's syndrome is the cause of dryness in that the disease is caused by the drying of the mucosa. It causes dryness in the moist areas of the body, eyes and nose.

Hormone changes can cause nasal dryness, especially during menopause. Dryness may occur in the mouth, nose, vagina and eyes.

High blood pressure disease can also cause a dry nose accompanying bleeding.

Environmental Precautions

Avoiding dry, very hot or very cold, air-conditioned air conditions that may cause nasal dryness or bringing the humidity level of the ambient air to normal with cold steam machines or other humidifiers.

Treatment for Nasal Mucosa

Nasal lavage with saline water (use of sinus rinse, ocean water or home-made saline), drops, sprays or ointments containing petroleum jelly, panthenol, vitamins A and E, as well as ointments containing ocean salt and glycerin derivative, make the nasal mucosa Prevention of moisture loss, regeneration of the mucosa and increasing ciliary movements can be achieved.

Dry Nose

In the photo above, there is a dry and crusty appearance on the mucosa that results from the insertion of paper towels into the nose.

Dry Nose Treatment

In the photo above, due to the habit of mixing nose with fingers, irritation and dryness of the mucous membrane on the protruding area with septum deviation draws attention.

Regulation of Nutrition

Increasing oral fluid intake is very important for the moisture balance in the nasal mucosa. Drinking at least 7-9 glasses of water or fruit juice a day, especially fruits and vegetables with high water content, will be beneficial for moisturizing the mucous membranes.

Apart from these, as excessive use of alcohol, coffee and salt may cause the mucous membranes to dry, reducing their use will also be beneficial.

Stopping Medications That Can Cause Dry Nose

There are many medications (such as allergy medications) that can cause nasal rinsing. Discontinuation of these drugs - in consultation with the doctor - will also be useful in the treatment of nasal dryness.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com
Mobile phone: +90 0533 6550199
Fax: +90 212 542 74 47

Sunday, September 27, 2020

Ethnic Rhinoplasty in Istanbul Video and Images

Ethnic Nose Job in Turkey

In patients with ethnic nasal features, the following characteristics can be detected, unlike other patients:

- thicker and oily skin features than normal
- flattened nasal root
- broad nasal bone
- wide and flat nose tip
- round nose tip
larger than normal nostrils
- Weak nose tip support (nose tip can hang down easily when touched or while the patient is laughing)

One or more of these features can occur simultaneously in patients. People in the Asian and African regions have different nasal features. Sometimes, in mixed people born from the marriage of people of different geographic locations, these traits can occur at different levels. The patient, who appears in the video and in the photos below, does not have all of the classic ethnic nose features. During the rhinoplasty operation performed on the patient, the alar base resection was not performed because the nose wings were not abnormally large. 

Ethnic Rhinoplasty in Istanbul

Especially in patients with extremely thick skin features, a longer recovery period than normal (sometimes up to 2 and a half years for the removal of edema), a longer period of swelling than normal, a long-term round appearance at the tip of the nose due to excessive camouflage effect may occur.

During the operation, I usually perform two-level skin dissection and subcutaneous tissue removal at the tip of the nose with open technique. Subcutaneous tissue can be used in some patients to fill the nasal root. Although the skin becomes thinner in this way; Subcutaneous tissue can reappear depending on genetic characteristics. In aesthetic nose surgeries, "skin shaping" can be perceived as almost impossible.

Unlike normal, the following recommendations may be appropriate for patients after thick-skinned rhinoplasty:

- bedtime nasal taping
- salt restriction
- nasal massage
- use of bormelian igib products to remove edema and bruises
- using arnica montana gel
cortisone injection

Despite all these precautions, retinio-derived creams and gels can be used in patients with excessive swelling in the nose. Laser application is controversial.

Ethnic Thick Skinned Rhinoplasty in Turkey, Ethnic Rhinoplasty in Istanbul, Thick Skinned Nose Job,Rhinoplasty In Istanbul

Ethnic Thick Skinned Rhinoplasty in Turkey, Ethnic Rhinoplasty in Istanbul, Thick Skinned Nose Job,Rhinoplasty In Istanbul

Ethnic Thick Skinned Rhinoplasty in Turkey, Ethnic Rhinoplasty in Istanbul, Thick Skinned Nose Job,Rhinoplasty In Istanbul

Ethnic Thick Skinned Rhinoplasty in Turkey, Ethnic Rhinoplasty in Istanbul, Thick Skinned Nose Job,Rhinoplasty In Istanbul

Ethnic Thick Skinned Rhinoplasty in Turkey, Ethnic Rhinoplasty in Istanbul, Thick Skinned Nose Job,Rhinoplasty In Istanbul

You can find more information and photos on the subject in the links below:

Similar links >> Why Ethnic Revision Rhinoplasty is a Difficult Operation? / Ethnic Rhinoplasty in Istanbul

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com
Mobile phone: +90 0533 6550199
Fax: +90 212 542 74 47

Thursday, September 24, 2020

Tertiary Revision Rhinoplasty With Rib Cartilage For Male Patient

Tertiary Revision Nose Aesthetic Operation in Istanbul

Revision rhinoplasty operations are difficult and sometimes very complicated surgeries, which consist of combining different surgical techniques, can change the surgical plan completely during the operation. As can be seen in the video here, we performed the third revision rhinoplasty operation using scraps of cartilage on the patient who had previously undergone a rhinoplasty operation in another clinic twice and who had various aesthetic / functional problems. Nasal problems that the patient particularly complains of:

- drooping nasal tip
- asymmetrical nasal tip, especially the lower right wing
- insufficient air removal from the left nostril (nasal valve problem)
- asymmetrical areas on the nose

Rhinoplasty In Istanbul,Tertiary Revision Rhinoplasty,revision rhinoplasty,Revision Rhinoplasty With Rib Cartilage,

As seen at the end of the video, we have applied different cartilage grafts for all these problems.

During the suturing of the cartilage grafts, completely self-absorbable suture materials were used in order to minimize the risk of foreign body rection. Basket stitches hanging from the outside of the nose were used to fix the cartilage grafts. After the procedure, a slight upward and forward elevation at the tip of the nose, improvement in the collapsed area on the right nasal wing and the disappearance of asymmetric light refractions on the back of the nose can be seen.

Minimal surgical trauma and minimal risk are the main goals in revision nose job operations. In patients, it is not always possible to achieve full symmetry with a single operation. Cartilage and bone memory can affect the result during healing.

You can see more detailed information about revision rhinoplasty at >> Revision Rhinoplasty in Istanbul

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com
Mobile phone: +90 0533 6550199
Fax: +90 212 542 74 47

How is Ovarian Cyst Surgery Performed?

Ovarian cyst surgery is generally a surgical operation performed with surgical removal of the ovarian cyst and preservation of the ovary. Ovarian cysts are formations that are common in women of reproductive age and develop in the tissue of the ovary. It can sometimes be seen in later ages, but there is a risk that the cysts seen in this period may develop due to ovarian cancer. Therefore, cysts removed by surgical intervention need to be sent to pathological diagnosis.

Ovarian cysts are formations filled with fluid, a gel-like substance or blood. We can state that most of these cysts occur due to hormonal reasons. These formations, which can also be called "ovulation cysts", can cause ovulation pain in the middle of two menstrual cycles. Their sizes range from 20 mm to 30 mm, but we can say that cyst sizes can even reach 4 cm to 5 cm in some women.

Cysts that grow to this size can cause complaints such as severe abdominal or groin pain. The cysts in question can be easily observed with ultrasound imaging performed during the ovulation period of women. Therefore, as it is possible to determine whether the cyst is physiological, tumoral, chocolate cyst or malignant cyst with ultrasound imaging, it is possible to plan ovarian cyst surgery.

How is Ovarian Cyst Surgery Performed

When Does Ovarian Cyst Require Surgery?

The diagnosis of ovarian cyst after the examinations and tests performed does not mean that the patient should have an ovarian cyst surgery immediately. Ovarian cysts may also occur during the menstrual cycle due to the inability of ovulation function. These cyst formations can disappear spontaneously after a few menstrual cycles. For this reason, except for some specific cases, it is necessary to wait for a while to determine whether the cyst will disappear after the diagnosis. If the cyst formation does not disappear on its own, then a surgical operation is performed.

Although rare, we can say that ovarian cysts can cause serious trouble in women's daily life. In such cases, surgery can be planned in order to relax the patient. Cyst formation can be observed as the first sign of ovarian cancer. In such cases, the cyst must be evacuated from the body by surgical operation and sent for pathological examination. Therefore, doubting that cyst formation is not benign may be sufficient for the decision of surgery.

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Dr. Ismet Yildirim says ...

Ovarian cyst is a fearful dream of women, when diagnosed, it causes stress, especially in many women. Most of the cysts occur due to hormonal reasons and usually resolve spontaneously, but some cysts may require surgical operation.

Before the cyst operation, it is necessary to determine the type of the cyst, find out where it originates, and determine whether it is related to cancer. Especially with ultrasonography and some other imaging methods, it is very important to determine the cause of the cyst, in addition to determining the cyst type with some blood tests. While medical treatment is applied in some cysts, surgical treatment may be considered in others.

How Is Ovarian Cyst Surgery Done?

How Is Ovarian Cyst Surgery Done

Ovarian cyst surgery performed under general anesthesia can be performed with two different techniques, open and closed. However, today we can state that the first approach is laparoscopic, ie closed technique. Cyst surgery performed with closed method is now accepted as one of the gold standards in this condition.

In the surgery, which is performed by inflating the abdominal cavity using carbon dioxide from the navel, a micro-sized optical camera displays the abdominal cavity. It is also possible to view the inguinal cavity with the camera. After the optical camera is placed, the uterus and abdominal internal organs are evaluated, especially the ovaries. The operation is started by placing trocars in the inguinal and lateral areas of the abdomen.

The cysts formed in the ovarian area after the procedure are separated from the ovaries and removed from the abdomen in the laparoscopy bag and evacuated from the body. Cysts are sent for pathological evaluation if needed. In some patients, the diagnosis of cyst is made as a preliminary diagnosis and the result of pathological evaluation is expected for the actual diagnosis. During the operation, it is not possible for the patient to feel pain or pain due to the effect of anesthesia.

We cannot say that the healing process is very difficult for patients. After a few days of rest, it is possible for patients to return to their daily life. Problems such as headache and nausea may occur only on the day of the operation. However, the reason for these is not the surgery but the anesthesia applied before the operation. Because it passes by itself after a few hours.

Laparotomy, ie open technique, is generally preferred in mandatory situations. In this method, an incision is applied to the abdomen to reach the ovaries and the cyst formation is removed and stitches are placed in the abdomen.

Thus, the operation is completed. We can say that the recovery time is a little longer in operations performed with open technique and it can make patients a little more difficult. Regardless of the technique used for ovarian cyst surgery, mild pain may occur. However, it will be possible to control the pain with the use of the medicine prescribed by the doctor.

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Ovarian Cyst Symptoms

Symptoms of cysts that occur with ovaries in the uterus can be different in each patient. We can also state that the severity of symptoms also varies from patient to patient. Common symptoms are as follows:

  • Irregular period
  • No menstruation
  • Painful menstruation
  • Pain in the groin
  • Pain during sexual intercourse
  • Swelling in the abdominal area
  • Fullness and tenderness in the breasts
  • Various complaints about the urinary tract and intestinal system
  • Getting fat
  • Nausea and vomiting
  • Increased hair growth on the body
  • Inability to get pregnant
  • Sudden and severe abdominal pain such as a stab

Some of these symptoms can be indicative of different health problems as well as ovarian cysts. Therefore, when symptoms occur, it is absolutely necessary to consult a gynecologist and obstetrician. Being diagnosed with cyst does not necessarily mean that you have to have ovarian cyst surgery. However, it is still necessary to determine the factors that cause the complaints and to apply the necessary treatments. Let us emphasize once again that early diagnosis is very important in all diseases.

Is Ovarian Cyst Dangerous?

Is Ovarian Cyst Dangerous

It cannot be said that not every ovarian cyst is dangerous. We can state that 80% of ovarian cysts are benign. However, cyst formation can be observed as a symptom of ovarian cancer. In this case, ovarian cyst surgery should be performed in a short time. The cyst is more likely to be malignant if:

  • Cysts that occur after menopause
  • Having cysts in both ovaries
  • Detection of the solid structure next to the fluid-filled cyst
  • Cysts that are adhered to the environment and have irregular contours
  • Cysts that grow very rapidly
  • Cysts that cause fluid buildup in the abdomen
  • How Long Does Ovarian Cyst Surgery Take?

The duration of ovarian cyst surgery performed by laparoscopic method is not the same in every patient. In general, we can say that the operation time varies between 1 hour and 2.5 hours. However, depending on the information such as the structure, size, type of the cyst and the part of the ovary, the procedure time may vary.

For example, the operation for a chocolate cyst takes longer. This is because the cyst has an adhesive structure. It should also be noted that the organs should be protected during the procedure. Therefore, when the cysts that are large enough to put pressure on the organs need to be removed, the operation time may be prolonged.

Is There A Death Risk In Ovarian Cyst Surgery?

All surgical operations involve some risks. There is no risk-free surgery. Therefore, ovarian cyst surgery also carries various risks such as bleeding and infection. However, it should be noted that general anesthesia applied before surgery also carries some risks.

Although the risk of death is valid for all surgeries, the possibility of occurrence also varies depending on which surgery is performed and which part of the body is intervened. The risk of death is extremely low in surgery performed to remove the ovarian cyst.

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Tuesday, September 22, 2020

Caudal Septum Deviation / Dislocation

Anterior Septal Dislocation

The nasal septum is the structure that divides the nasal cavity into two, consisting of cartilage and bone, and covered with mucosa. Columella is the part between the nostrils and when viewed from the outside, between the two nostrils. Curvatures in the nasal septum to one side are called "nasal septum deviation". This curvature, which is found in certain levels in many people, can cause symptoms such as nasal congestion, sleeping with open mouth, dry throat at night, sweating during sleep, and decreased sleep quality when it is excessive. In this case, septoplasty operation can be performed. Classical deviation surgeries are a simple surgical procedure frequently performed by many ENT specialists.

The part closest to the floor of the nasal septum, that is, when you look at the nostrils in front, the part just behind the "columella", which is the part between the holes, "caudal septum" is very important, especially in the nasal tip support and in the shape of the tip of the nose. The curvatures in this section are termed "caudal septum deviation", "caudal septal deviation" or "anterior septal deviation", as my above patient points out, can cause 3 major problems:
  • nasal congestion
  • asymmetric nose tip
  • columellar irregularities

The deviations of the nasal septum that appear outward from the columella, ie the curvatures in the lowest part of the nasal septum, are called "caudal septal deviations". The lower part of the nasal septum is dislocated from the midline to one side (also called "Anterior Septal Dislocation" or "Caudal Septal Dislocation").

There may be many different curvatures in the nasal septum. Nasal septum deviation can vary depending on the species, genetic characteristics, and nasal trauma.

In some types of nasal septum deviation, open technical operations may be required. Especially in nasal septum deviations close to the "nasal valve" area, which is the narrowest airway area in the nose, the complaint of nasal obstruction may be high.

"Anterior septal dislocation" or "caudal septum deviation" between the nasal septum deviations is not only for nasal obstruction; It can also cause asymmetry and functional problems at the tip of the nose. As seen in the photo, the lower part of the cartilage that should sit on the lower bone notch (anterior nasal spine area) has shifted to the side, and when resection of this area is planned, the nasal tip support must be reconstructed using a cartilage graft.

Caudal septal deviations are cartilaginous curvatures in the support part of the nasal septum at the tip of the nose and narrow the nasal valve area, which is the narrowest part of the nose. Therefore, the surgical correction of caudal septum deviations is more difficult than classical nasal septum deviations. The video above shows the caudal deviation visible from the right nostril and obstructing the left air passage.

Patients with caudal septum deviation usually have a protrusion that can be seen from the front just behind the columella and inside the nostril, and further back in the opposite nasal cavity, as seen in the above photo, septum deviation. Patients may notice the relief of nasal breathing when pulling their cheeks sideways with their hands.

Apart from this, as a result of the lateral sliding of the caudal septum, the nasal tip support decreases, and patients may notice that when they touch the nasal tips, they are softer than normal, and that they spread or hang sideways while laughing. Sometimes, patients may describe a sitting sound instead of a sound due to the movement of the caudal septum area during handling.

Causes of Caudal Septum Deviation

Causes of nasal septum deviation are also valid for caudal septum deviation and can be summarized as follows:
- The most common facial trauma and trauma (perhaps the most common cause of caudal septum deviation, especially at the tip of the nose)
- direct compression and trauma of the nose during childbirth (this can also be considered a congenital disease)
genetic connective tissue disorders such as Marfan syndrome, Homocystinuria, and Ehlers-Danlos syndrome, which can cause septum deviation (sources: Nasal septum deviation / Marfan Syndrome Long-term Survival and Complications After Aortic Aneurysm Repair / Deviated Septum)

Caudal Septum Deviation Surgery

Caudal Septum Deviation / Dislocation

When the curved caudal septum section is removed alone, softening of the nasal tip, nasal tip sagging and retraction in the columella may occur!

The caudal septum contributes to the support of the nasal tip against gravity by being in the midline at the tip of the nose. Removing and removing this curved part, which is very important in the nasal tip support, during the surgical procedure and not making new cartilage support to the nasal tip, may cause a fall in the nasal tip after surgery.

In patients with caudal septum deviation, if the curved part of the septum deviation is surgically removed with the classical closed technique simple cartilage curvature surgery performed through the nose and lasting only a few minutes, loss of support tissue and a fall may occur at the tip of the nose. Therefore, instead of the curved area at the tip of the nose; Different techniques may be required, such as the placement of new cartilage grafts with open technique operation, or the closed technique and the "swinging door technique - swinging door" technique, including stretching and placing it back in the midline rather than completely removing the curved area.

The oldest and most common method for correcting septal caudal dislocations is Metzenbaum's "movable door" technique. Using this technique, the dislocated caudal septum is shifted to the midline and fixed to the nasal spine. In later years, Noorman published a movable gate technique modification involving the use of the maxillary crest as the door stopper after the dislocated septum was shifted to the opposite side of the dislocation. Another method has been defined by Goldman in which cartilage scoring, resection and suture steps are defined. In addition, the modified Goldman technique, involving resection of dislocated caudal septal cartilage and triangular cartilage from suture steps, was described by Lawson. In the literature, two different suture techniques that can be used both to correct caudal septal dislocation and to complement the previous cartilage fixation to cartilage nasal spine techniques have been published in the literature.

The first suture technique has described a caudal septal suture technique that can be used alone or as a complement to prior techniques; A technique is described involving fixation of the dislocated caudal septum with midpoint mattress stitching in the second suture technique with non-absorbable suture material from the outside.

Septoplasty is one of the most important operations in ear, nose and throat applications. Since the most affected area is the anterior part of the nose, the septum must be firmly fixed during suturing at the end of the surgery. It is particularly effective in preventing many complications such as anterior septal deformity repair, supratip depression, columellar retraction and enlargement of the nasal base.

Differences between caudal septum deviation surgery and normal septoplasty operation

In patients with caudal septum deviation, removing only the curved part is not sufficient as in normal deviation operations. This part is very important for the nasal tip support and for the nasal tip to stand upright. If the curvature area is removed, the nasal tip may fall and the nasal airways in the nasal passage area may cause problems such as nasal congestion to reappear over time and nasal deformity. In patients with caudal septum deviation, the open technique should be planned in the form of nasal tip aesthetics, after the front curved part is removed, replacing it with a cartilage graft taken from the back of the septum, or partial resection with a closed technique and placing the septum by sliding it into place. In other words, simple cartilage removal is not sufficient.

The closed technique "swinging door" technique may not always be sufficient!

With the covered technique, in patients with caudal septum deviation, it may be difficult to adjust the position of the caudal septum in the columnellar pocket, expand the algebra, insert the cartilage into the midline pocket and fix it with suture. In addition, it can only stabilize the septum vertically, and when made alone, it may be insufficient for fixation as it is a bearing column and is made at one level. In the patient given in the first photograph, a limited amount of resection (caudal septoplasty operation) was performed in the caudal septum section and external columellar sturt graft was placed in the midline from the outside. Open technical septoplasty operation is required for patients with severe deviation.

Caudal Septum Deviation / Dislocation

Caudal septum deviation surgery (caudal septoplasty surgery) can be performed with open technique or closed technique. When the curvature is excessive, an operation can be planned in the form of open technique nose tip aesthetics or nasal aesthetics. In the video above, an open technique septorhinoplasty operation was performed on the patient.

I generally prefer surgery in the form of open technique septoplasty or open technique nasal tip aesthetics for my patients with caudal septum deviation. In the open technique (external) approach, I prefer the closed technique (endonasal) approach because the surgeon has more control of the nasal tip anatomy and it is easier to place additional support cartilages at the tip of the nose.

Similar links >> What is The "Nasal Septum Deviation" and "Septoplasty Operation"?Open Techique Septoplasty Operation in İstanbul, Turkey / Caudal Septal Deviation

You can find details about "Nasal septum deviation definition - Nasal septum deviation causes - Symptoms of deviated septum - Diagnosis of septum deviation with turbinate hypertrophy - Treatment of nasal septum deviation - Septoplasty in Istanbul - Septoplasty in Turkey" at >> Nasal Septum Deviation - Symptoms, Diagnosis and Treatment

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
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