Researcher: Gökler, Ozan
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Gökler, Ozan
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Publication Metadata only Virtual reality simulation-based training in otolaryngology(Springer London Ltd, 2023) N/A; Ünsaler, Selin; Hafız, Ayşenur Meriç; Gökler, Ozan; Özkaya, Yasemin Sıla; School of Medicine; Koç University HospitalVR simulators will gain wider place in medical education in order to ensure high quality surgical training. The integration of VR simulators into residency programs is actually required more than ever in the era after the pandemic. In this review, the literature is reviewed for articles that reported validation results of different VR simulators designed for the field of otolaryngology. A total of 213 articles searched from Pubmed and Web of Science databases with the key words "virtual reality simulation" and "otolaryngology" on January 2022 are retrieved. After removal of duplicates, 190 articles were reviewed by two independent authors. All the accessible articles in english and which report on validation studies of virtual reality systems are included in this review. There were 33 articles reporting validation studies of otolaryngology simulators. Twenty one articles reported on otology simulator validation studies, eight articles reported rhinology simulator validation studies and four articles reported on pharyngeal and laryngeal surgery simulators. Otology simulators are shown to increase the performance of the trainees. In some studies, efficacy of simulators has been found comparable to cadaveric bone dissections and trainees reported that VR simulators was very useful in facilitating the learning process and improved the learning curves. Rhinology simulators designed for endoscopic sinus surgery are shown to have the construct validity to differentiate the surgeons of different level of expertise. Simulators in temporal bone surgery and endoscopic sinus surgery can mimic the surgical environment and anatomy along with different surgical scenarios, thus can be more implemented in surgical training and evaluation of the trainees in the future. Currently there are no validated surgical simulators for pharyngeal and laryngeal surgery.Publication Metadata only The combined use of spreader flap and asymmetric spreader graft in crooked nose(Springer, 2022) Koçak, İlker; N/A; Gökler, Ozan; Teaching Faculty; School of Medicine; 311179Objective The crooked nose is still a challenging deformity for rhinoplasty surgeons although a significant number of correction methods have previously been described. The aim of this study is to present a new technique that the authors have used to correct the crooked nose in selected patients. Materials and Methods This retrospective study was carried out on 53 patients who underwent open technique rhinoplasty due to crooked nose. Pictures were taken from five different angles using digital cameras and recorded pre- and postoperatively. Patients who have a minimum follow-up period of 12 months are included in the study. Results Fifty-three patients who have I-shaped and C-shaped crooked nose were enrolled in this study. The mean ages were 27.4 years. The mean follow-up period of the patients was 19.1 months. Patients who have I-shaped and C-shaped crooked nose deviation angle values were calculated preoperatively as 7.1 +/- 2.1 and 163.4 +/- 3.6, respectively. Postoperatively, deviation angle values were 0.75 +/- 0.83 and 177.9 +/- 3.1. Postoperative deviation angles were significantly lower than preoperative angles on patients who have I-shaped crooked noses (p < 0.001). On patients who have C-shaped crooked nose, postoperative deviation angles were significantly higher than preoperative angles (p < 0.001). Conclusions This unique study shows that the combined use of one-sided spreader flap and asymmetric spreader grafts is a very good choice for satisfactory long-term outcome and durable correction of crooked nose deformity.Publication Metadata only Can yoga cause benign paroxysmal positional vertigo?(Türk Kulak Burun Boğaz ve Baş Boyun Cerrahisi Vakfı, 2017) N/A; N/A; Koçak, İlker; Gökler, Ozan; Aydoğan, Esra; Karanfil, Işıl; Ünal, Ömer Faruk; Doctor; Teaching Faculty; Doctor; Undergraduate Student; Other; N/A; School of Medicine; N/A; School of Medicine; N/A; Koç University Hospital; N/A; Koç University Hospital; N/A; Koç University Hospital; 135447; 311179; N/A; N/A; 199800Objectives: This study aims to investigate any correlation between benign paroxysmal positional vertigo (BPPV) and yoga. Patients and Methods: Two groups were compared in the study: group 1 consisting of volunteers who performed yoga at regular intervals (38 females, 16 males; mean age 32.3 years; range 23 to 50 years) and group 2 as the control group (29 females, 25 males; mean age 34.6 years; range 21 to 46 years). All participants have undergone complete audio-vestibular tests and received Dix-Hallpike maneuver for the diagnosis of posterior semicircular canal BPPV and Roll maneuver for the diagnosis of lateral semicircular canal BPPV. The participants with the definitive diagnosis of BPPV were treated with Epley or Lempert maneuver, according to the affected semicircular canal. Results: Benign paroxysmal positional vertigo was diagnosed in one participant in the control group (1.9%) while it was seen in eight participants in the yoga group (14.8%). We observed the posterior canal to be affected in seven out of eight BPPV patients and lateral semicircular canal was affected in the remaining one patient. We found the prevalence of BPPV to be significantly higher in the yoga group compared to the control group (p=0.031). Although there is no correlation observed between the years of yoga performance and development of BPPV (p>0.05), a positive correlation is found between weekly practice hours of yoga and development of BPPV (p=0.009). Conclusion: There is a statistically significant correlation between BPPV and yoga. Therefore, performing yoga might be a risk factor for BPPV. / Amaç: Bu çalışmada benign paroksismal pozisyonel vertigo (BPPV) ile yoga arasındaki ilişki araştırıldı. Hastalar ve Yöntemler: Bu çalışmada iki grup karşılaştırıldı; grup 1 düzenli aralıklarla yoga yapan gönüllü grubu (38 kadın, 16 erkek; ort. yaş 32.3 yıl; dağılım 23-50 yıl) ve grup 2 gönüllü kontrol grubu (29 kadın, 25 erkek; ort. yaş 34.6 yıl; dağılım 21-46 yıl). Tüm katılımcılara posterior semisirküler kanal BPPV tanısı için komple odyovestibüler testlerle birlikte Dix-Hallpike manevrası ve lateral semisirküler kanal BPPV tanısı için Roll manevrası yapıldı. Benign paroksismal pozisyonel vertigo tanısı konulan katılımcılar, etkilenen semisirküler kanala göre Epley veya Lempert manevrası ile tedavi edildi. Bulgular: Benign paroksismal pozisyonel vertigo kontrol grubunda bir katılımcıda (%1.9) saptanırken, yoga grubunda sekiz katılımcıda (%14.8) saptandı. Bu sekiz BPPV hastasının yedisinde posterior kanal tutulumu, birinde ise lateral semisirküler kanal tutulumu izlendi. Yoga yapan grupta BPPV görülme olasılığı kontrol grubuna kıyasla anlamlı olarak yüksek bulundu (p=0.031). Yoga yapma yılı ile BPPV gelişme riski arasında ilişki yokken (p>0.05), haftalık yoga yapma süresi ile BPPV gelişme riski arasında doğru orantılı ilişki saptandı (p=0.009). Sonuç: Yoga ile BPPV arasında istatistiksel olarak anlamlı bir ilişki saptandı. Dolayısıyla yoga yapmak BPPV için bir risk faktörü olabilir.Publication Metadata only Is ginger effective in reducing post-tonsillectomy morbidity? a prospective randomised clinical trial(Korean Soc Otorhinolaryngol, 2018) Yucepur, Cemil; N/A; Koçak, İlker; Gökler, Ozan; Doctor; Teaching Faculty; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; N/A; 311179Objectives. An assessment of the effects of ginger on pain, nausea, vomiting, bleeding, and wound site healing that occur after tonsillectomy. Methods:Ibis prospective clinical study was participated by 49 patients aged 18-15 years out of 56 patients that underwent tonsillectomy and regularly attended follow-up visits. The patients were randomly divided into two groups. Group 1 consisted of 23 patients that used ginger capsules and group 2 consisted of 26 patients that did not use ginger capsules in addition to the routine antibiotic and paracetamol treatment following tonsillectomy. The pain, nausea, vomiting, and bleeding scores of patients were assessed on days 1, 4, 7, and 10 by using the visual analogue scale. Similarly, the epithelialization degrees of tonsillar bed were assessed on postoperative days 1, 4, 7, and 10 and regular oral intake times of patients were recorded. Results. There were no differences between groups in terms of age and sex. On the postoperative days 1, 4, 7, and 10, the pain scores were lower in the group 1 (all P < 0.001) and there were no differences between the two groups in terms of postoperative nausea, vomiting, and bleeding scores (P=0.35 and P=0.53). On the postoperative days 7 and 10, epithelialization in the tonsil bed was quicker in the group 1 (P=0.041 and P=0.026) and the regular oral intake time was earlier in group 1 (P < 0.001). Conclusion. In this study, ginger relieved pain, accelerated wound site epithelialization, and decreased duration of oral intake following tonsillectomy. It did not result in postoperative bleeding or any other complications. Ginger can be recommended as an adjunct to routine medical treatment for decreasing morbidity following tonsillectomy.Publication Metadata only A comparison of piezosurgery with conventional techniques for internal osteotomy(Springer, 2017) Dogan, R.; N/A; Koçak, İlker; Gökler, Ozan; Doctor; Teaching Faculty; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; N/A; 311179To compare conventional osteotomy with the piezosurgery medical device, in terms of postoperative edema, ecchymosis, pain, operation time, and mucosal integrity, in rhinoplasty patients. In this prospective study, 49 rhinoplasty patients were randomly divided into two groups according to osteotomy technique used, either conventional osteotomy or piezosurgery. For all patients, the total duration of the operation was recorded, and photographs were taken and scored for ecchymosis and edema on postoperative days 2, 4, and 7. In addition, pain level was evaluated on postoperative day 2, and mucosal integrity was assessed on day 4. All scoring and evaluation was conducted by a physician who was blinded to the osteotomy procedure. In the piezosurgery group, edema scores on postoperative day 2 and ecchymosis scores on postoperative days 2, 4, and 7 were significantly lower than in the conventional osteotomy group (p < 0.05). On postoperative day 2, the pain level was lower in the piezosurgery group than in the conventional osteotomy group (p < 0.05). In an endoscopic examination on postoperative day 4, while 24% of the patients in the conventional osteotomy group had mucosal damage, no such damage was observed in the piezosurgery group. When total operation duration was compared, there was no significant difference between the groups (p > 0.05). Piezosurgery is a safe osteotomy method, with less edema (in the early postoperative period) and ecchymosis compared with conventional osteotomy, as well as less pain, a similar operation duration, and no mucosal damage.Publication Metadata only The effect of training the health care providers with simulation model on the care of patients with chronic tracheostomy(European Respiratory Society (ERS), 2021) Atag, Emine; Ergenekon, Almala Pinar; Gokdemir, Yasemin; Ay, Pinar; Ikizoglu, Nilay Bas; Cenk, Muruvvet; Eralp, Ela Erdem; Girit, Saniye; Cakir, Erkan; Kilic, Ayse Ayzit; Yazan, Hakan; Oksay, Sinem Can; Hepkaya, Evrim; Karadag, Bulent; Karakoc, Fazilet; Oktem, Sedat; Uyan, Zeynep Seda; Gökler, Ozan; Sivrikaya, Ulufer G.; Faculty Member; Teaching Faculty; Other; School of Medicine; School of Medicine; School of Medicine; 153502; 311179; N/AIntroduction: Tracheostomy care in children may be challenging, due to lack of knowledge of health care providers. The aim of this study was to determine the level of knowledge of health care providers who follow patients with tracheostomy and to increase this level with theoretical education and training in a simulation laboratory. Materials and Methods: Volunteer participants were subjected to a theoretical pretest which evaluated their knowledge level for the care, follow-up and treatment of patients with tracheostomy. Then, practical testing with three subheadings evaluating the change of the tracheostomy cannula was applied. After theoretical training and one-on-one practical training given to the participants with a simulation model, theoretical and practical posttests were applied. Results: Fifty-one health care providers from six tertiary pediatric clinics in Istanbul were enrolled in the educational course. Only 6 (11.8%) of them received standardised training programme previously. Regarding the theoretical tests, seven of the 33 questions were indicated as crucial. The knowledge level of the participants based on the crucial questions significantly increased after the training (p value <0.05 for all of the crucial questions). Total number of correct answers and correct answers of 3 subheadings also significantly increased after the practical training (p value <0.001 for all). Ninety-five percent of the participants assessed the course as good or excellent. Conclusion: Training in simulation laboratory together with theoratical education can improve the knowledge and skills of the health care providers enabling improved care of children with tracheostomy.Publication Metadata only Evaluation of benign paroxysmal positional vertigo in American football players(Aves, 2018) N/A; N/A; Gökler, Ozan; Koçak, İlker; Aydoğan, Esra; Karanfil, Işıl; Baş, Ceren; Teaching Faculty; Doctor; Doctor; Undergraduate Student; Undergraduate Student; School of Medicine; N/A; N/A; School of Medicine; School of Medicine; N/A; Koç University Hospital; Koç University Hospital; N/A; N/A; 311179; N/A; N/A; N/A; N/AOBJECTIVES: The aim of this investigation was to evaluate the association between posterior channel benign paroxysmal positional vertigo (BPPV) and trauma that is frequently experienced by American football players. MATERIALS and METHODS: Participants wee classified into the following two groups: (1) a study group consisting of 63 male participants aged 18-30 years who had been playing American football for more than 2 years and (2) a control group consisting of 49 male participants aged 18-27 years with no history of otologic/vestibular disease or acute/chronic trauma. Trauma, age, total duration of playing Amer ican football, and weekly training hours of subjects in the study group were analyzed to deter mine any relationship with BPPV occurrence. We performed otologic, audiologic, and vestibular assessments of pure sound audiometry, tympanometry, tandem walking test with eyes open and eyes closed, Romberg, head shaking, roll, and Dix-Hallpike tests to all participants. RESULTS: A positive cor relation between the total year s of Amer ican football played and posterior channel BPPV frequency was observed in the study group. In addition, increasing weekly hours of training was shown to further increase the risk of BPPV. A total of 16 out of 63 athletes experienced BPPV, whereas none of the participants in the control group experienced BPPV. All participants completed the Vertigo Symptom Scale, which revealed that vertigo did not cause any significant negative impact on their training routine and activities of daily living. CONCLUSION: Our results indicate that the weekly training hours and total years of training with American football increase posterior channel BPPV frequency.Publication Metadata only Efficacy of standardized tracheostomy training with a simulation model for healthcare providers: a study by ISPAT team(Wiley, 2022) Sivrikaya, Ulufer G.; Atag, Emine; Ergenekon, Almala P.; Gokdemir, Yasemin; Ay, Pinar; Ikizoglu, Nilay Bas; Cenk, Muruvvet; Eralp, Ela Erdem; Girit, Saniye; Cakir, Erkan; Kilic, Ayse A.; Yazan, Hakan; Oksay, Sinem Can; Hepkaya, Evrim; Kiyan, Gursu; Karadag, Bulent; Karakoc, Fazilet; Oktem, Sedat; Uyan, Zeynep Seda; Gökler, Ozan; Faculty Member; Teaching Faculty; School of Medicine; School of Medicine; 153502; 311179Introduction: Tracheostomy care in children may be challenging, due to lack of knowledge of healthcare providers (HCPs). The aim of this study was to determine the level of knowledge of HCP who follow patients with tracheostomy and to increase this level with theoretical training and training in a simulation laboratory. Materials and Methods: ISPAT (IStanbul PAediatric Tracheostomy), a multidisciplinary team for tracheostomy care was established and a training program was prepared. Participants were subjected to theoretical and practical pretests which evaluated their knowledge levels and skills for care, follow-up, and treatment of a patient with tracheostomy. After the theoretical and practical training given to the participants with a simulation model, theoretical and practical posttests were applied. Results: Fifty-one HCP from nine tertiary pediatric clinics in Istanbul were enrolled in the training program. Only six (11.8%) of them had received standardized training programs previously. Regarding the theoretical tests, seven of the 33 questions were indicated as essential. The knowledge level of the participants based on the essential questions significantly increased after the training (p < 0.05 for all of the essential questions). The total number of correct answers and correct answers of three subheadings also significantly increased after the practical training (p < 0.001 for all). Ninety-five percent of the participants assessed the course as good or excellent in general. Conclusion: Training in a simulation laboratory in combination with theoretical education can improve the knowledge and skills of the HCP enabling improved care of children with a tracheostomy.Publication Metadata only Evaluation of the effect of naringenin on cisplatin induced ototoxicity in animal model summary(Anatomi Araştırmaları Derneği, 2021) N/A; Gökler, Ozan; Teaching Faculty; School of Medicine; 311179Introduction: The aim of this study is to investigate the protective effect of naringenin against cisplatin induced ototoxicity by evaluating audiological and biochemical parameters. Materials and methods: Thirty-two male rats were divided into 4 groups (control, cisplatin, naringenin + cisplatin and naringenin) including eight rats each. Distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) tests from both ears were performed in all groups at the beginning of the study and also on day 6. Intracardiac blood samples were taken on day 6 for assessment of biochemical parameters. Results: In audiological assessment, in group 2 (cisplatin), there were significant decreases in DPOAE values and significant increases in ABR thresholds on day 6 as compared with other groups. In Groups 1 (control), 3 (naringenin + cisplatin) and 4 (naringenin) there was no significant difference between the pre- and posttreatment DPOAE and ABR results. In biochemichal analyses, the total oxidant status (TOS) value was significantly higher in group 2 (cisplatin) than in the other groups. The total antioxidant status (TAS) value was significantly higher in group 3 (naringenin+cisplatin) than in group 2. Conclusions: The audiologic tests and biochemical revealed that naringenin may have protective effect against cisplatin ototoxicity by increase antioxidant levels and reduce oxidative stress parameters. / Öz: Giriş: Bu çalışmanın amacı, naringeninin sisplatin kaynaklı ototoksisiteye karşı koruyucu etkisini odyolojik ve biyokimyasal parametreleri değerlendirerek araştırmaktır. Gereç ve yöntemler: Otuz iki erkek sıçan, her biri sekiz sıçan olmak üzere 4 gruba (kontrol, sisplatin, naringenin + cisplatin ve naringenin) ayrıldı. Her iki kulaktan distorsiyon ürünü otoakustik emisyon (DPOAE) ve işitsel beyin sapı yanıtı (ABR) testleri tüm gruplarda çalışmanın başında ve 6. günde yapıldı. Biyokimyasal parametrelerin değerlendirilmesi için 6. günde intrakardiyak kan örnekleri alındı. Bulgular: Odyolojik değerlendirmede, grup 2' de (sisplatin), diğer gruplarla karşılaştırıldığında 6. günde DPOAE değerlerinde anlamlı düşüşler ve ABR eşiklerinde anlamlı artışlar vardı. Grup 1 (kontrol), 3 (naringenin + cisplatin) ve 4' te (naringenin) tedavi öncesi ve sonrası DPOAE ve ABR sonuçları arasında anlamlı bir fark yoktu. Biyokimyasal analizlerde toplam oksidan durumu (TOS) değeri grup 2' de (cisplatin) diğer gruplara göre anlamlı olarak daha yüksekti. Toplam antioksidan durumu (TAS) değeri grup 3' te (naringenin + sisplatin) grup 2' ye göre anlamlı olarak yüksekti. Sonuç: Odyolojik testler ve biyokimyasal, naringeninin antioksidan düzeylerini artırarak ve oksidatif stres parametrelerini azaltarak sisplatin ototoksisitesine karşı koruyucu etkisi olabileceğini ortaya koymuştur.Publication Metadata only A novel modification of tongue in groove technique (auto-septal projection graft) in rhinoplasty(Springer, 2021) Koçak, İlker; N/A; Gökler, Ozan; Teaching Faculty; School of Medicine; 311179Introduction Derotation of the nasal tip with narrow nasolabial angle is a common nasal deformity that leads to a long nose appearance, named drooping nose. In these patients, there are various techniques described to fix droopy tip and to achieve a desirable nasal tip rotation such as caudal septal extension graft, extended columellar strut graft, tongue in groove, columellar strut graft, and tip rotation sutures. This study aimed to evaluate changes in nasal tip support after modified tongue-in-groove technique (auto-septal projection graft). Materials and Methods Forty-two patients who underwent a primary open approach septorhinoplasty using the modified tongue-in-groove technique between June 2017 and March 2019 were retrospectively analyzed. Postoperative and preoperative photographs were analyzed, and nasolabial angle and the nasal tip projection ratio were recorded and compared before and average of 17.3 months after the surgery. Results Forty-two patients (33 female and 9 male) were included the study. The mean nasolabial angle was 85.7 degrees preoperatively and 99.3 degrees postoperatively. The nasal tip projection ratio was 0.60 preoperatively and 0.64 postoperatively. Both the tip rotation and the tip projection increased significantly after the modified tongue in groove (p<0.05). Conclusion It seems that modified tongue-in-groove method (auto-septal projection graft) is an effective technique in maintaining tip projection and rotation in rhinoplasty and safe method to correct droopy nasal tip in selected cases.
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