GÝRÝÞ ve AMAÇ: Keratoplasti (KP) operasyonlarýnda, endikasyonlarýn ve operasyon tipinin daðýlýmýný saptamak.
YÖNTEM ve GEREÇLER: Ümraniye Eðitim ve Araþtýrma Hastanesi Göz Kliniði’nde Eylül 2010–Aralýk 2011 tarihleri arasýnda yapýlan KP ameliyatlarý retrospektif olarak incelendi. Hastalarýn yaþý, cinsiyeti, KP endikasyonu ve operasyon tipi (Penetran keratoplasti (PKP), Derin anterior lameller keratoplasti (DALK), tek baþýna KP veya eþlik eden cerrahi iþlemler) kaydedildi.
BULGULAR: Toplam 95 keratoplasti operasyonu çalýþmaya dahil edildi. En sýk rastlanan endikasyon psödofakik kornea ödemi idi (32 göz; %33.6). Ýkinci sýklýkta keratokonus (29 göz %30.5) ve 3. sýklýkta regreft (11 göz %11.5) izlendi. Toplam 95 operasyonun 82’si (%86.3) PKP ve 13’ü DALK (%13.6) idi. PKP olanlarýn 4’ü (%4.8) ekstrakapsüler katarakt ekstraksiyonu (EKKE) ve arka kamara (AK) göz içi lensi (GiL) implantasyonu, 3’ü (%3.6) skleral fikse GiL implantasyonu, 1’i (%1.2) sulcusa GÝL implantasyonu, 2’ si (%2.4) pupilloplasti, 2’si (%2.4) sinefliolizis ile kombineydi.
TARTIÞMA ve SONUÇ: Kliniðimizde psödofakik kornea ödemi en sýk keratoplasti endikasyonu olarak tespit edilmiþtir. Keratokonus, regreft, korneal distrofi ve travmatik skar ise diðer yaygýn endikasyonlardýr.

INTRODUCTION: To evaluate the distribution of indications and the type of operation for keratoplasty (KP) operations.
METHODS: Records of all patients who underwent KP at Umraniye Training and Research Hospital Eye Clinic, between September 2010- December 2011 were rewiewed retrospectively. The age and sex of the patient, indication for keratoplasty and type of the operation (penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), penetrating keratoplasty (PK) only or concomitant surgical procedures) were recorded.
RESULTS: A total of 95 operations were included in the study. The most common indication was pseudophakic corneal edema ( 32 eyes; %33.6), keratoconus is the second most common indication (29 eyes %30.5) and regraft is the third most viewed (11 eyes; %11.5). Of the 95 operations, 82 (%86.3) were PK and 13 (%13.6) were DALK. Of the PK operations, 4 (%4.8) were combined with extracapsular cataract extraction (ECCE) and posterior chamber (PC) intraocular lens (IOL) implantation, 3 (%3.6) were combined with scleral fixated (SF) IOL implantation, 1 (%1.2) were combined with sulcus IOL implantation, 2 (%2.4) were combined with pupilloplasty, 2 (%2.4) were combined with synechiolysis.
DISCUSSION AND CONCLUSION: In our clinic, pseudophakic corneal edema was the most common indication for keratoplasty. Keratoconus, regraft, corneal dystrophy and traumatic skar were other common indications.

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GÝRÝÞ ve AMAÇ: Hastane yöneticilerinin ekonomik performansýn saðlanmasý ve yükseltilmesi için yapacaklarý çalýþmalara yön veren en önemli unsur, birimlerin hizmetlerine göre maliyetlerini bilmeleridir. Araþtýrmamýzda; Haydarpaþa Numune Eðitim ve Araþtýrma Hastanesi’nde 2010 yýlý Yoðun Bakým Ünitesi (YBÜ) hizmetlerinin hastane maliyetlerine etkisini belirlemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Araþtýrmada retrospektrif yaklaþým benimsenmiþtir. Kurum onayý alýnarak hastane ve servis yöneticileri ile yüz yüze görüþmenin yaný sýra maaþ mutemetliði, ihale iþlem dosyalarý, gider tahakkuk belgeleri, personel þubesi, depolar ve döner sermaye kayýtlarý incelenerek bilgi toplanmýþtýr. Maliyetlerin analizinde kademeli daðýtým yöntemi uygulanmýþtýr.
BULGULAR: YBÜ, Hastane yatak sayýsýnýn % 3,43’ünü oluþtururken, maliyeti hastane toplam maliyetinin % 5,09’unu oluþturmaktadýr. Araþtýrmada YBÜ maliyeti 6.112.864 TL. ve yoðun bakým hasta günü maliyeti ortalama 711,62 TL., Hastane toplam maliyeti 119.919.010 TL., YBÜ hariç 113.806.146 TL.ve hastane hasta günü maliyeti ortalama 578,97 TL. bulunmuþtur. YBÜ hasta günü maliyeti hastane hasta günü maliyetinden ortalama %22,91 oranýnda daha fazladýr.
TARTIÞMA ve SONUÇ: Hastanede maliyetleri kontrol altýna almak için sürekli maliyet kontrolü yapýlmalý ve veri toplama sistemleri geliþtirilerek kaliteli hizmet sunumu ile birlikte optimum maliyet saðlanmalýdýr. Araþtýrmanýn, üst yönetimin yoðun bakým yatak sayýsýný artýrmanýn hastaneye maliyetinin diðer birimlere göre % 22,91 daha fazla olduðunu bilmesi, YBÜ yatak ve personel sayýsýnýn planlanmasýnda yol gösterici olacaðý kanaatindeyiz.

INTRODUCTION: The most important factor in directing hospital managers’ studies to ensure and improve the economic performance is understanding units cost according to services. In our study; we aimed to determine the impact of 2010 Intensive Care Unit (ICU) services on the hospital costs in Haydarpasa Numune Training and Research Hospital.
METHODS: Our study is designed as retrospective. After getting the institution approval, face-to-face interview was performed with managers of hospital and services, and also salivary trustee, procurement processing files, accrue expense documents, branch staff, storage, revolving fund records were examined to collect information. In analysis of costs, fractional distribution method was applied.
RESULTS: ICU constitutes 3.43% of hospital bed count, though its cost has high ratio of 5.09% of total hospital cost. In the study, cost of intensive care unit was 6.112.864 TL, mean intensive care patient day cost was 711.625 TL. Hospital total cost was found to be 119.919.010 TL, excluding ICU was 113.806.146 TL and mean hospital patient day cost excluding ICU was 578.97 TL. The cost of ICU patient per day was higher than hospital patient per day cost in a ratio of 22.91%.
DISCUSSION AND CONCLUSION: The optimum cost should be maintained by developing data collection systems to provide qualified services together with continuous supervision performed to control costs in hospitals. This study will lead senior management to evaluate requests of ICU bed and staff number by their knowing that increasing intensive care bed number results in 22.91% higher costs than that of other units.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý pilonidal sinüs ameliyatlarýnda kullanmakta olduðumuz açýk býrakma,
Karydakis ve Limberg flep yöntemlerinden elde ettiðimiz sonuçlarý incelemek ve güncel literatür eþliðinde tartýþmaktýr.
YÖNTEM ve GEREÇLER: Ocak 2008-Aralýk 2009 arasý dönemde pilonidal sinüs nedeniyle ameliyat ettiðimiz hastalar deðerlendirmeye alýndý. Hastalarýn dosyalarý taranarak demografik özellikleri, uygulanan ameliyat tekniði, hastanede kalýþ süreleri, postoperatif komplikasyonlarý ve nüks oranlarý belirlendi. Ýstatistiksel deðerlendirme ANOVA (post hoc Tukey-HSD) yöntemi ile yapýldý; p<0.05 anlamlý olarak kabul edildi.
BULGULAR: 84 hastanýn 79 u erkek (% 94) 5 i kadýn (% 6) idi. Yaþ ortalamasý 24.6 (15-44) olarak hesaplandý. Hastalar; sinüs eksizyonundan sonra yarasý açýk býrakýlan hastalar (Grup 1, N=22, % 26.1), sinüs eksizyonu sonrasý Karydakis lateral flep ameliyatý yapýlanlar (Grup 2, N=27, % 32.1) ve sinüs eksizyonu ardýndan romboid Limberg flep çevrilenler (Grup 3, N=35, % 41.6) olmak üzere üç grupta incelendi. Postoperatif takip süresi ortalama 32 ay (18-44) idi. Hastanede yatýþ süreleri gruplar arasýnda bir farklýlýk göstermemekle
birlikte (p>0.05), grup 1’ de yaranýn kapanmasý için geçen süre diðer gruplara oranla belirgin olarak uzun bulundu (p<0.05). Yara yeri akýntýsý, infeksiyonu ve absesi grup 3’ te diðer gruplara oranla belirgin olarak fazla bulundu. Yara detaþmaný da kapatma için sütür kullanýlan gruplarda (grup 2 ve 3) görüldü. Nüks en sýk grup 2 de saptand› (% 11).
TARTIÞMA ve SONUÇ: Açýk býrakma, Karydakis flep ve Limberg flep yöntemlerinin herbirinin kendine özgü avantaj ve dezavantajlarý mevcuttur. Nüks açýsýndan en güvenilir teknikler ise açýk býrakma ve Limberg flep teknikleridir.

INTRODUCTION: The purpose of this study was to compare the results of laying open, Karydakis flap and Limberg flap techniques used in our patients with pilonidal sinus disease and to discuss our findings with current literature.
METHODS: Patients operated for pilonidal disease between January 2008 and December 2009 were evaluated. Medical records were investigated for demographics, operative technique applied, hospitalization period, complications and recurrences. Statistical analysis was done using ANOVA (post hoc Tukey-HSD) test, and p<0.05 was considered as statistically significant.
RESULTS: There were 84 patients (79 men, 94 % and 5 women, 6 %). Mean age was calculated as 24.6 (15-44). Patients were evaluated as laymen after sinus excision (Group 1, N=22, 26.1 %), Karydakis lateral flap (Group 2, N=27, 32.1 %) and romboid Limberg flap group (Group 3, N=35, 41.6 %). Average postoperative follow-up period was 32 months (18-44). Even there were no difference among the groups regarding hospitalisation period (p>0.05), healing process was seen to be longer for group 1 in comparison to the other groups (p<0.05). Wound discharge, infection and abscess were seen to be more often in group 3. Wound detachment rate was higher for the groups in whom suture closure was applied (groups 2 and 3). Recurrence rate was highest in group 2 (11 %).
DISCUSSION AND CONCLUSION: Laying open, Karydakis flap and Limberg flap techniques all have their own advantage and disadvantages. The most reliable methods regarding the recurrence rate were laymen and Limberg flap techniques.

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GÝRÝÞ ve AMAÇ: Biz, 2007-2009 yýllarý arasýnda Kýrým Kongo Kanamalý Ateþ Hastalýðý riski taþýyan, kene tarafýndan ýsýrýlarak kliniðimize getirilen çocuklarý semptomlar, demografik özellikler ve laboratuvar bulgularý açýsýndan deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Bu çalýþmaya, kene tarafýndan ýsýrýlmýþ yaþlarý 0-14 yaþ arasý olan 32 erkek ve 31 kýz çocuðu alýnmýþtýr. Kýz çocuklar için ortalama yaþ aralýðý 3,92 ± 2.75, erkek çocuklar için ise 4,42 ± 2.77 yaþ idi. Baþvuru semptomlarý, hematolojik bulgular (hemogram, AST, ALT, INR, PT ) ve hastalýðýn sonucu deðerlendirildi.
BULGULAR: Kliniðimize yatýrýlarak, takip ve tedavi edilen çocuklarda 3-10 günlük inkübasyon dönemini takiben akut baþlangýçlý ateþ en sýk görülen semptomdu. Ateþi baþ aðrýsý, myalji, artralji, iþtahsýzlýk, güçsüzlük gibi nonspesifik semptomlar takip etti. Laboratuvar bulgularýnda lökositoz, düþük hemoglobin ve hematokrit deðerleri, yüksek AST, uzamýþ PT ve trombositopeni görüldü. Tüm çocuklarda tam iyileþme saðlandý.
TARTIÞMA ve SONUÇ: 2007-2009 salgýnlarýnda, Kýrým Kongo Kanamalý Ateþi etkeni olan Hyalomma cinsi kenenin Ýstanbul daki olgulardan sorumlu olmadýðýný gözledik. Kýrým Kongo Kanamalý Ateþi epidemiyolojisi ve yayýlýmýný; iklim, çevresel etmenler ve kiþilerin alýþkanlýklarý gibi faktörler etkilediðinden, halkýn bilinçlendirilmesini içeren kene kontrol ve korunma stratejilerinin farkýnda olmalýyýz.

INTRODUCTION: We aimed to evaluate the symptoms, demographic features and laboratory findings of children who were bited by ticks and taken to our clinic with risk assessment of Crimean- Congo Hemorrhagic Fever (CCHF) between 2007- 2009 years.
METHODS: This study included 32 male and 31 female children aged between 0 and 14 years old who were bited by ticks. The mean ages were 3.92 ± 2.75 years for girls and 4.42 ± 2,77 years for boys. Presenting symptoms, haematological manifestations (hemogram, AST, ALT, INR, PT ) and outcome of the disease were evaluated.
RESULTS: Following an incubation period of 3-10 days, acute- onset fever was the most commonly seen symptom among our hospitalized children. Nonspesific symptoms such as headache, myalgia, arthalgia, nausea, weakness followed the fever. Laboratory findings revealed leucocytosis, decreased hemoglobin and haematocrit levels, elevated AST, prolonged prothrombin time and thrombocytopenia. Full recovery was obtained in all children without any fatal outcome.
DISCUSSION AND CONCLUSION: We experienced that, the vector for CCHF, the Hyalomma tick was not present in Ýstanbul between 2007-2009 outbreaks. Since climate, environmental factors and human behaviour influence CCHF epidemiology and spread, whe should be aware of tick-control and prevention strategies including public education.

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GÝRÝÞ ve AMAÇ: Çalýþmamýzda transrektal ultrasonografi (TRUS) eþliðinde prostat biyopsisi yapýlan hastalarda prostat kanseri (PK) insidansýný belirlemeyi ve prostat kanseri ile benign prostat hiperplazisi (BPH) arasýndaki yaþ ve prostat spesifik antijen (PSA) deðerleri arasýndaki farklýlýðý tespit etmeyi amaçladýk.
YÖNTEM ve GEREÇLER: 2004 ve 2010 yýllarý arasýnda TRUS eþliðinde prostat biyopsisi yapýlan 2175 hasta çalýþmaya alýndý. Total PSA, prostat hacmi tespit edildi. Hastalarýn yaþý 41 ile 96 arasýndaydý. Anormal rektal muayene bulgusu varlýðý ve yüksek PSA deðerleri (>4 ng/ml) TRUS eþliðinde prostat biyopsi endikasyonlarýydý.
BULGULAR: PK 662 hastada tespit edildi. 1403 hastada BPH patolojisi vardý. Yüksek dereceli intraepitelyal neoplazi ve atipik küçük asiner proliferasyon sýrasýyla 13 ve 81 hastada tespit edildi. Granülomatöz prostatit (GP) 7 hastada saptandý. BPH’ li ve PK’ li hastalarýn ortalama yaþý 66.2±9.4 ve 70.3±8.7 idi. Total PSA deðerlerin BPH’ li hastalarda 9.5±7.2 ng/ml iken PK’ li hastalarda 90.2±31.1 ng/ml idi.
TARTIÞMA ve SONUÇ: PK tanýsý için TRUS eþliðinde biyopsi gereklidir. Fakat yaklaþýk olarak biyopsi yapýlan hastalarýn üçte biri prostat kanseridir. PK BPH’ ne göre daha ileri yaþlarda görülür. PSA deðerleri PK’ li hastalarda daha yüksektir.

INTRODUCTION: In our study we aimed to determine incidence of prostate cancer (PC) in patients who underwent transrectal ultrasound (TRUS) guided prostate biopsy and the differences between benign prostatic hyperplasia (BPH) and PC in terms of age and PSA levels.
METHODS: 2175 patients who underwent TRUS guided prostate biopsy between 2004 and 2010 years were studied. Total PSA, prostate volume (PV) were determined. Patients’ ages were between 41 and 96 years. Abnormal digital rectal examination and high PSA levels (>4 ng/ml) were the indications of TRUS guided prostate biopsy.
RESULTS: PC was diagnosed in 662 patients (%30.4).1403 patients (%64.5) had BPH pathology. High grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acing proliferation (ASAP) were diagnosed in 13 (%0.6) and 81 (%3.6) patients. Granulomatous prostatitis (GP) was detected in 7 patients (%0.3). Mean ages of BPH and PC patients were 66.2±9.4 and 70.3±8.7. Total PSA levels were 9.5±7.2 ng/ml in BPH patients and 90.2±31.1 ng/ml in PC patients.
DISCUSSION AND CONCLUSION: TRUS guided biopsy is necessary for diagnosis of PC. But approximately one third of the patients who were biopsied have PC. PC is seen in more advanced ages than BPH. PSA levels are higher in PC patients when compared with BPH patients.

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GÝRÝÞ ve AMAÇ: Çalýþmamýzda, týp fakültesi öðrencilerinin ötanaziyle ilgili görüþleri deðerlendirilmiþtir.
YÖNTEM ve GEREÇLER: Çalýþmamýz Zonguldak Karaelmas Üniversitesi Týp Fakültesi 1., 2., 3., 4., 5. ve 6. sýnýf öðrencilerine uygulanmýþtýr. Çalýþmamý za toplam 195 Týp Fakültesi öðrencisi alýnmýþtýr. Veriler bir anket formu ile toplanmýþtýr.
BULGULAR: Anket sonuçlarýna göre ö¤rencilerin %45.6’sý ötanazinin yasallaþmasý gerektiðini bildirmiþlerdir. Öðrencilerin %39.5’i ötanaziye karþý olduklarýný bildirmiþler ve bunun nedenleri arasýnda ilk sýrada dini inançlarý (%39.2) belirtmiþlerdir. ikincil neden olarak ise, istismar riski (%34.2) belirtilmiþtir. 139 öðrenci (%71.3) ötanazi uygulayan hekime ceza verilmemesi gerektiðini düþünmektedir. Öðrencilerin %82.6’sý ötanazi konusunun ülkemizde tartýþýlmasýný yararlý bulmaktadýr.
TARTIÞMA ve SONUÇ: Ötanazinin ülkemizde hukuken yasak olmasýna raðmen önemli ölçüde týp fakültesi öðrencisinin ötanazi taraftarý olduðu görülmektedir. Ötanazi hekimlerin ya da diðer toplumun kesimlerinin kolayca taraftar ya da karþý olabilecekleri bir konu olmamalýdýr. Ülkemiz için ötanaziye en uygun yaklaþýmýn belirlenmesi amacýyla; ülkemiz koþullarýnýn ve bölgelere özgü farklýlýklarýn yalnýzca hekimlerde deðil toplumun her kesiminde araþtýrýlmasý gereklidir.

INTRODUCTION: In this study opinions of medical students about euthanasia were evaluated.
METHODS: After approval from the ethics committee, Karaelmas University Faculty of Medicine 1stst, 2th, 3th, 4th, 5th and 6th class students were administered in our study. Total of 195 students were taken our study. Datas were collected by a questionnaire.
RESULTS: According to results of this questionnaire 45.6 % of medical students thought that euthanasia must be legalized. 39.5 % of students were against the euthanasia and the was primary cause of this opposition religious beliefs (39.2%). Secondary cause was determined as risk of misusing (34.2%). 139 students (71.3%) adduce not to punish the physician who performs euthanasia. 161 (82.6%) think that it’s appropriate to discuss euthanasia in our country.
DISCUSSION AND CONCLUSION: Although our country legally prohibited, significant medical students are seen as supporters of euthanasia. Physician’s or other public sector could not be easily supporters or opposition of euthanasia. Most appropriate approach for our country’s determination to euthanasia in order for our country and region-specific differences in terms not only of physicians in every segment of society is necessary to investigate.

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Günümüzde hekimlerin sanatlarýný uygularken, sadece en güncel týbbi bilgi becerileri takip etmeleri ve edinmeleri yeterli deðildir. Týp uygulamalarý nýn diðer dayanaklarý olan týp hukuku ve týbbi etik de, mesleðimizin uygulanmasý sýrasýnda belirleyici olmaktadýr. Týbbi uygulamalarýmýz sýrasýnda hukuksal sorunlarla karþý karþýya kalýnmamasý için týp biliminin genel kabul görmüþ ilke ve kurallarýna, anestezi ve reanimasyon alanýnda belirlenmiþ olan standart uygulamalara uygun hareket edilmesinin yanýnda, hekimlik mesleðinin etik deðerlerine uyulmasý ve mesleðimiz ile ilgili mevzuatýn bilinmesi de önem taþýmaktadýr. Tüm toplumlarda, toplumu ve toplum düzenini korumak amacýyla “ceza” adý verilen yaptýrým sistemleri uygulanýr. Ceza; iþlendiði nesnel olarak kanýtlanmýþ bir suçun karþýlýðý olarak uygulanýr. Sadece suçu iþleyenlere yöneliktir. Yargýsal bir kararla hükmedilir. Yasal düzenlemelerle belirlenebilir. Türkiye’de suçlar ve bunlarýn cezalarý, 1 Haziran 2005 tarihinden itibaren, 5237 numaralý yeni Türk Ceza Kanunu (TCK) ile düzenlenmektedir. 5237 numaralý TCK’nýn 4. maddesi ile “kanunlarý bilmemenin mazeret sayýlmayacaðý” açýk ve net olarak belirtilmiþtir. Hekimler týbbi uygulamasý sýrasýnda “mesleki acemilik-yetersizlik”, “dikkatsizlik”, “tedbirsizlik”, “özen eksikliði” veya “talimatlara uymamak” gibi nedenlerle hastaya zarar verebilir. Hekimler bu durumda yasal olarak “kusurlu” sayý labilirler. Dolayýsýyla tüm hekimler, mesleði ile ilgili hukuksal, yasal ve cezai sorumluluklarý; bu sorumluluklar dýþýna çýkmasý halinde uygulanabilecek yaptýrýmlarýn neler olduðunu bilmelidir. Yazýmýzda 5237 numaralý Yeni Türk Ceza kanununu getirdiði yükümlülükler ýþýðýnda Anesteziyoloji ve Reanimasyon uzmanýnýn yasal sorumluluklarý özetlenecektir.

In our day, it is not enough for doctors to merely follow and obtain the latest medical knowledge and skills while they perform their art. Other bases of medical practice, medical law and medical ethics, are also determinants in the profession. In addition to complying with the generally accepted principles and rules of medicine and the standard implementations of anesthesia and reanimation, it is of primary importance for doctors so as not to come face to face with legal issues during medical practice to also follow the ethical values of the profession and be informed about the relevant laws. All societies is applied the sanctions system, wich called “penalty”, because of maintain order communities and society. Criminal business objective as is a proven crime shall be implemented as money. Process is aimed at crime only. A judicial decision is dominating. Law and may be determined by law Crime and punishment in Turkey is organised by the new Turkish Penal Code (TPC) number 5237, since the 1st June 2005. 4th articles in penal code of 5237 was stated “an excuse for not knowing the law is being considered”, open and clearly. Physicians may be harm the patient such as “professional ineptitude-deficiency”, “careless”, “imprudence,” or “lack of care” in their medical practice. Physicians can be considered legally “defective” in this case. Therefore, all physicians should be aware of, about the legal profession, legal and criminal responsibility and what sanctions this responsibility can be applied in case of out order. This article summarizes the legal responsibilities of Anesthesia and Reanimation experts in light of the New Turkish Penal Code No. 5237.

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Ýmerslund-Grasbeck sendromu (ÝGS), vitamin B12 eksikliði ve proteinüri ile seyreden iyi prognozlu bir malabsorpsiyon sendromudur. Ýleri yaþlarda bu hastalarda osteoporoz geliþimi önemli bir sorundur. Bu makalede, kliniðimizde ÝGS düþündüðümüz ve erken adölesans dönemde radyolojik osteoporoz bulgularýna rastladýðýmýz bir hastanýn taný süreci sunulmuþtur.

Imerslund-Grasbeck syndrome (ÝGS) is a malabsorption syndrome with favorable prognosis where vitamin B12 deficiency and proteinuria is detected. One of the major problems that patients with this disease face in the elderly is osteoporosis. In this case report, we summarize the diagnostic course of a suspected ÝGS patient presented to our clinic with initial radiologic findings of osteoporosis in early adolescence.

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Kraniyofasiyal disostozis olarak da bilinen Crouzon sendromu, erken kraniyal sütür kapanmasý, hipertelorizm, ekzoftalmus, maksilla hipoplazisi ve tipik kurbaða benzeri yüz görünümü ile karakterize, genellikle otozomal dominant geçiþ gösteren bir kraniyofasiyal sendromdur. Hava yollarýnýn küçüklüðüne baðlý olarak solunum problemleri sýktýr. Genel anestezi uygulanan olgularda zor entübasyon ve ayrýca periopereatif dönemde solunumsal komplikasyonlar sýk görülmektedir. Olgumuzda, doðumunda Crouzon Sendromu tanýsý almýþ onüç aylok erkek bebeðe kraniyosinostoz nedeniyle nöroþirürji kliniði tarafýndan kraniotomi planlandý. Nadir görülen bu sendromda anatomik bozukluklar zor hava yoluna sebep olduðundan, Crouzon sendromunda anestezi uygulamasýna, bu olguyla dikkat çekmek istedik.

Crouzon syndrome, also known as craniofacial disostosis, is an autosomal dominant condition characterised by early closure of cranial suture, hypertelorism, exophthalmus, maxillar hypoplasia and typical frog-like appearance of face. Respiration problems are often due to narrow air ways. Difficult intubation and respiratuar complications in preoperative period are often seen in general anaesthesia. In our case, crainotomy was planned by the neurosurgery clinic for craniosynostosis to a 13 months old male baby diagnosed as Crouton syndrome at birth. We aimed to draw attention with this case to anaesthesia practice of Crouton syndrome, a rare case which causes difficult airway due to anatomic disorders.

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