Publications by authors named "Cengiz Ozcan"

101 Publications

Olfactory neuroepithelium in the middle turbinate: is there any impact on olfaction function after lateral marsupialization for concha bullosa surgery?

Braz J Otorhinolaryngol 2021 Jul 20. Epub 2021 Jul 20.

University of Mersin, Faculty of Medicine, Department of Otorhinolaryngology, Mersin, Turkey.

Introduction: The effect of the quantity of olfactory neuroepithelium in the middle turbinate on the postoperative olfactory function for middle turbinate concha bullosa patients has not yet been evaluated.

Objective: The primary aim of this study was to investigate the olfactory structures in the middle turbinate by immunohistochemical analysis of the olfactory marker protein and to correlate the immunostaining results with the olfaction test results for patients with middle turbinate concha bullosa.

Methods: Surgical materials of 18 middle turbinate concha bullosa patients who had undergone lateral marsupialization surgery were immunostained with olfactory marker protein antibodies. Smell diskettes olfaction test was applied to all of the study group patients both preoperatively and three months postoperatively. A visual analog scale was used to quantify the sense of nasal obstruction.

Results: It was observed that the postoperative smell scores and the nasal obstruction visual analog scale values were significantly improved as compared to the preoperative values (p < 0.05). In addition, there was a significant correlation between the smell score gain and the visual analog scale gain values (r = 0.682). Results also indicated no significant correlation between the olfactory marker protein staining scores and the smell scores (p > 0.05).

Conclusion: This first paper demonstrated that the quantity of the olfactory mucosa in the middle turbinate was not a determining factor for the postoperative smell function degree for middle turbinate concha bullosa patients. The underlying cause of the olfactory deficit for middle turbinate concha bullosa patients seems to be obstruction related rather than the middle turbinate's olfactory mucosa containing status.
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http://dx.doi.org/10.1016/j.bjorl.2021.06.005DOI Listing
July 2021

Differential Expression of Ki-67 and P27 in Cholesteatoma Compared to Skin Tissue Predicts the Prognosis of Adult Acquired Cholesteatoma.

J Int Adv Otol 2021 Jul;17(4):306-312

Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.

Background: The aim of this study was to compare the differential Ki-67 and p27 staining properties of acquired cholesteatoma in adult patients for prognostic analysis.

Methods: Forty-two adult patients with acquired cholesteatoma were enrolled. The cholesteatoma and matched meatal skin tissues of the patients were immunostained with Ki-67 and p27 antibodies. Canal wall down mastoidectomy was performed in all patients. The differential staining properties--positive staining in the cholesteatoma and negative staining in the skin tissue (C+S-), negative staining in the cholesteatoma and positive staining in the skin tissue(C-S+)--were compared for bone erosion scores (BES), stage, and recurrence rates.

Results: Isolated findings in the cholesteatoma tissues, without matching with the skin tissues, demonstrated that stage and recurrence rates were not related to findings in the cholesteatoma tissues (P > .05). However, C+S- for Ki-67 and C-S+ for p27 are risk factors for worse prognosis including advanced stage (P < .001 for Ki-67 and P = .008 for p27), BES values (P < .001 for Ki-67 and P = .001 for p27), and recurrence rates (P < .001 for Ki-67 and P = .037 for p27).

Conclusion: This is the first paper assessing the cholesteatoma prognosis according to the differential Ki-67 and p27 staining properties of cholesteatoma and healthy skin tissues. Cellular proliferation rate in the cholesteatoma is important but insufficient by itself for predicting the prognosis of cholesteatoma patients. Patients having lower basal levels of cellular proliferation rate and higher cellular activity in the cholesteatoma tissue are prone to worse prognosis with increased stage, recurrence rates, and degree of bone erosion.
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http://dx.doi.org/10.5152/iao.2021.9453DOI Listing
July 2021

Surgical Outcomes of Transmastoid Facial Nerve Decompression for Patients With Traumatic Facial Nerve Paralysis.

J Int Adv Otol 2021 Jul;17(4):294-300

Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.

Objective: To evaluate the facial nerve function and audiological results of delayed (by at least one month after the insult) transmastoid facial nerve decompression (FND) in traumatic facial nerve paralysis (FNP).

Methods: Medical records of 57 patients with traumatic FNP were reviewed and surgical results of 13 patients (mean age 28.0 ± 17.67, range 3-67) undergoing transmastoid FND were analyzed. Preoperative and postoperative mean hearing thresholds were compared using 0.5, 1, 2, and 3 kHz. Facial nerve function was graded according to the House-Brackmann scale (HB) before and after surgery. HB scale results of grade III or better were accepted as good results postoperatively.

Results: Preoperative HB grades were V in 5 and VI in 8 patients. Twelve of 13 patients had good recovery of facial nerve function regardless of the operation timing. When mean preoperative and postoperative air-bone gap (ABG) values were compared (except the patients with total sensorineural hearing loss), the mean preoperative ABG was 33 ± 15.9 dB, and mean postoperative ABG was 17.2 ± 8.68 dB. There was a mean hearing gain of 15.8 dB after transmastoid facial nerve decompression surgery. Surgery and anesthesia-related complications were not seen in any patients.

Conclusion: The transmastoid route can be used safely and effectively with elimination of the risks of craniotomy and middle fossa surgery for patients with traumatic FNP. Hearing improvement can be achieved by performing ossicular chain reconstruction during decompression surgery for patients with conductive or mixed hearing loss (HL).
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http://dx.doi.org/10.5152/iao.2021.8506DOI Listing
July 2021

Clinical and surgical factors affecting the prognosis and survival rates in patients with mucormycosis.

Eur Arch Otorhinolaryngol 2021 Jun 1. Epub 2021 Jun 1.

Department of Otorhinolaryngology, University of Mersin School of Medicine, Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey.

Purpose: To investigate the factors affecting disease specific mortality (DSM) in patients with mucormycosis.

Methods: This retrospective study included 24 patients diagnosed with mucormycosis and who had undergone surgical and medical treatment between 2010 and 2020. There were 14 male and 10 female patients whose mean age was 53.70 ± 16.87 years, range 18-83. We reviewed the factors affecting DSM, including the extent of disease (paranasal sinus, palatal, orbital or intracranial involvement) and blood parameters (BP) that are serum glucose level (SGL), white blood cell, neutrophil, lymphocyte counts, C-reactive protein and hemoglobulin levels. Also, the effect of SGL in diabetes mellitus and BP in hematological malignancies on DSM was additionally evaluated.

Results: Orbital (p = 0.001) and intracranial (p < 0.01) involvement had statistically significant effect on DSM but not the palatal involvement. When Cox regression analysis was employed to analyze the effect of multiple independent factors on DSM, only the extent of disease (p = 0.023) had statistically significant effect. Receiver operating characteristic analysis of SGL for diabetic patients demonstrated that the area under the curve was 0.917 (p = 0.016). A cut-off SGL of 360 mg/dl revealed an 83.3% sensitivity and 83.3% specificity for mortality outcome for diabetic patients having mucormycosis.

Conclusion: Orbital or cerebral involvement is related to a poor prognosis, so early endoscopic nasal examination, diagnosis and treatment are of vital importance for DSM in mucormycosis. Serum glucose level over 360 mg/dl in uncontrolled diabetic patients with fever, ophthalmological findings and facial hypoesthesia should necessitate a consultation to an otolaryngologist and an endoscopic careful nasal examination.
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http://dx.doi.org/10.1007/s00405-021-06910-6DOI Listing
June 2021

Effectiveness of sialendoscopy on the symptoms of chronic obstructive sialadenitis and patient satisfaction degree.

J Stomatol Oral Maxillofac Surg 2021 May 24. Epub 2021 May 24.

Department of Otorhinolaryngology, Faculty of Medicine, University of Mersin, Mersin, Turkey.

Objectives: The purpose of this study was to assess the effectiveness of sialendoscopy (SE) on the symptom severity of chronic obstructive sialadenitis (COS) and patient satisfaction by using the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire and the Patient Satisfaction Scores (PSS).

Patient And Methods: COSS questionnaire was employed to 51 Turkish patients with COS before and three months after SE. Patients' satisfaction with SE was evaluated by analyzing the PSS.

Results: Gland preservation rate of the SE operation was 96.2%. The sialolith extraction rate was 74.2%. A significant decrease in the COSS scores of all of the patients in the study sub-groups was observed (p < 0.05). The effectiveness of SE was more pronounced for patients with sialolithiasis and submandibular gland (SG) involvement (p < 0.001, p = 0.03, respectively). Totally extracted stone and symptom duration were the only independent factors that significantly affected the COSS score gain values in patients with and without sialolithiasis, respectively (p < 0.001). There was a statistically significant correlation between COSS score gain values and PSS values. (r = 0.786) CONCLUSION: The benefit of SE was more pronounced in patients with sialolithiasis and SG involvement. Successful stone extraction and symptom duration were two independent factors that influenced both clinical improvement and patient satisfaction for patients with and without sialolithiasis, respectively. COSS questionnaire results correlated with the PSS values; thus, this questionnaire can also be used to evaluate the patients' satisfaction with SE.
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http://dx.doi.org/10.1016/j.jormas.2021.05.010DOI Listing
May 2021

The effectiveness of propranolol, flunarizine, amitriptyline and botulinum toxin in vestibular migraine complaints and prophylaxis: a non-randomized controlled study.

Braz J Otorhinolaryngol 2021 Mar 7. Epub 2021 Mar 7.

Mersin University, School of Medicine, Department of Otorhinolaryngology, Mersin, Turkey.

Introduction: Vestibular migraine is the most common cause of spontaneous episodic vertigo in adult patients and the second most common cause of vertigo in patients of all ages.

Objective: To assess the effectiveness of oral medication type (propranolol, flunarizine, and amitriptyline) and botulinum toxin A application on vestibular symptoms, headache severity and attack frequency for vestibular migraine patients.

Methods: Sixty patients with vestibular migraine were enrolled. Thirty patients received botulinum toxin A treatment (B+ group) in addition to the oral medication, whereas 30 patients received only oral medication (B- group). Headache severity was evaluated with Migraine Disability Assessment Scale and vertigo severity was evaluated with Dizziness Handicap Inventory scale. Vestibular migraine attack frequencies in the last three months were also evaluated.

Results: There was a statistically significant decrement in mean Dizziness Handicap Inventory scores, Migraine Disability Assessment Scale scores and vertigo attack frequencies after treatment for all patients, B+ and B- group patients (p<0.001 for all). The mean Migraine Disability Assessment Scale score gains (p<0.001) and vertigo attack frequency gains (p= 0.003) were significantly higher in the B+ patients than B- patients.

Conclusions: Both B+ and B- group patients exhibited significant improvement in vestibular migraine attack frequencies, Dizziness Handicap Inventory score and Migraine Disability Assessment Scale score values. However, botulinum toxin A application had a more pronounced effect for Migraine Disability Assessment Scale score gain and vestibular migraine attack frequency values, but not for Dizziness Handicap Inventory score gain values. Thus, botulinum toxin A application should be considered for vestibular migraine patients whose headache severity degrees are more profound. The oral medication type (propranolol, flunarizine or amitriptyline) did not differ in influencing the vestibular migraine attack frequency, Dizziness Handicap Inventory score gain and Migraine Disability Assessment Scale score gain values.
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http://dx.doi.org/10.1016/j.bjorl.2021.02.005DOI Listing
March 2021

Effect of humate supplementation to feed and/or litter on performance, intestinal viscosity, litter quality, and occurrence of footpad dermatitis in broilers fed barley-based diets.

Trop Anim Health Prod 2021 Jan 7;53(1):80. Epub 2021 Jan 7.

Department of Animal Nutrition and Nutritional Diseases, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Işıklı, Efeler, 09016, Aydın, Turkey.

We investigated the effect of in-feed and/or in-litter supplemental humate against footpad dermatitis (FPD) in broilers fed diets based on barley. Three hundred and sixty 1-day-old Ross 308 broiler chickens were randomly distributed to 24 floor pens (4 treatments, each consisting of 6 replicate pens; 15 chickens per pen) as a completely randomized design with 2 × 2 factorial arrangement of two levels of supplemental humate in feed (0 and 1 g/kg feed) and litter (0 and 5 g/kg litter). Growth performance, intestinal viscosity, litter quality, and incidence and severity of FPD in broilers were measured. In addition, malondialdehyde (MDA) and superoxide dismutase (SOD) levels were determined in blood and footpad tissues of broilers with different FPD scores. The results revealed that there was no interaction between humate supplementation to feed and litter. Neither dietary nor litter supplementation of humate had a significant effect on growth performance, intestinal viscosity, litter quality, and occurrence of FPD. And also, MDA and SOD levels in serum and footpad tissue did not affect by either dietary or litter supplementation of humate. The presence of FPD (score 1) had no effect on MDA and SOD levels in serum, however, increased the MDA and SOD levels (P < 0.001, P = 0.001, respectively) in footpad tissue of broilers. The intestinal viscosity did not differ between FPD scores 0 and 1. In conclusion, findings of this experiment suggest that humate supplementation to feed and litter did not alleviate FPD development in broilers fed diets based on barley. In addition, the presence of FPD lesions increases the MDA and SOD levels in the footpad tissues.
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http://dx.doi.org/10.1007/s11250-020-02530-0DOI Listing
January 2021

Endoscope Assisted Subcochlear Approach for Symptomatic Petrous Apex Effusion.

J Craniofac Surg 2021 May;32(3):e286-e288

Department of Otorhinolaryngology, University of Mersin School of Medicine, Mersin, Turkey.

Abstract: Petrous apex effusions are rare disorders and usually occur in the petrous apex (PA) having well-aerated cells and it may present with several symptoms or can be diagnosed incidentally on imaging methods obtained for another reason. If there are persistent symptoms despite the conservative treatment in symptomatic patients, a surgical attempt can be considered. In patients with favorable hearing levels and with the well-pneumatized petrous bone, PA cells may be effectively drained through subcochlear or supracochlear approaches by preserving patient's hearing levels. In this case report, the authors presented a severe symptomatic patient with petrous apex effusion who did not respond to conservative treatment and petrous apex drainage was performed via the subcochlear approach.
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http://dx.doi.org/10.1097/SCS.0000000000007204DOI Listing
May 2021

Is There any Possible Role of Neurotrophin 3 in the Pathogenesis of Antrochoanal Polyp?

Medeni Med J 2020 28;35(1):40-46. Epub 2020 Feb 28.

Mersin University, Department of Otorhinolaryngology, Mersin, Turkey.

Objective: Antrochoanal polyp (ACP) is a benign soft tissue lesion arising from the inner wall of the maxillary sinus that extends into the nasal cavity and choana. Although it was first explained by Killian in 1906, the underlying pathogenesis has not been yet fully understood. Neurotrophins have been demonstrated to have a possible role in the pathogenesis of allergic rhinitis, idiopathic rhinitis and nasal polyps. To date any study has not investigated the function of neuronal inflammation and neurotrophins in the development of ACP. The objective of this study was to investigate the possible effect of neurotrophin-3 (NT-3) in ACP pathogenesis.

Method: Twenty adult patients with ACP who underwent endoscopic sinus surgery in our department were included in the study group. The control group included 15 patients with concha bullosa of middle concha who underwent lateral excisional surgery. Nasal tissue NT-3 staining scores were evaluated using immunohistochemical methods. Blood NT-3 levels of both groups were evaluated by enzyme-linked immunosorbent assay (ELISA).

Results: There were no statistically significant differences between these two groups regarding tissue NT-3 staining scores (p=0.843) and blood NT-3 levels (p=0.463). In addition, no statistically significant correlation has been observed between tissue NT-3 staining scores and blood NT-3 levels in both ACP (p=0.578) and control (p=0.359) group patients.

Conclusion: NT-3-related neuronal inflammation does not seem to have any role in ACP pathogenesis.
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http://dx.doi.org/10.5222/MMJ.2020.78889DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384499PMC
February 2020

The effect of partial and total laryngectomy on couples' sexual functions in men with larynx cancer.

Eur Arch Otorhinolaryngol 2020 Dec 28;277(12):3397-3402. Epub 2020 Jun 28.

Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.

Purpose: To investigate effect of total or partial laryngectomies with or without adjuvant treatments on couples' sexual functions.

Methods: The study included 39 male patients with laryngeal cancer and their female partners who were sexually active. Twenty-six patients underwent total laryngectomy, and 13 had partial laryngectomy. Sexual functions were assessed with the International Index of Erectile Function (IIEF-5) questionnaire for erectile functions, the Male Sexual Health Questionnaire (MSHQ-4) for ejaculatory functions and the Female Sexual Function Index (FSFI) for female partners' sexual functions.

Results: The mean IIEF score significantly decreased from 21.51 ± 8.78 to 16.13 ± 9.6 after the surgery (p = 0.000). The mean MSHQ score significantly decreased from 12.95 ± 3.14 to 10.32 ± 4.59 after the surgery (p = 0.000). To investigate risk factors that might predict decreasing in post-operative erectile and ejaculatory function of the male patients, presence of pre-operative erectile dysfunction (p = 0.04) and additional treatment with chemo-radiation therapy were the predictors for decreases in erectile (p = 0.006) and ejaculatory functions (p = 0.036). The mean FSFI total score significantly decreased from 25.83 ± 7.42 to 13.45 ± 10.09 after the surgery (p = 0.000).

Conclusion: Laryngectomies have negative impact on male erectile and ejaculatory functions, and also have negative effect on female partners' sexual functions. Presence of pre-operative erectile dysfunction and additional chemo-radiation therapy were the predictors to decrease in erectile and ejaculatory functions after surgery. Therefore, male patients and their female partners should be informed in light of these findings before laryngeal surgery and adjuvant therapy.
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http://dx.doi.org/10.1007/s00405-020-06167-5DOI Listing
December 2020

Double-Layered (Cartilage Island + Extra Perichondrium) Graft for Type 1 Tympanoplasty.

Otolaryngol Head Neck Surg 2020 Oct 16;163(4):806-813. Epub 2020 Jun 16.

Department of Otorhinolaryngology, Faculty of Medicine, University of Mersin, Mersin, Turkey.

Objective: To compare the graft success rates and hearing results of single-layered (composite island) grafting (SLG) vs double-layered (composite plus second layer of perichondrium) grafting (DLG) for over-under type 1 tympanoplasty techniques.

Study Design: Retrospective chart review.

Settings: Tertiary center otorhinolaryngology clinic.

Subjects And Methods: Medical charts of the patients who underwent type 1 tympanoplasty via the microscopic technique by a single surgeon between 2015 and 2019 were analyzed.

Results: A total of 48 patients were included. The DLG (n = 26) group had higher graft take rates as compared to the SLG group (n = 22) for all patients ( = .038) and for moderate- to high-risk patients according to Middle Ear Risk Index (MERI) scores ( = .029) but not for patients with mild disease ( = .429) or myringosclerotic patients ( = .242). The DLG group exhibited higher air-bone gap closure (C-ABG) values as compared to the SLG group for all patients ( = .018). However, there was no noticeable difference in C-ABG values within the patients with successful grafting ( = .217). Only graft success status had a significant effect on C-ABG values when the multivariate linear regression was performed. ( = .016). Higher MERI scores and presence of myringosclerosis were related to the unsuccessful grafting ( < .01).

Conclusion: DLG tympanoplasty is encouraged, especially for patients with higher MERI scores, to increase the graft success rates. Better hearing outcomes of DLG tympanoplasty were related to the higher graft success status of this technique; DLG had no additional hearing effect for patients with successful grafting. Higher MERI scores and presence of myringosclerosis were related to graft failure.
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http://dx.doi.org/10.1177/0194599820931400DOI Listing
October 2020

Treatment of Otomycosis in Ears with Tympanic Membrane Perforation is Easier with Paper Patch.

Turk Arch Otorhinolaryngol 2019 Dec 1;57(4):182-186. Epub 2019 Dec 1.

Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.

Objective: To assess the effectiveness of paper patch closure of tympanic membrane perforation in patients with otomycosis and tympanic membrane perforation.

Methods: Fifty-six otomycosis patients with central tympanic membrane perforations were included in the study. Patients were randomized into two groups as (PG) and (NPG) groups. In both groups, Castellani's solution was applied to the external auditory canal. In PG patients, the perforated tympanic membrane was covered with carbon paper patch soaked in Castellani's solution to reduce ear canal humidity and to prevent fungi from passing from the ear canal to the middle ear mucosa. Paper patch was not used in NPG patients.

Results: There were statistically significant differences between the two groups in terms of severity scores in the first, second, third, fourth and sixth weeks of admission (p=0.004, p=0.018, p=0.001, p=0.009, and p<0.001, respectively). Time to complete recovery was statistically shorter in PG patients (p<0.001). Disease recurrence was statistically less among PG patients compared to NPG patients (p=0.025).

Conclusion: Closing of perforation with paper patch and topical application of Castellani's solution was found to be an effective and safe method. The method eliminated otomycosis in a shorter period and reduced recurrence rate in patients with eardrum perforation.
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http://dx.doi.org/10.5152/tao.2019.4384DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7032552PMC
December 2019

Radiologic Evaluation of Exiting Points of Supraorbital Region Neurovascular Bundles in Patients With Migraine.

J Craniofac Surg 2019 Oct;30(7):2198-2201

Oral and Maxillofacial Surgery Department, Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Purpose: To reveal the presence and nature of exiting points of supraorbital region neurovascular structures and determine the distances of those structures to midline with computed tomography images by taking into account gender and sides in patients with migraine.

Methods: The study was conducted retrospectively on computed tomography images of 70 migraine and 70 control patients with a mean age of 39.5 ± 13.8 years (range: 18-80). Presence and nature (foramen or notch) of exiting points of neurovascular structures in terms of side and gender in both groups, and the distances of these structures to the midline of the face were evaluated.

Results: In migraine and control groups, the most commonly seen structure was single notch. Coexistence of foramen and notch was statistically significant in migraine and female migraine groups than control and female control groups (P < 0.05). Bilateral presence of supraorbital structure was 51.4% in migraine group and 64.3% in control group patients. In all cases, foramen-midline distance was statistically significant longer than the notch-midline distance (P < 0.05). In migraine patients, no statistically significant difference was detected regarding distances of foramen and notch to midline in terms of side and gender.

Conclusion: Consideration of variable presence and location of the supraorbital notch and foramen, analysis of computed tomography scan might be beneficial in preoperative planning of foraminotomy and fascial band release in adult migraine patients to prevent intraoperative complications. Also, coexistence is more frequent on left side in migraine patients that might cause overlooking those structures during surgery.
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http://dx.doi.org/10.1097/SCS.0000000000005751DOI Listing
October 2019

False-Positive Laryngeal FDG Uptake During PET/CT Imaging: Reinke's Edema.

Turk Arch Otorhinolaryngol 2018 Jun 1;56(2):114-116. Epub 2018 Jun 1.

Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.

Positron emission tomography/computed tomography (PET/CT) is frequently used for diagnosing, staging, and following-up various malignancy types because it provides information on the site and metabolic activity of the tumor. Fluorodeoxyglucose (FDG) uptake by the normal laryngeal tissue is symmetric and low, whereas that under some non-malignant conditions of the larynx, such as vocal cord paralysis and Teflon granuloma, is asymmetrically increased. We reported the first case of histologically proven Reinke's edema causing false-positive laryngeal FDG uptake on PET/CT imaging. A clinician must be aware of these rare benign lesions in the case of increased FDG uptake, and histopathological investigation is mandatory to rule out malignancy for suspicious cases.
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http://dx.doi.org/10.5152/tao.2018.3123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123119PMC
June 2018

Supplemental boric acid does not prevent the development of footpad dermatitis in broilers subjected to high stocking density.

Poult Sci 2018 Dec;97(12):4342-4350

Department of Animal Nutrition and Nutritional Diseases, Faculty of Veterinary Medicine, Adnan Menderes University, Isikli, Aydin 09016, Turkey.

The present study was conducted to evaluate the protective effect of dietary boric acid supplementation on the development of incidence and severity of footpad dermatitis (FPD) in broiler chickens subjected to normal or high stocking densities (NSD or HSD). A total of 576 1-day-old ROSS 308 broiler chickens were randomly allocated to 4 treatments (8 replicate pens per treatment) in a 2 × 2 factorial arrangement of dietary boric acid (0 and 60 mg/kg) and stocking density (NSD 14 birds/m2 and HSD 22 birds/m2). Basal diets were formulated for starter, grower, and finisher phases. Growth performance, litter quality (litter pH, moisture, temperature, and NH3 volatilization), serum and litter boron levels, and incidence and severity of FPD were recorded. The HSD affected the body weight gain and feed intake of broiler chickens during all phases and 0 to 42 (P < 0.05), whereas feed conversion ratio (FCR) was poor at 0 to 21 days only. Dietary boric acid had no effect on the growth performance of broiler chickens. Litter pH, moisture, and NH3 volatilization were higher in broiler chickens subjected to HSD (P < 0.05). Thus, the incidence and severity of FPD increased in response to HSD (P < 0.05). Dietary boric acid reduced the litter pH and NH3 volatilization on day 42 of experiment (P < 0.05). However, dietary boric acid supplementation had no effect on the incidence and severity of FPD. Boric acid supplementation in broiler diets increased the serum and litter boron levels at day 42 in broiler chickens subjected to NSD or HSD (P < 0.05). In conclusion, HSD resulted in poor growth performance, litter quality, and greater incidence and severity of FPD in broiler chickens. Dietary boric acid was ineffective against FPD in broiler chickens although it improved the litter quality by lowering the litter pH and NH3 volatilization.
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http://dx.doi.org/10.3382/ps/pey337DOI Listing
December 2018

Surgical Treatment of Rhinosinusitis-Related Orbital Complications: Factors Affecting Irreversible Blindness.

J Craniofac Surg 2018 Jul;29(5):1294-1299

Department of Otorhinolaryngology, Faculty of Medicine.

If left untreated, rhinosinusitis can rarely cause a devastating complication irreversible blindness (IB). Despite new technologies in endoscopic sinus surgery and use of new broad-spectrum antibiotics, IB outcome is still a problem for surgically treated orbital complication of paranasal sinus infection (OCPSI) patients, and factors leading to IB outcome are not actually known. The aim of this study was to assess the factors leading to the IB outcome for surgically treated OCPSI patients. Results of 25 surgically treated OCPSI patients in our clinic were combined with surgically treated OCPSI patients reported through the PubMed database search from the year 2007. Patients were divided into 2 groups: IB group and recovery group. Patients having at least 1 immune status-related additional risk factor (ARF) were more common in the IB group, having an at least 1 ARF had 1.683 risk value of IB outcome (RR: 1.683, P = 0.006). IB patients had statistically significant higher mean (21.87 ± 40.35, P = 0.005) time interval (days) (TI) between onset of ophthalmological symptoms and surgical intervention compared to recovery group patients (2.92 ± 2.53). ROC curve analysis for an estimation of IB outcome according to the TI value demonstrated that a cut-off value of ≥2.5 days had the ideal sensitivity (87.5%) and specificity (71.9%) that resulted in IB outcome. (80.5% power, P = 0.008) IB and recovery group patients did not differ according to orbital complication type according to Chandler's classification (P = 0.492) and white blood cell count status (P = 0.584). In conclusion, OCPSI patients with ARFs and delayed admission after onset of orbital symptoms have a higher risk of IB outcome. These patients deserve prompt evaluation and early surgical intervention to prevent blindness. With future studies, new surgical criteria, including the ARF status and onset of ophthalmological symptoms (≥2.5 days) may be added to classical surgical criteria to prevent IB for OCPSI cases.
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http://dx.doi.org/10.1097/SCS.0000000000004531DOI Listing
July 2018

TNF-α and IL-1 β Cytokine Gene Polymorphism in Patients with Nasal Polyposis.

Turk Arch Otorhinolaryngol 2017 Jun 1;55(2):51-56. Epub 2017 Jun 1.

Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.

Objective: Nasal Polyp (NP) is a benign mass of the paranasal sinuses that protrudes into the nasal cavity. The exact underlying pathogenesis is not known. In this study we aimed to determine the genetic susceptibility of NP formation in relation to TNF-α-308 and IL-1β-511 promoter region gene polymorphisms.

Methods: A total of 71 patients with NP with asthma (n=21) or without asthma (n=50) were taken as the study group, and 91 healthy volunteers were taken as the control group. Blood was gathered into EDTA-containing tubes, and patient DNA was extracted. The polymorphisms of the IL-β and TNF-α cytokine genes were analyzed using real time polymerase chain reaction.

Results: The GG genotype in the TNF-α-308 region and the CC genotype in the IL-1β-511 region were found to be risk factors for NP formation (OR: 9.2, p=0.007 and OR: 33.3, p=0.001, respectively). Regarding allelic frequencies, the G allele at the TNF-α-308 promoter region was a risk factor for NP formation (OR: 6.06, p<0.001).

Conclusion: TNF-α GG genotype in the -308 promoter region and the IL-1β CC genotype in the -511 region are genetic risk factors for NP formation.
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http://dx.doi.org/10.5152/tao.2017.2389DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5782942PMC
June 2017

Denmark: coronary and structural heart interventions from 2010 to 2015.

EuroIntervention 2017 May;13(Z):Z17-Z20

The Heart Centre, Rigshospitalet, Copenhagen, Denmark.

Interventional cardiology in Denmark has been carried out since the mid 1980s. Interventional cardiology is only performed at a few high-volume centres. Healthcare coverage is universal and is essentially free of charge. Hospitals are mostly publicly owned and financed by fixed budgets and, in part, an activity-based funding system. Approximately 30,000 coronary angiographies (CAG), 10,000 percutaneous coronary interventions (PCIs) of which approximately 25% are primary PCIs, and 500 transcatheter aortic valve implantations (TAVIs) are carried out each year. The numbers of CAG and PCI have reached a plateau in recent years, whereas structural heart interventions, in particular TAVI, are increasing. Around 90% of all patients treated with PCI have a stent implanted, with more than 95% of these being drug-eluting stents. There is a low but increasing use of bioabsorbable scaffolds and drug-eluting balloons.
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http://dx.doi.org/10.4244/EIJ-D-16-00857DOI Listing
May 2017

Coronary artery disease severity and long-term cardiovascular risk in patients with myocardial infarction: a Danish nationwide register-based cohort study.

Eur Heart J Cardiovasc Pharmacother 2018 01;4(1):25-35

Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegårdsvej 28, 2900 Hellerup, Denmark.

Aim: Long-term prognostic impact of coronary artery disease (CAD) severity in stable post-myocardial infarction (MI) patients is not well known. We examined the impact of CAD severity and co-morbidity on the long-term (1 year and beyond) risk of cardiovascular events post-MI.

Methods And Results: From nationwide administrative and clinical registers, we identified 55 747 MI patients, during 2004-2010, who had not experienced subsequent MI, stroke, or death within 7 days post-discharge. The risk for primary composite endpoint (MI, stroke, or cardiovascular death) was estimated for the first 365 days after MI (index MI) and from day 366 to study completion (stable post-MI population), corresponding to a mean follow-up of 3.6 (2.2) years. Risk was assessed using cumulative incidence, multivariable adjusted logistic regression and Cox proportional-hazards models. The 1-year cumulative incidence for primary endpoint was 20.0% [95% confidence interval (CI), (19.6-20.3)]. Correspondingly, the 4-year cumulative incidence for primary endpoint was 21.0% (95% CI, 20.6-21.4) in patients without events on the first year. In multivariable models with no significant stenosis as reference, CAD severity was the most important risk factor for cardiovascular events the first 365 days [left main stenosis (LMS): odds ratio and 95% CI, 4.37, 3.69-5.17; 3-vessel disease (VD), 4.18, 3.66-4.77; 2-VD, 3.23, 2.81-3.72; 1-VD, 2.12,-1.85-2.43] and remained from day 366 to study completion [LMS: hazard ratio and 95% CI, 1.91, 1.64-2.22; 3-VD, 1.85,1.65-2.07; 2-VD, 1.55, 1.38-1.74; 1-VD, 1.30, 1.16-1.45].

Conclusion: Despite contemporary treatment at baseline, stable post-MI patients' 4-year outcome was similar to 1-year outcome after MI, and CAD severity remained a critical risk factor the first year and thereafter.
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http://dx.doi.org/10.1093/ehjcvp/pvx009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843132PMC
January 2018

Difficult Cases of Odontogenic Deep Neck Infections: A Report of Three Patients.

Balkan Med J 2017 Apr;34(2):172-179

Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.

Background: Deep neck infections are important otolaryngologic emergencies due to serious complications and the risk of airway compromise, which can lead to mortality. Although the most common causes among pediatric patients are tonsillitis and pharyngeal infections, odontogenic infections are an important cause in adults.

Case Report: We present three patients with multiple deep neck space abscess formation due to odontogenic infection. Two of them required tracheotomy due to airway compromise, and one had mediastinitis.

Conclusion: An underestimated tooth infection can cause hazardous complications such as mediastinitis and respiratory distress requiring tracheotomy.
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http://dx.doi.org/10.4274/balkanmedj.2015.1379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394301PMC
April 2017

The Role of Rho/Rho-Kinase Pathway in the Pathogenesis of Cholesteatoma.

Otol Neurotol 2017 04;38(4):516-520

*ENT Department†Pharmacology Department, Mersin University School of Medicine, Mersin, Turkey.

Objective: To assess the role of Rho/Rho-kinase pathway in the pathogenesis of cholesteatoma.

Materials And Methods: Thirty-eight patients with cholesteatoma, who had gone mastoidectomies were enrolled in this prospective study. Cholesteatomas matrix (CM) and a piece of the external ear canal skin (EECS as control) were taken and transferred to the liquid nitrogen and kept at -86 °C for Rho A and Rho-kinase (ROCK) analysis with Western blotting and commercial ELISA kits (Cell Biolabs Inc., San Diego, CA). The tissues were homogenized by an appropriate ice-cold lysis buffer. Following centrifugation, the supernatant was taken and total protein amount was detected by the Bradford method. Thereafter, tissue homogenates were subjected to sodium dodecyl sulphate (SDS)-polyacrylamide gel electrophoresis electrophoresis then transferred to nitrocellulose membrane where it was treated with specific monoclonal primary antibody against to ROCK-2 and HRP-conjugated seconder antibody, respectively. The protein blots were visualized with commercial x-ray film and dansitometrically analyzed by the Scion Image Program (Cell Biolabs Inc., San Diego, CA). In another series of experiments, Rho-kinase activities were assessed by ROCK-2 ELISA kits.

Results: There were no statistical differences in Rho A translocation between CM and EECS. However, ROCK activity was found to be lower in CM than EECS as detected by ELISA kits. Furthermore, ROCK protein expression was also significantly lower in CM than EECS as demonstrated by Western blotting.

Conclusion: Given Rho-kinase could take essential roles in cell differentiation, the results of this study implicate that down-regulated Rho-kinase could be responsible for the keratinocyte undifferentiation seen in cholesteatoma pathogenesis.
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http://dx.doi.org/10.1097/MAO.0000000000001344DOI Listing
April 2017

Transseptal suturing technique in septoplasty: impact on bacteremia and nosocomial colonization.

Eur Arch Otorhinolaryngol 2017 May 20;274(5):2189-2195. Epub 2017 Feb 20.

Mersin Üniversitesi Tıp Fakültesi Hastanesi, Kulak Burun Boğaz A.D Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey.

Although effects of Merocel nasal packs and silicone splints on nasal flora alterations and bacteremia formation after septoplasty were assessed before, the effect of transseptal suturing technique has not been studied yet. The objective of this study is to compare nasal flora alterations and bacteremia occurrence rates between Merocel packs, silicone splints, and transseptal suturing technique in septoplasty. Ninety patients were divided into three groups randomly: Merocel packing (Group M), silicone splint (Group S), and transseptal suturing without packing (Group T). Group M and S received prophylactic antibiotics and antibiotic pomade application to packs, whereas neither antibiotic prophylaxis nor topical pomade was applied to Group T. Preoperative, after pack removal and 1 month after pack removal nasal swab cultures and preoperative, immediately after surgery and 24 h after surgery blood cultures were taken from all patients. Group M increased Methicillin-sensitive Staphylococcus aureus (MSSA) colonization (p = 0.003) and decreased normal flora colonization (p = 0.038), whereas Group S and T did not affect MSSA or normal flora colonization (p > 0.05). Antibiotic prophylaxis did not affect MSSA colonization (p = 0.14), whereas decreased normal flora colonization (p = 0.029). Transseptal suturing did not prevent bacteremia formation. Postoperative increasing of MSSA colonization in nasal cavity for septoplasty patients can be prevented by using transseptal suturing technique or silicone splints instead of Merocel packing, rather than applying prophylactic antibiotic treatment. Using transseptal suturing does not prevent bacteremia formation during septal surgery. These findings should be kept in mind to prevent postoperative life-threatening infective complications of septoplasty especially in immunosuppressive patients and patients with cardiovascular diseases.
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http://dx.doi.org/10.1007/s00405-017-4479-xDOI Listing
May 2017

Infective endocarditis and risk of death after cardiac implantable electronic device implantation: a nationwide cohort study.

Europace 2017 Jun;19(6):1007-1014

Department of Cardiology, Copenhagen University Hospital Gentofte, 2900 Hellerup, Denmark.

Aims: To determine the incidence, risk factors, and mortality of infective endocarditis (IE) following implantation of a first-time, permanent, cardiac implantable electronic device (CIED).

Methods And Results : From Danish nationwide administrative registers (beginning in 1996), we identified all de-novo permanent pacemakers (PMs) and implantable cardioverter defibrillators (ICDs) together with the occurrence of post-implantation IE-events in the period from 2000-2012. Included were 43 048 first-time PM/ICD recipients. Total follow-up time was 168 343 person-years (PYs). The incidence rate (per 1000 PYs) of IE in PM was 2.1 (95% confidence interval [CI]: 1.7-2.6) for single chamber devices and 6.2 (95% CI: 4.5-8.7) for cardiac resynchronization therapy (CRT); similarly, the rate of IE in ICD was 3.7 (95% CI: 2.9-4.7) in single chamber devices and 6.3 (95% CI: 4.4-9.0) in CRT. In multivariable analysis, increased PM complexity served as independent risk factor for IE {dual chamber PM [hazard ratio (HR) 1.39; 95% CI: 1.07-1.80] and CRT [HR: 1.84; 95% CI: 1.20-2.84]}. During follow-up, generator replacement (HR: 2.79; 95% CI: 1.87-4.17) and lead revision (HR: 4.33; 95% CI: 3.25-5.78) in PMs were associated with increased risk. Corresponding estimates in ICDs were 2.49 (95% CI: 1.28-4.86) and 6.58 (95% CI: 4.49-9.63). Risk of death after IE was significantly increased in PM and ICD with HRs of 1.56 (95% CI: 1.33-1.82) and 2.63 (95% CI: 2.00-3.48), respectively.

Conclusion: The risk of IE increased with increasing PM complexity. Other important risk factors were subsequent generator replacement and lead revision. IE was associated with an increased risk of mortality in the area of CIED.
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http://dx.doi.org/10.1093/europace/euw404DOI Listing
June 2017

Stapler Esophageal Closure During Total Laryngectomy.

J Craniofac Surg 2017 Jan;28(1):e35-e40

*Department of Otorhinolaryngology, Faculty of Medicine †Department of Business Information Management, Silifke School of Applied Technology and Management, University of Mersin, Mersin, Turkey.

Mechanical esophageal closure with stapler during total laryngectomy has been used by various authors to decrease the surgical time and pharyngocutaneous fistula (PCF) rates. In a few of the studies, surgical site infection (SSI) rates are mentioned and none of the studies emphasize the effect of decreased surgical time on postoperative cardiovascular and cerebrovascular complications. In this study, the authors compared the PCF rates, SSI rates, operation times between 30 mechanical stapler and 40 manual esophageal closure during total laryngectomy for laryngeal cancer patients. National Nasocomial Infections Surveillance system (NNISS) scores were recorded and compared between groups. Total laryngectomy and total operation times were lower in the stapler group patients (P < 0.001 for total laryngectomy time, P = 0.024 for total operation time). There were lower rates of pharyngocutaneous fistula (P = 0.032), surgical site infection (P = 0.019), and NNISS scores (P = 0.009) in the stapler group. There was no statistically significant difference between groups regarding postoperative systemic complications (P = 0.451). In conclusion, stapler esophageal closure decreases operation time, PCF, SSI rates, and NNISS scores but not the systemic complication rates. Comorbid illnesses and prolonged surgical time are risk factors for postoperative systemic complications in total laryngectomy patients, but patients with additional illnesses must not encourage the surgeon to use stapler for decreasing postoperative systemic complications.
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http://dx.doi.org/10.1097/SCS.0000000000003196DOI Listing
January 2017

The Danish Heart Registry.

Clin Epidemiol 2016 25;8:503-508. Epub 2016 Oct 25.

The National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark; Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.

Aim: The Danish Heart Registry (DHR) seeks to monitor nationwide activity and quality of invasive diagnostic and treatment strategies in patients with ischemic heart disease as well as valvular heart disease and to provide data for research.

Study Population: All adult (≥15 years) patients undergoing coronary angiography (CAG), percutaneous coronary intervention (PCI), coronary artery bypass grafting, and heart valve surgery performed across all Danish hospitals were included.

Main Variables: The DHR contains a subset of the data stored in the Eastern and Western Denmark Heart Registries (EDHR and WDHR). For each type of procedure, up to 70 variables are registered in the DHR. Since 2010, the data quality protocol encompasses fulfillment of web-based validation rules of daily-submitted records and yearly approval of the data by the EDHR and WDHR.

Descriptive Data: The data collection on procedure has been complete for PCI and surgery since 2000, and for CAG as of 2006. From 2000 to 2014, the number of CAG, PCI, and surgical procedures changed by 231%, 193%, and 99%, respectively. Until the end of 2014, a total of 357,476 CAG, 131,309 PCI, and 60,831 surgical procedures had been performed, corresponding to 249,445, 100,609, and 55,539 first-time patients, respectively. The DHR generally has a high level of completeness (1-missing) of each procedure (>90%) when compared to the National Patient Registry. Variables important for assessing the quality of care have a high level of completeness for surgery since 2000, and for CAG and PCI since 2010.

Conclusion: The DHR contains valuable data on cardiac invasive procedures, which makes it an important national monitoring and quality system and at the same time serves as a platform for research projects in the cardiovascular field.
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http://dx.doi.org/10.2147/CLEP.S99475DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094640PMC
October 2016

Does stapes surgery improve tinnitus in patients with otosclerosis?

Braz J Otorhinolaryngol 2017 Sep - Oct;83(5):568-573. Epub 2016 Aug 2.

University of Mersin, Faculty of Medicine, Department of Otorhinolaryngology, Mersin, Turkey.

Introduction: Otosclerosis (OS) is the primary disease of the human temporal bone characterized by conductive hearing loss and tinnitus. The exact pathogenesis of tinnitus in otosclerosis patients is not known and factors affecting the tinnitus outcome in otosclerosis patients are still controversial.

Objectives: To find the effect of stapedotomy on tinnitus for otosclerosis patients.

Methods: Fifty-six otosclerosis patients with preoperative tinnitus were enrolled to the study. Pure tone average Air-Bone Gap values, preoperative tinnitus pitch, Air-Bone Gap closure at tinnitus frequencies were evaluated for their effect on the postoperative outcome.

Results: Low pitch tinnitus had more favorable outcome compared to high pitch tinnitus (p=0.002). Postoperative average pure tone thresholds Air-Bone Gap values were not related to the postoperative tinnitus (p=0.213). There was no statistically significant difference between postoperative Air-Bone Gap closure at tinnitus frequency and improvement of high pitch tinnitus (p=0.427). There was a statistically significant difference between Air-Bone Gap improvement in tinnitus frequency and low pitch tinnitus recovery (p=0.026).

Conclusion: Low pitch tinnitus is more likely to be resolved after stapedotomy for patients with otosclerosis. High pitch tinnitus may not resolve even after closure of the Air-Bone Gap at tinnitus frequencies.
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http://dx.doi.org/10.1016/j.bjorl.2016.07.001DOI Listing
December 2017

Botulinum Toxin for Rhinitis.

Curr Allergy Asthma Rep 2016 08;16(8):58

Department of Otorhinolaryngology, School of Medicine, Mersin University, Mersin, Turkey.

Purpose Of Review: Rhinitis is a common clinical entity. Besides nasal obstruction, itching, and sneezing, one of the most important symptoms of rhinitis is nasal hypersecretion produced by nasal glands and exudate from the nasal vascular bed. Allergic rhinitis is an IgE-mediated inflammatory reaction of nasal mucosa after exposure to environmental allergens. Idiopathic rhinitis describes rhinitis symptoms that occur after non-allergic, noninfectious irritants. Specific allergen avoidance, topical nasal decongestants, nasal corticosteroids, immunotherapy, and sinonasal surgery are the main treatment options. Because the current treatment modalities are not enough for reducing rhinorrhea in some patients, novel treatment options are required to solve this problem.

Recent Findings: Botulinum toxin is an exotoxin generated by Clostridium botulinum. It disturbs the signal transmission at the neuromuscular and neuroglandular junction by inhibiting the acetylcholine release from the presynaptic nerve terminal. It has been widely used in neuromuscular, hypersecretory, and autonomic nerve system disorders. There have been a lot of published articles concerning the effect of this toxin on rhinitis symptoms. Based on the results of these reports, intranasal botulinum toxin A administration appears to be a safe and effective treatment method for decreasing rhinitis symptoms in rhinitis patients with a long-lasting effect. Botulinum toxin type A will be a good treatment option for the chronic rhinitis patients who are resistant to other treatment methods.
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http://dx.doi.org/10.1007/s11882-016-0636-3DOI Listing
August 2016

Endoscopic Sphenopalatine Artery Ligation in Posterior Epistaxis: Retrospective Analysis of 30 Patients.

Turk Arch Otorhinolaryngol 2016 Jun 1;54(2):47-52. Epub 2016 Jun 1.

Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.

Objective: Although posterior epistaxis is rarely seen, it is an important medical problem that both decreases the quality of life of the patient and causes difficulties in the management for otorhinolaryngologists. In this study, we aimed to present the results of 30 patients who underwent transnasal endoscopic sphenopalatine artery ligation (TESPAL) for posterior epistaxis in our department.

Methods: The records of 30 patients who underwent TESPAL from January 2014 to April 2016 were analyzed retrospectively, and the relationship between perioperative factors and need for revision surgery was assessed.

Results: The success rate of TESPAL in posterior epistaxis was 90%. There was no relationship between surgical failure and antiaggregant use (p=0.224), anticoagulant use (p=0.534), hypertension (p=0.564), previous nasal surgery (p=0.279), and bilateral TESPAL application (p=0.279). TESPAL was seen to be effective in cases with Osler-Weber-Rendu disease, pregnancy, and uncontrollable epistaxis after rhinoplasty surgery. Mortality was seen in one of our patients not related to endoscopic ligation in the follow-up period.

Conclusion: TESPAL is an effective method in the treatment of posterior epistaxis. Hypertension, antiaggregant or anticoagulant use, bilateral sphenopalatine artery ligation, and previous nasal surgery do not seem to be factors leading to surgical failure.
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http://dx.doi.org/10.5152/tao.2016.1713DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5782932PMC
June 2016

Metastatic Papillary Thyroid Cancer Diagnosed and Treated during Pregnancy.

Turk Arch Otorhinolaryngol 2016 Mar 1;54(1):39-42. Epub 2016 Mar 1.

Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.

Physiological changes of the thyroid gland encountered during pregnancy can cause previously diagnosed thyroid nodules to grow or new nodules to form. Surgery of the slowly growing, localized, non-metastatic, well-differentiated, thyroid cancers diagnosed during pregnancy can be delayed to after delivery, whereas rapidly growing and metastatic cancers with compressive symptoms may be a candidate for surgery during pregnancy. In this case report, we present a case of cervical metastatic papillary thyroid cancer diagnosed and treated by total thyroidectomy and right functional neck dissection during pregnancy in a 22-year-old pregnant woman at 23-week pregnancy. In this case report, the optimal treatment for papillary thyroid cancer diagnosed during pregnancy is discussed under the light of current endocrine guidelines and previous case reports and series.
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http://dx.doi.org/10.5152/tao.2016.1454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5782974PMC
March 2016

Local Effect of Neurotrophin-3 in Neuronal Inflammation of Allergic Rhinitis: Preliminary Report.

Balkan Med J 2015 Oct 1;32(4):364-70. Epub 2015 Oct 1.

Department of Otorhinolaryngology, Mersin University Faculty of Medicine, Mersin, Turkey.

Background: Allergic rhinitis is a common inflammatory nasal mucosal disease characterized by sneezing, watery nasal discharge, nasal obstruction and itching. Although allergen-specific antibodies play a main role in the allergic airway inflammation, neuronal inflammation may also contribute to the symptoms of allergic rhinitis. Neuronal inflammation is primarily caused by the stimulation of sensory nerve endings with histamine. It has been shown that neurotrophins may also have a role in allergic reactions and neuronal inflammation. Nerve growth factor, neurotrophin 3 (NT-3), neurotrophin 4/5 and brain-derived neurotrophic factor are members of the neurotrophin family. Although nerve growth factor and brain-derived neurotrophic factor are well studied in allergic rhinitis patients, the exact role of Neurotrophin-3 is not known.

Aims: To investigate the possible roles of neurotrophin-3 in allergic rhinitis patients.

Study Design: Case-control study.

Methods: Neurotrophin-3 levels were studied in the inferior turbinate and serum samples of 20 allergic rhinitis and 13 control patients. Neurotrophin-3 staining of nasal tissues was evaluated by immunohistochemistry and ELISA was used for the determination of serum Neurotrophin-3 levels.

Results: Neurotrophin-3 staining scores were statistically higher in the study group than in the control patients (p=0.001). Regarding serum Neurotrophin-3 levels, no statistically significant difference could be determined between allergic rhinitis and control patients (p=0.156). When comparing the serum NT-3 levels with tissue staining scores, there were no statistically significant differences in the allergic rhinitis and control groups (p=0.254 for allergic rhinitis and p=0.624 for control groups).

Conclusion: We suggest that Neurotrophin-3 might affect the nasal mucosa locally without being released into the systemic circulation in allergic rhinitis patients.
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http://dx.doi.org/10.5152/balkanmedj.2015.151028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692335PMC
October 2015
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