Publications by authors named "Mustafa Colak"

24 Publications

  • Page 1 of 1

Cochlear Implantation in Inner Ear Malformations: Considerations Related to Surgical Complications and Communication Skills.

ORL J Otorhinolaryngol Relat Spec 2021 Sep 9:1-8. Epub 2021 Sep 9.

Department of Otolaryngology, Faculty of Medicine, Medipol University, Istanbul, Turkey.

Introduction: There are particular challenges in the implantation of malformed cochleae, such as in cases of facial nerve anomalies, cerebrospinal fluid (CSF) leaks, erroneous electrode insertion, or facial stimulation, and the outcomes may differ depending on the severity of the malformation. The aim of this study was to assess the impact of inner ear malformations (IEMs) on surgical complications and outcomes of cochlear implantation.

Methods: In order to assess the impact of IEMs on cochlear implant (CI) outcomes, 2 groups of patients with similar epidemiological parameters were selected from among 863 patients. Both the study group (patients with an IEM) and control group (patients with a normal inner ear) included 25 patients who received a CI and completed at least 1 year of follow-up. Auditory performance, receptive and expressive language skills, and production and use of speech were evaluated preoperatively and at least 1 year after implantation. Types of surgical complications and rates of revision surgeries were determined in each group.

Results: In the study group, the most common malformation was an isolated enlarged vestibular aqueduct (EVA) (44.8%). Overall, the patients with IEMs showed significant improvement in auditory-verbal skills. In general, the patients who had normal cochleae scored significantly better compared to patients with IEMs (p < 0.05). The complication rate was significantly lower in the control group compared to the study group (p = 0.001), but the rate of revision surgeries did not differ significantly (p = 0.637).

Conclusion: It is possible to improve communication skills with CIs in patients with IEMs despite the variations in postoperative performances. Patients with EVA, incomplete partition type 2, and cochlear hypoplasia type 2 were the best performers in terms of auditory-verbal skills. Patients with IEMs scored poorly compared to patients with normal cochleae. CSF leak (gusher or oozing) was the most common complication during surgery, which is highly likely in cases of incomplete partition type 3.
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http://dx.doi.org/10.1159/000517562DOI Listing
September 2021

Postoperative Audiometric Results of Patients with Otosclerosis in relation with High-resolution Computed Tomography and Intraoperative Macroscopic Findings.

J Coll Physicians Surg Pak 2021 Aug;31(8):969-974

Department of Otorhinolaryngology, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.

Objective: To analyse postoperative audiological findings in fenestral otosclerosis patients treated with stapedotomy, focal location-extensiveness findings on temporal high-resolution computed tomography (HRCT), and intraoperative macroscopic stapes footplate findings. Moreover, preoperative audiological findings were compared with HRCT and intraoperative macroscopic findings.

Study Design: An observational study.

Place And Duration Of Study: Department of Otorhinolaryngology, University of Health Sciences, Ankara Numune Training and Research Hospital, Turkey from January 2015 to January 2018.

Methodology: Patients were classified according to the temporal bone HRCT findings into three groups based on otosclerotic focus location and extensiveness. Macroscopic classification was based on the intraoperative findings of blue and white footplate. Patients with obliterative otosclerosis were not included in the study. Preoperative and postoperative audiological findings as well as surgical success were investigated. Findings were compared with HRCT and macroscopic classification groups.

Results: Postoperative air bone gap (ABG) increased as HRCT class increased from 0 to 3, meaning a more extensive otosclerotic focus (p=0.002). The comparison of the audiological outcomes, in accordance with the intraoperative findings, revealed that the postoperative air conduction pure-tone averages (AC PTA), ABG and ABG difference were higher in the white footplate group, with statistically significant differences compared to blue footplate group (p = 0.039, p = 0.001 and p=0.029, respectively).

Conclusion: Postoperative audiological findings were found to be correlated with intraoperative and HRCT findings. A white footplate seen at surgery or a more extensive otosclerotic focus on temporal HRCT indicates a suboptimal audiological outcome. HRCT findings should be taken into account when planning the surgery. Key Words: Otosclerosis, Temporal bone HRCT, Footplate color, Stapedotomy, Audiometry.
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http://dx.doi.org/10.29271/jcpsp.2021.08.969DOI Listing
August 2021

Randomized crossover trial to compare driving pressures in a closed-loop and a conventional mechanical ventilation mode in pediatric patients.

Pediatr Pulmonol 2021 Sep 22;56(9):3035-3043. Epub 2021 Jul 22.

Department of Pediatric Intensive Care Unit, Dr Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, Turkey.

Introduction: In mechanically ventilated patients, driving pressure (ΔP) represents the dynamic stress applied to the respiratory system and is related to ICU mortality. An evolution of the Adaptive Support Ventilation algorithm (ASV® 1.1) minimizes inspiratory pressure in addition to minimizing the work of breathing. We hypothesized that ASV 1.1 would result in lower ΔP than the ΔP measured in APV-CMV (controlled mandatory ventilation with adaptive pressure ventilation) mode with physician-tailored settings. The aim of this randomized crossover trial was therefore to compare ΔP in ASV 1.1 with ΔP in physician-tailored APV-CMV mode.

Methods: Pediatric patients admitted to the PICU with heterogeneous-lung disease were enrolled if they were ventilated invasively with no detectable respiratory effort, hemodynamic instability, or significant airway leak around the endotracheal tube. We compared two 60-min periods of ventilation in APV-CMV and ASV 1.1, which were determined by randomization and separated by 30-min washout periods. Settings were adjusted to reach the same minute ventilation in both modes. ΔP was calculated as the difference between plateau pressure and total PEEP measured using end-inspiratory and end-expiratory occlusions, respectively.

Results: There were 26 patients enrolled with a median age of 16 (9-25 [IQR]) months. The median ΔP for these patients was 10.4 (8.5-12.1 [IQR]) and 12.4 (10.5-15.3 [IQR]) cmH2O in the ASV 1.1 and APV-CMV periods, respectively (p < .001). The median tidal volume (VT) selected by the ASV 1.1 algorithm was 6.4 (5.1-7.3 [IQR]) ml/kg and RR was 41 (33 50 [IQR]) b/min, whereas the median of the same values for the APV-CMV period was 7.9 (6.8-8.3 [IQR]) ml/kg and 31 (26-41[IQR]) b/min, respectively. In both ASV 1.1 and APV-CMV modes, the highest ΔP was used to ventilate those patients with restrictive lung conditions at baseline.

Conclusion: In this randomized crossover trial, ΔP in ASV 1.1 was lower compared to ΔP in physician-tailored APV-CMV mode in pediatric patients with different lung conditions. The use of ASV 1.1 may therefore result in continued, safe ventilation in a heterogeneous pediatric patient group.
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http://dx.doi.org/10.1002/ppul.25561DOI Listing
September 2021

Analysis of the Effect of Weight Loss on Eustachian Tube Function by Transnasal Videoendoscopy.

J Craniofac Surg 2021 Jul 15. Epub 2021 Jul 15.

Department of Otorhinolaryngology, Meram Medical Faculty, Necmettin Erbakan University, Konya Department of General Surgery Department of Otorhinolaryngology, Ministry of Health Ankara City Hospital Department of General Surgery, Liv Hospital, Ankara Department of Otorhinolaryngology, Medical Faculty, Ordu University, Ordu Department of Otorhinolaryngology, Ministry of Health Tepecik Education and Research Hospital, Izmir, Turkey.

Objective: To investigate the effect of weight loss after bariatric surgery on eustachian tube (ET) function with video endoscopy.

Materials And Methods: The present study was conducted as a prospective cohort and was completed with 19 patients. Three-step tympanometry (basal, Toynbee, Valsalva), dynamic slow-motion video endoscopy, and the Eustachian Tube Dysfunction Questionnaire-7 (ETDA-7) were applied to the patients preoperatively before bariatric surgery and in the postoperative 6th month. Dynamic slow-motion video endoscopy was graded between 0 and 3, or classified as patulous, as indicated in the literature.

Results: The mean body mass index of 6 male and 13 female patients decreased from 47.3 ± 4.6 to 31.2 ± 5.4. Grade decline (median 2 ± 1) was experienced in all patients in DSVE, and 1 patient resulted as patulous ET. The ETDA-7 scores decreased in 11 patients, remained stable in 7 patients, and increased in 1 patient with patulous ET. The statistical analysis of the preoperative and postoperative DSVE grading and ETDA-7 scores, excluding the patulous ET patient, was found to be significant (P = 0.001 and P = 0.003, respectively). There was no significant change in any of the tympanometry parameters (P > 0.05).

Conclusions: Rapid weight loss with bariatric surgery results in an improvement in both the DSVE images and in the complaints of ET dysfunction in the majority of patients, but in some patients it may result in patulous ET. Therefore, preoperative evaluation of the ET with DSVE and questioning the patient's complaints are important in predicting patients who may develop patulous ET.
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http://dx.doi.org/10.1097/SCS.0000000000007965DOI Listing
July 2021

[Asthma and nasal polyposis: Are biological treatments effective?]

Tuberk Toraks 2021 Jun;69(2):253-260

Division of Immunology and Allergic Diseases, Ankara University Faculty of Medicine, Ankara, Turkey.

Chronic rhinosinusitis with nasal polyps often accompanies severe asthma. Uncontrolled nasal polyp does not only impair the quality of life, but also makes it difficult to control the accompanying asthma. Eosinophilic chronic sinusitis dominated by type 2 inflammation is phenotypically manifested by nasal polyps. In recent years, approaches towards phenotype and endotype have developed in patients with chronic sinusitis as well as in asthma; biological treatments come into question in uncontrolled patients with appropriate endotype. Randomized controlled trials conducted on treatments that antagonize the Ig-E, IL-5, and IL-4a pathways in these patients are promising. The effectiveness of biological treatments, which we think will be more involved in clinical practice in the management of nasal polyp patients in the near future, will become clear with the increase in real life data in the literature.
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http://dx.doi.org/10.5578/tt.20219816DOI Listing
June 2021

Acoustic parameter changes after bariatric surgery.

Logoped Phoniatr Vocol 2021 Jul 2:1-6. Epub 2021 Jul 2.

Department of Otorhinolaryngology, University of Health Science, Ankara Numune Training and Research Hospital, Ankara, Turkey.

Objective: To investigate the acoustic parameter changes after weight loss in bariatric surgery patients.

Materials And Methods: This prospective, longitudinal study was conducted with 15 patients with planned bariatric surgery, who were evaluated pre-operatively and at 6 months post-operatively. Fundamental frequency (F0), Formant frequency (F1, F2, F3, and F4), Frequency perturbation (Jitter), Amplitude perturbation (Shimmer) and Noise-to-Harmonics Ratio (NHR) parameters were evaluated for /a/, /e/, /i/, /o/, and /u/ vowels. Changes in the acoustic analysis parameters for each vowel were compared. The study group was separated into two groups according to whether the Mallampati score had not changed (Group 1) or had decreased (Group 2) and changes in the formant frequencies were compared between these groups.

Results: A total of 15 patients with a median age of 40 ± 11 years completed the study. The median weight of the patients was 122 ± 14 kg pre-operatively and 80 ± 15 kg, post-operatively. BMI declined from 46 ± 4 to 31 ± 5 kg/m. The Mallampati score decreased by one point in six patients and remained stable in nine. Of the acoustic voice analysis parameters of vowels, in general, fundamental frequency tended to decrease, and shimmer and jitter values tended to increase. Some of the formant frequencies were specifically affected by the weight loss and this showed statistical significance between Group 1 and Group 2.

Conclusion: The present study reveals that some specific voice characteristics might be affected by successful weight loss after bariatric surgery.HighlightsObesity reduces the size of the pharyngeal lumen at different levels.The supralaryngeal vocal tract size and configuration is a determinative factor in the features of the voice.Changes in the length and shape of the vocal tract, or height and position of the tongue can result in changes especially in formant frequencies in acoustic analysis.
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http://dx.doi.org/10.1080/14015439.2021.1945676DOI Listing
July 2021

Evaluation of retinal vessel density and foveal avascular zone measurements in patients with obstructive sleep apnea syndrome.

Int Ophthalmol 2021 Apr 8;41(4):1317-1325. Epub 2021 Jan 8.

Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey.

Purpose: To compare retinal capillary plexus vessel densities, choroidal thickness, optic disc vessel densities and foveal avascular zone measurements between normal subjects and subjects with obstructive sleep apnea syndrome (OSAS) using spectral-domain OCT angiography (OCTA).

Methods: Forty eyes of patients with overall OSAS, 20 eyes of patients with mild-moderate OSAS, 20 eyes of patients with severe OSAS on polysomnography and 21 controls were evaluated with the RTVue-XR Avanti OCTA (Optovue, Inc., Fremont, CA). Superficial and deep retinal capillary plexus vessel densities, choroidal thickness and foveal avascular zone (FAZ) parameters (area, diameter, acircularity index of the FAZ, foveal density-300) were measured for all subjects.

Results: Superficial capillary plexus vessel densities of the groups were similar. Deep capillary plexus (DCP) vessel densities of all three OSAS groups decreased in the parafoveal region (< 0.001). In the perifoveal region, DCP vessel densities were decreased in the Overall OSAS group (p = 0.023) and in the Severe OSAS group (p = 0.021), whereas it was similar in the Mild-moderate OSAS group. Choroidal thickness decreased in all three OSAS groups (p < 0.001). All FAZ measurements and foveal density-300 measurements were similar compared to the control group.

Conclusion: Our findings indicate that in severe OSAS patients, deep parafoveal, perifoveal vascular densities decrease and the choroid layer becomes thinner. When evaluating a patient with OSAS, it should be kept in mind that there may be eye involvement due to the disease.
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http://dx.doi.org/10.1007/s10792-020-01690-0DOI Listing
April 2021

Treatment of a case of COVID-19 by intravenous immunoglobulin.

J Glob Antimicrob Resist 2021 03 24;24:106-107. Epub 2020 Dec 24.

Department of Emergency Medicine, Manisa City Hospital, Manisa, Turkey. Electronic address:

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a positive-sense single-stranded RNA virus. As of today, no specific treatment has been found COVID-19. İntravenous immunoglobulin (IVIG) is a widely used therapy to prevent life-threatening infections in patients with primary and secondary immune deficiencies and autoimmune/inflammatory conditions. IVIG administration could be beneficial in the treatment of patients with severe COVID-19. In this respect, this presentation aimed to report a case of COVID-19 treated with IVIG.
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http://dx.doi.org/10.1016/j.jgar.2020.12.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834104PMC
March 2021

Conventional and Diffusion-Weighted MR Imaging Findings of Parotid Gland Tumors.

Turk Arch Otorhinolaryngol 2020 Sep 1;58(3):174-180. Epub 2020 Sep 1.

Department of Otorhinolaryngology, University of Health Sciences, Ankara Numune Training and Research Hospital, Ankara, Turkey.

Objective: To investigate diffusion-weighted magnetic resonance imaging (MRI) findings of parotid gland lesions in addition to conventional MRI findings and demographic data.

Methods: A retrospective evaluation was made of the demographic data, histopathologic data, preoperative conventional and diffusion-weighted MRI of 74 patients who underwent parotidectomy. The patients were categorized according to the histopathology (pleomorphic adenoma [PA], Warthin's Tumor [WT] and malignant Tumor [MT]).

Results: Histologically, 30 patients had PA, 27 patients had WT, and the remaining 17 patients had MT. The mean age of the PA, WT and MT groups were 44±21 (20-72), 55±10 (41-71) and 62±20 (21-76) years, respectively. The WT (81%) and MT (70%) groups were male dominant, while the PA group showed female dominance (55%). The PA group showed statistically significant difference in terms of age (p<0.05) and gender (p=0.009) compared to the other two groups. The median apparent diffusion coefficient (ADC) values for the PA, WT and MT groups were 1.99±0.94 (1.10-2.41) × 10-3 mm2/s, 0.92±0.35 (0.21-1.79) × 10-3 mm2/s and 1.20±0.34 (0.78-1.47) × 10-3 mm2/s, respectively. PA was differentiated from the other two groups (p=0.001). The sensitivity and specificity for distinguishing PAs from WT was 97% and 85%, respectively, when the ADC cutoff value was 1.25; and for distinguishing PAs from MT was 77% and 83%, respectively, when the ADC cutoff value was 1.35.

Conclusion: ADC measurements are useful for the differentiation of PA from both WT and MT; and can be used as a complementary tool to predict the histopathology in the preoperative planning of parotid tumors.
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http://dx.doi.org/10.5152/tao.2020.5379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580514PMC
September 2020

A neglected cause of recurrent rhabdomyolysis, LPIN1 gene defect: a rare case from Turkey.

Turk J Pediatr 2020 ;62(4):647-651

Department of Child Health and Diseases, University of Health Sciences, Dr. Behcet Uz Children's Diseases and Surgery Training and Research Hospital, İzmir.

Background: Rhabdomyolysis; can occur due to toxic, infectious, metabolic, and genetic causes. Severe rhabdomyolysis may progress to several clinical manifestations such as cardiac arrest and may pose a risk of mortality if it is not treated timely.

Case: In this article, we presented a 26-month-old patient who was admitted with an acute rhabdomyolysis attack and a venovenous hemodiafiltration (CVVHDF) was initiated on the 5th hour of hospitalization. Creatine kinase (CK) levels of the patient continued to increase (max: 943 452 IU/L) until the 5th day of treatment and hereafter began to decrease. As the common causes of rhabdomyolysis were excluded and the CK levels were the highest values reported in the literature, although, LPIN1 deficiency was the most suspected diagnosis, to facilitate the diagnostic procedures a whole-exome sequencing was performed. A homozygous [c.1696G > C p. (Asp566His)] mutation was detected on LPIN1 gene. This variant has not been described previously, however, when examined with programs such as SIFT and Mutation taster, it has been considered as pathogenic.

Conclusion: In the pediatric age group, especially in infants presenting with severe rhabdomyolysis, LPIN1 deficiency should also be considered; as early diagnosis and appropriate treatment may reduce mortality.
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http://dx.doi.org/10.24953/turkjped.2020.04.015DOI Listing
August 2021

The effect of chemotherapy on olfactory function and mucociliary clearance.

Support Care Cancer 2021 Mar 4;29(3):1635-1641. Epub 2020 Aug 4.

Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey.

Objectives: Olfactory sensory neurons and the olfactory mucosa are both important for optimal olfactory function. The potential nasal mucosal toxicity of chemotherapy regimens has not been assessed yet. The aim of this study was to objectively investigate the effect of chemotherapy on mucociliary clearance and olfactory function and to evaluate whether this effect differs between different chemotherapy regimens and age groups.

Patients And Methods: The study included consecutive patients admitted for the treatment of a variety of primary tumors (except head and neck and brain malignancies). Patients were evaluated for olfaction and mucociliary clearance before and immediately after completing the last session of chemotherapy cycles, according to the therapeutic protocol. For objective evaluation, the saccharine test was used for mucociliary clearance and the Sniffin' Sticks test for olfactory function. Of the 46 initial patients, 30 completed the study. Groups were formed according to the chemotherapy regimen (four groups: CA (doxorubicin + cyclophosphamide), Folfox (oxaliplatin +5-FU + folinic acid), DCF (docetaxel + cisplatin +5-FU), and GC (gemcitabine + cisplatin)) and according to age (two groups: < 55 years and > 55 years).

Results: In the overall analyses, significant deterioration was noted in both mucociliary clearance time and smell scores (olfactory threshold (OT), olfactory discrimination (OD), olfactory identification (OI), and the composite threshold-discrimination-identification (TDI) score). The changes in these scores showed no significant differences between chemotherapy groups. The decrease in OT and global TDI scores was more severe in the younger age group.

Conclusions: Chemotherapy impairs both the mucociliary clearance and olfactory function in cancer patients. This might reflect the collective negative effect of chemotherapy on olfactory function, not only through the neurocytotoxic effect but also the cytotoxic effect on the nasal mucosa. In addition, the reduction in olfactory threshold and total olfactory function scores was seen to be more profound in younger patients, which could have been due to higher initial scores.
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http://dx.doi.org/10.1007/s00520-020-05639-yDOI Listing
March 2021

Efficacy of thymoquinone in the treatment of experimental lipopolysaccharide-induced acute lung injury.

Kardiochir Torakochirurgia Pol 2020 Jun 20;17(2):65-69. Epub 2020 Jul 20.

Chest Disease Department, Dokuz Eylül Üniversity, Izmir, Turkey.

Introduction: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are acute onset syndromes affecting the lungs, which develop for several reasons and are characterized by hypoxemia and diffuse lung infiltration. The activity of thymoquinone (TQ) is known in acute lung injury. It is considered that it could be effective in ALI/ARDS treatment by ensuring possible COX-2 inhibition.

Aim: By this study was to show the protective activity of TQ in lipopolysaccharide (LPS) induced acute lung injury.Material and methods: A total of 28 BALB/c male mice were randomized to 4 groups of 7 as the Control group, TQ group (3 mg/kg), LPS group (5 mg/kg) and TQ treatment group. TQ was administered intraperitoneally 1 hour before the intratracheal administration of LPS (5 mg/kg). The mice were sacrificed 6 hours after the LPS administration and the lungs were extracted for histopathological examination. All experimental procedures complied with the requirements of the Animal Care and Ethics Committee of Dokuz Eylul University.

Results: When all the study groups were compared, significant differences were found between the groups in terms of the degrees of neutrophil migration ( = 0.042), intra-alveolar hemorrhage ( = 0.004) and alveolar destruction ( < 0.0006). A significant recovery was observed in the lung histopathological changes (neutrophil migration, intra-alveolar hemorrhage and alveolar destruction) in the TQ treatment group.

Conclusions: The results of this study showed that TQ may have a protective effect against LPS-induced acute lung injury. The possible mechanism could be considered to be cyclooxygenase 2 (COX-2) inhibition.
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http://dx.doi.org/10.5114/kitp.2020.97259DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379226PMC
June 2020

Does the Change in the Indications of Endoscopic Sinonasal Surgery Continue? Data between 1994-2018.

Turk Arch Otorhinolaryngol 2020 Mar 1;58(1):5-9. Epub 2020 Mar 1.

Department of Otorhinolaryngology, University of Health Sciences Ankara Numune Training and Research Hospital, Ankara, Turkey.

Objective: Endoscopic sinonasal surgery (ESS) has changing over the years in parallel with the developments in endoscopy devices, video-imaging techniques, and surgical instruments. In the present study we investigated whether the indications of patients who underwent surgery over a period of 25 years have accommodated to these changes.

Methods: We retrospectively evaluated 1173 patients who underwent surgery in our clinic from 1994 through 2007, and 954 patients who underwent surgery from 2008 through 2018. The patients were divided into three groups as follows: chronic rhinosinusitis with polyps (CRSwNP), chronic rhinosinusitis without polyps (CRSsNP), and others. The changes in the indications during the first 14 years and the following 11 years were compared, and the results were statistically evaluated.

Results: A significant decrease was observed in the number of patients who underwent surgery following the diagnosis of CRSsNP (p<0.001). In addition, a statistically significant increase was found in CRSwNP (p<0.001) and other (p<0.001) indications.

Conclusion: When ESS indications identified in our clinic were reviewed, it was observed that the increasing trend in CRSwNP rate in the first 14 years continued, there was a significant increase in non-CRS indications in the last 11 years, and there has been an increase in patients with fungal sinusitis, especially in this group.
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http://dx.doi.org/10.5152/tao.2020.4828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162596PMC
March 2020

The Effect of the Körner's Septum on Graft and Hearing Success after Type 1 Tympanoplasty.

J Coll Physicians Surg Pak 2020 Feb;30(2):154-157

Department of Otorhinolaryngology, University of Health Sciences, Ankara Numune Training and Research Hospital, Ankara, Turkey.

Objective: To determine the effect of Körner's septum (KS) on graft success and hearing in patients who were treated with type 1 tympanoplasty.

Study Design: An observational study.

Place And Duration Of Study: Department of Otorhinolaryngology, University of Health Sciences, Ankara Numune Training and Research Hospital, Turkey, from July 2013 to July 2018.

Methodology: Patients undergoing type 1 tympanoplasty were divided into 2 groups as patients with KS and without KS (WKS), according to the findings of high-resolution computed tomography of the temporal bone. Two different grafts (fascia and cartilage) in two groups (KS and WKS) were compared for graft success rate of different graft materials and pre- and postoperative hearing levels. The effect of the presence of KS on hearing was examined.

Results: The anatomical graft success rate of type 1 tympanoplasty was 75.9% in the KS group and 88.5% in the WKS group (p = 0.026). In the presence of KS, graft success rate decreased with the use of a fascia graft (p = 0.044). In the presence of KS, the use of cartilage graft did not affect functional hearing; whereas, poor functional outcomes were obtained in ears operated using a temporalis fascia graft in the KS group than in the WKS group (p = 0.003).

Conclusion: KS adversely affects graft success in type 1 tympanoplasty. Cartilage should be preferred as the graft material for patients with KS.
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http://dx.doi.org/10.29271/jcpsp.2020.02.154DOI Listing
February 2020

The effect of tracheotomy on ventilator-associated pneumonia rate in children.

Int J Pediatr Otorhinolaryngol 2020 May 21;132:109898. Epub 2020 Jan 21.

Health Sciences University, Dr. Behcet Uz Children's Hospital, Pediatric Intensive Care Unit, Turkey.

Objectives: Data on the relationship between tracheotomy and ventilator-associated pneumonia (VAP) in children is very limited. We planned to evaluate the effect of tracheotomy on VAP rates in children.

Materials And Methods: We evaluated patients who underwent tracheotomy during follow-up at the pediatric intensive care unit (PICU) of our hospital. Patients who were diagnosed as VAP at least once and followed by a mechanical ventilation (MV) for at least 30 days before and after tracheotomy were included in our study. The underlying diagnoses of the patients and the number of VAP diagnosis, VAP rates (VAP number x1000/day of MV) before and after tracheotomy were recorded. Logistic regression analysis was used to compare VAP rates before and following a tracheotomy.

Results: There were a total of 47 patients including 28 (59.6%) girls and 19 (40.4%) boys in our study. The duration of MV before tracheotomy was 74.9 ± 48.9 (31-295) days and after tracheotomy, it was 103.3 ± 102.8 (30-586) days. The number of VAP before tracheotomy was 0.9 ± 1.2 (0-8) and after tracheotomy, it was 0.6 ± 0.6 (0-3). The VAP rate before tracheotomy was 5.9 ± 6.3 (0-26.5) and the VAP rate after tracheotomy was 3.2 ± 3.8 (0-11.4). Ventilator-associated pneumonia rates were lower following tracheotomy (OR:0.91,95%CI:0.826-0.981,p = 0.017).

Conclusion: Tracheotomy decreased the VAP rate in children receiving long-term mechanical ventilatory support.
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http://dx.doi.org/10.1016/j.ijporl.2020.109898DOI Listing
May 2020

Evaluation of olfactory function in patients with obstructive sleep apnea syndrome.

Sleep Breath 2020 Sep 16;24(3):1137-1142. Epub 2019 Dec 16.

Ankara Numune Training and Research Hospital ENT & HNS Clinic, Talatpaşa Bulvarı No: 44, 06230, Ankara, Turkey.

Purpose: To investigate the pathophysiological mechanisms underlying the effects of obstructive sleep apnea syndrome (OSAS) on olfactory functions.

Methods: Study subjects consisted of patients with newly diagnosed OSAS divided by polysomnography into subgroups of mild, moderate, and severe disease. Subjects identified as not having OSAS served as controls. All subjects were subjected to the Sniffin' Sticks test to evaluate olfactory functions. Control subjects and subgroups with OSAS were compared for sleep characteristics and olfactory scores. In the patient group, correlations were investigated between olfactory scores and polysomnographic parameters.

Results: Of 99 subjects (64 men), there were 20 controls, 23 with mild OSAS, 25 moderate, and 31 severe. There was a decreasing trend from the control group towards the severe subgroup in mean odor threshold, odor discrimination, odor identification, and threshold-discriminationidentification (TDI) scores. In the patient group, there was a strong inverse correlation between AHI and TDI scores (r = - 0.62, p < 0.001). Arousal index and TDI scores had a strong negative correlation (r = - 0.81, p < 0.001). There was a weak positive correlation between the minimum SPO2% and TDI scores (r = 0.34, p = 0.002) and a weak negative correlation between TST <90% and TDI scores (r = - 0.24, p = 0.027).

Conclusion: The finding that arousal index showed a stronger correlation with odor scores than with hypoxemia-related parameters suggests that sleep fragmentation may be a more prominent mechanism underlying the pathophysiology of olfactory malfunction in patients with OSAS.
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http://dx.doi.org/10.1007/s11325-019-01996-zDOI Listing
September 2020

The Predictive Value of Neutrophil-to-Lymphocyte Ratio for Hodgkin's Lymphoma Diagnosis in Patients with Asymptomatic Cervical Lymphadenopathy.

Indian J Otolaryngol Head Neck Surg 2019 Oct 5;71(Suppl 1):986-991. Epub 2019 Jun 5.

Department of Otorhinolaryngology, Health Sciences University, Ankara Numune Training and Research Hospital, Talatpaşa Blv. No: 44, 06230 Ankara, Turkey.

In patients with asymptomatic cervical lymphadenopathy, the physician often has to choose between evaluation via follow-up or open biopsy. Follow-up evaluation may lead to a delayed diagnosis of lymphoma, while an open biopsy is associated with surgical risks and costs. This dilemma can be avoided using predictive parameters. In the present study, we aimed to investigate whether neutrophil-to-lymphocyte ratio (NLR), a parameter which can be assessed quickly with ease and at low cost, has predictive value for Hodgkin's lymphoma diagnosis in patients with asymptomatic cervical lymphadenopathy. A total of 46 patients with asymptomatic cervical lymphadenopathy who underwent open biopsy were included in the study. Based on the biopsy results, the patients were divided into two groups, Hodgkin lymphoma (26 patients) and reactive lymphadenopathy (20 patients). The mean NLR in the groups was calculated and compared based on the results of complete blood count performed before biopsy. We found that mean NLR ( = 0.022) and mean neutrophil count ( = 0.046) were higher and mean lymphocyte count was lower ( = 0.054) in patients with Hodgkin's lymphoma compared to those in patients with reactive lymphadenopathy. Our results indicate that a high NLR may have predictive value for Hodgkin's lymphoma diagnosis in patients with asymptomatic cervical lymphadenopathy.
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http://dx.doi.org/10.1007/s12070-019-01676-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848596PMC
October 2019

The Voice Performance After Septoplasty With Surgical Efficacy Demonstrated Through Acoustic Rhinometry and Rhinomanometry.

J Voice 2020 Jul 7;34(4):649.e15-649.e20. Epub 2019 Feb 7.

Department of Otorhinolaryngology, Head and Neck Surgery, Ankara Numune Education and Research Hospital, Ankara, Turkey.

Objective: To demonstrate the surgical efficacy of septoplasty using acoustic rhinometry (AR) and anterior rhinomanometry (ARM) and to evaluate the effect of septoplasty on voice performance through subjective voice analysis methods.

Materials And Methods: This prospective study enrolled a total of 62 patients who underwent septoplasty with the diagnosis of deviated nasal septum. Thirteen patients with no postoperative improvement versus preoperative period as shown by AR and/or ARM tests and three patients with postoperative complications and four patients who were lost to follow-up were excluded. As a result, a total of 42 patients were included in the study. Objective tests including AR, ARM, acoustic voice analysis and spectrographic analysis were performed before the surgery and at 1 month and 3 months after the surgery. Subjective measures included the Nasal Obstruction Symptom Evaluation questionnaire to evaluate surgical success and Voice Handicap Index-30 tool for assessment of voice performance postoperatively, both completed by all study patients.

Results: Among acoustic voice analysis parameters, F0, jitter, Harmonics-to-Noise Ratio values as well as formant frequency (F1-F2-F3-F4) values did not show significant differences postoperatively in comparison to the preoperative period (P > 0.05). Only the shimmer value was statistically significantly reduced at 1 month (P < 0.05) and 3 months postoperatively (P < 0.05) versus baseline. Statistically significant reductions in Voice Handicap Index-30 scores were observed at postoperative 1 month (P < 0.001) and 3 months (P < 0.001) compared to the preoperative period and between postoperative 1 month and 3 months (P < 0.05).

Conclusion: In this study, first operative success of septoplasty was demonstrated through objective tests and then objective voice analyses were performed to better evaluate the overall effect of septoplasty on voice performance. Shimmer value was found to be improved in the early and late postoperative periods.
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http://dx.doi.org/10.1016/j.jvoice.2019.01.008DOI Listing
July 2020

Histopathologic comparison of dexmedetomidine's and thiopental's cerebral protective effects on focal cerebral ischemia in rats.

Braz J Anesthesiol 2016 Nov - Dec;66(6):583-593. Epub 2016 Feb 5.

Atatük University, Faculty of Medicine, Research Hospital, Clinic of Anesthesiology and Reanimation, Erzurum, Turkey.

This study was designed to investigate whether dexmedetomidine and thiopental have cerebral protective effects after focal cerebral ischemia in rats. Thirty male Sprague Dawley rats were randomly assigned to three groups: control group (Group C, n=10), dexmedetomidine group (Group D, n=10), thiopental group (Group T, n=10). After all rats were anesthetized, they were intubated, then mechanically ventilated. A catheter was inserted into the right femoral artery for continuous mean arterial pressure, physiological parameters and blood sampling at baseline, 5min after occlusion and 20min after reperfusion. A catheter was inserted into the left femoral vein for intravenous (IV) medication administration. Right common carotid artery of each rat was isolated and clamped for 45min. At the end of the duration common carotid artery were unclamped and the brain reperfusion was achieved for 90min. Dexmedetomidine was administered for Group D IV infusion, and Group T received thiopental IV. According to histopathologic scores cerebral ischemia was documented in all rats in Group C, but no ischemia was found in three rats in Group T and in four rats in Group D. Grade 3 cerebral ischemia was documented in three rats in Group C, and in only one rat in both groups T and D. For histopathologic grades the difference between Group T and Group D was not significant (p>0.05). But the differences between Group C and Group T (p<0.05) and Group C and Group D (p<0.01) were statically significant. In conclusion, we demonstrated that dexmedetomidine and thiopental have experimental histopathologic cerebral protective effects on experimental focal cerebral ischemia in rats.
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http://dx.doi.org/10.1016/j.bjane.2015.03.009DOI Listing
April 2017

[Histopathologic comparison of dexmedetomidine's and thiopental's cerebral protective effects on focal cerebral ischemia in rats].

Rev Bras Anestesiol 2016 Nov - Dec;66(6):583-593. Epub 2016 Sep 15.

Atatük University, Faculty of Medicine, Research Hospital, Clinic of Anesthesiology and Reanimation, Erzurum, Turquia.

This study was designed to investigate whether dexmedetomidine and thiopental have cerebral protective effects after focal cerebral ischemia in rats. Thirty male Sprague Dawley rats were randomly assigned to three groups: control group (Group C, n=10), dexmedetomidine group (Group D, n=10), thiopental group (Group T, n=10). After all rats were anesthetized, they were intubated, then mechanically ventilated. A catheter was inserted into the right femoral artery for continuous mean arterial pressure, physiological parameters and blood sampling at baseline, 5min after occlusion and 20min after reperfusion. A catheter was inserted into the left femoral vein for intravenous (IV) medication administration. Right common carotid artery of each rat was isolated and clamped for 45min. At the end of the duration common carotid artery were unclamped and the brain reperfusion was achieved for 90min. Dexmedetomidine was administered for Group D IV infusion, and Group T received thiopental IV. According to histopathologic scores cerebral ischemia was documented in all rats in Group C, but no ischemia was found in three rats in Group T and in four rats in Group D. Grade 3 cerebral ischemia was documented in three rats in Group C, and in only one rat in both groups T and D. For histopathologic grades the difference between Group T and Group D was not significant (p>0.05). But the differences between Group C and Group T (p<0.05) and Group C and Group D (p<0.01) were statically significant. In conclusion, we demonstrated that dexmedetomidine and thiopental have experimental histopathologic cerebral protective effects on experimental focal cerebral ischemia in rats.
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http://dx.doi.org/10.1016/j.bjan.2015.12.006DOI Listing
September 2016

[An easy, safe and affective method for the treatment of intussusception: ultrasound-guided hydrostatic reduction].

Ulus Travma Acil Cerrahi Derg 2014 Mar;20(2):127-31

Department of General Surgery, Kahramanmaraş Pazarcık State Hospital, Kahramanmaraş, Turkey.

Background: Intussusception is one of the important causes of intestinal obstruction in children. Hydrostatic reduction under ultrasound guidance is a popular treatment method for intussusception. In the present study, we aimed to explain the demographic characteristics of and treatment approaches in patients diagnosed with intussusception by ultrasound.

Methods: Forty-one patients diagnosed with intussusception by ultrasound between August 2011 and May 2013 were retrospectively analyzed. Twenty-four of these patients who had no contraindications had been treated with ultrasound-guided hydrostatic reduction.

Results: Twenty-four of the patients were male and 17 were female, a 1.4/1 male-to-female ratio. The majority of the patients were between the ages of 6-24 months and 2-5 years. The mean age was 31.12±26.32 months (range 3-125). Patients were more frequently diagnosed in April and May. Seventeen patients who had clinical contraindications enrolled directly for surgery. In 20 of the 24 patients who underwent ultrasound-guided hydrostatic reduction, reduction was achieved. Three experienced recurrence. In two of these patients, successful reduction was achieved with the second attempt. The remaining patient was enrolled for surgery. Hydrostatic reduction was performed 26 times on these 24 patients, and in 22, success was achieved (84.6%). No procedure-related complications occurred in the patients.

Conclusion: Ultrasound-guided hydrostatic reduction, with its high success rates and lack of radiation risk, should be the first choice therapeutic approach for children diagnosed with intussusception.
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http://dx.doi.org/10.5505/tjtes.2014.37898DOI Listing
March 2014

Absence of the right common carotid artery: Doppler ultrasonographic and MR angiographic findings.

Vascular 2014 Oct 17;22(5):364-7. Epub 2014 Jan 17.

Department of General Surgery, Kahramanmaraş Pazarcık State Hospital, Kahramanmaraş, Turkey.

We present a case of common carotid artery agenesis which is an extremely rare congenital anomaly. Less than 35 cases have been reported. These anomalies are typically asymptomatic and usually discovered as an incidental finding. Color Doppler ultrasonography is an effective and sensitive method for detecting absence of common carotid artery. But it is insufficient to identify the anomaly as a whole. Magnetic resonance angiography is a complementary technique to describe the origin of the external carotid artery and internal carotid artery.
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http://dx.doi.org/10.1177/1708538113516316DOI Listing
October 2014

Horner's syndrome following a subtotal thyroidectomy for a benign nodular goitre.

BMJ Case Rep 2013 Jun 13;2013. Epub 2013 Jun 13.

Faculty of Medicine, Department of Ophthalmology, Sutcu Imam University, Kahramanmaraş, Turkey.

We present a case of Horner's syndrome occurring as a complication of thyroidectomy. A 42-year-old female patient presented with eyelid drop which developed immediately after thyroidectomy for goitre. Ophthalmic examination revealed eyelid ptosis, miosis and anhidrosis. Preoperative ultrasonography showed multiple isohyperechogenic solid nodules in each lobe, consistent with multinodular goitre. Therefore, the patient underwent subtotal thyroidectomy. The ophthalmic findings did not improve at the end of 6 months follow-up. Similar cases have been reported related to neck tumours or their surgery, mediastinum-located goitre and retropharyngeal abscess surgeries, but not after benign nodular goitre surgery. Several possible mechanisms have been proposed to explain this phenomenon; anatomical variations making the patient susceptible to damage to the sympathetic chain seem to be most likely in our patient.
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http://dx.doi.org/10.1136/bcr-2013-009907DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3702989PMC
June 2013

[A parotid gland lymphoma presenting with steroid-responsive recurrent sialadenitis: a case report].

Kulak Burun Bogaz Ihtis Derg 2012 May-Jun;22(3):172-5

Department of Otolaryngology, Medical Faculty of Gazi University, Ankara, Turkey.

Parotid gland located lymphomas are rarely seen. The most common lymphomas involving salivary gland include B-cell MALT (mucosa-associated lymphoid tissue) lymphomas. Of them, extranodal marginal zone B-cell lymphomas are the most frequently seen pathologies. They usually present with painless swelling of the parotid gland. The diagnosis is often based on parotidectomy. In this article, we report a 46-year-old male patient who was admitted with recurrent sialadenitis attacks which responded well to steroid treatment for three years, but recur after the cessation of the therapy. With the initial diagnosis of recurrent parotitis, the patient was scheduled for total parotidectomy for the definitive diagnosis and treatment. When the frozen-section of specimens during superficial parotidectomy revealed lymphoma, the operation was terminated.
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http://dx.doi.org/10.5606/kbbihtisas.2012.032DOI Listing
February 2014
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