Publications by authors named "Nuri Ozgirgin"

25 Publications

  • Page 1 of 1

How Much Covid-19 Will Change the World.

Authors:
Nuri Özgirgin

J Int Adv Otol 2020 04;16(1)

Editor in Chief.

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http://dx.doi.org/10.5152/iao.2020.310320DOI Listing
April 2020

European Position Statement on Diagnosis, and Treatment of Meniere's Disease.

J Int Adv Otol 2018 Aug;14(2):317-321

Universita degli Studi di Siena, Siena, Italy.

Meniere Disease keeps challenges in its diagnosis and treatment since was defined by Prosper Meniere at the beginning of 19th Century. Several classifications and definition were made until now and speculations still exist on its etiology. As the etiology remains speculative the treatment models remain in discussion also. The European Academy of Otology and Neurotology Vertigo Guidelines Study Group intended to work on the diagnosis and treatment of Meniere's disease and created the European Positional Statement Document also by resuming the consensus studies on it. The new techniques on diagnosis are emphasized as well as the treatment models for each stage of the disease are clarified by disregarding the dilemmas on its treatment. The conservative, noninvasive and invasive therapeutic models are highlighted.
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http://dx.doi.org/10.5152/iao.2018.140818DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354459PMC
August 2018

Cholesteatoma Definition and Classification: A Literature Review.

J Int Adv Otol 2017 Aug 9;13(2):266-271. Epub 2017 Mar 9.

Department of Otolaryngology, Medical University of Bialystok, Bialystok, Poland.

Cholesteatoma is a serious otolaryngologic condition that to date remains an important problem and poses a challenge to otolaryngologists around the world. To improve the approach pertaining to the diagnosis and management of middle ear cholesteatoma, clear, clinically applicable, and useful definition and classification of cholesteatoma are required. This review aimed to evaluate the current and most accepted descriptions and opinions concerning cholesteatoma. A review of the literature concerning different definitions and classifications of cholesteatoma was used in the preparation of the Cholesteatoma Guidelines, a project implemented by the European Academy of Otology - Neuro-otology.
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http://dx.doi.org/10.5152/iao.2017.3411DOI Listing
August 2017

EAONO/JOS Joint Consensus Statements on the Definitions, Classification and Staging of Middle Ear Cholesteatoma.

J Int Adv Otol 2017 Apr 6;13(1):1-8. Epub 2017 Jan 6.

The Ipswich Hospital NHS Trust, Heath Road, Suffolk, United Kingdom IP4 5PD.

The European Academy of Otology and Neurotology (EAONO) has previously published a consensus document on the definitions and classification of cholesteatoma. It was based on the Delphi consensus methodology involving the broad EAONO membership. At the same time, the Japanese Otological Society (JOS) had been working independently on the "Classification and Staging of Cholesteatoma." EAONO and JOS then decided to collaborate and produce a joint consensus document. The EAONO/JOS joint consensus on "Definitions, Classification and Staging of Middle Ear Cholesteatoma" was formally presented at the 10th International Conference on Cholesteatoma and Ear Surgery in Edinburgh, June 5-8, 2016. The international otology community who attended the consensus session was given the chance to debate and give their support or disapproval. The statements on the "Definitions of Cholesteatoma" received 89% approval. The "Classification of Cholesteatoma" received almost universal approval (98%). The "EAONO/JOS Staging System on Middle Ear Cholesteatoma" had a majority of approval (75%). Some international otologists wanted to see more prognostic factors being incorporated in the staging system. In response to this, the EAONO/JOS steering group plans to set up an "International Otology Outcome Working Group" to work on a minimum common otology data set that the international otology community can use to evaluate their surgical outcome. This will generate a large database and help identify relevant prognostic factors that can be incorporated into the staging system in future revisions.
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http://dx.doi.org/10.5152/iao.2017.3363DOI Listing
April 2017

Scientific journals and indexes.

Authors:
Nuri Özgirgin

J Int Adv Otol 2015 Aug;11(2):97

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August 2015

Consensus-Based Recommendations on the Definition and Classification of Cholesteatoma.

J Int Adv Otol 2015 Apr;11(1):81-7

Department of Otolaryngology, Medical University of Bialystok, Bialystok, Poland.

Development of a consensus on the definitions and classification of cholesteatoma is essential for scientific community to exchange information on clinical studies and compare their outcomes. The aim of the study is to reach a consensus among members of the European Academy of Otology and Neurotology (EAONO) regarding the definitions and classification related to cholesteatoma. A set of statements was developed by the authors utilizing the literature on the definition and classification of cholesteatoma. A questionnaire was sent to the members of the EAONO, inviting them to state if they are in agreement with each of the statements and if not, then to provide comments or suggestions for revision. Responses were evaluated and modified using online questionnaire and survey software based on the Delphi technique, a cyclical process of gathering information, summarizing, and re-submitting the revised statements to the same target population until a consensus is reached. Target agreement among the responders was set at a minimum of 80%, and the cycle of revision and re-submission of the statements were repeated until a consensus was reached on a majority of the statements. A steering group has been established to evaluate the results of the survey and worked via the process of cognitive debriefing. Out of 364 EAONO members, 123 responded to the first consensus cycle, 77 to the second cycle, and 53 to the third cycle. After three cycles, all statements concerning cholesteatoma definitions reached the target of 80% consensus. However, a consensus on the classification of cholesteatoma could not be achieved. The steering group excluded four statements of cholesteatoma definition and established a consensus on cholesteatoma classification. A consensus on cholesteatoma definitions was reached among the members of the EAONO. The final revision on consensus statements for cholesteatoma definition and classification has been made via the process of cognitive debriefing of the steering group.
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http://dx.doi.org/10.5152/iao.2015.1206DOI Listing
April 2015

Epidermoid carcinoma involving the parotid gland and orbital region: case report of a rare entity.

Ear Nose Throat J 2008 Jul;87(7):394-8

Department of Otorhinolaryngology, Baskent University School of Medicine, Ankara, Turkey.

Epidermoid carcinoma (also known as squamous cell carcinoma) of the parotid gland is more prevalent among the elderly, as are other head and neck tumors. In most cases it is observed either as a nodal metastasis of a primary tumor that drains into the parotid area or as a direct extension of a tumor that has originated in the upper dermis. Primary epidermoid carcinomas arising directly from the parotid gland are extremely rare. Similarly, secondary invasion of the orbital region by a neighboring tumor is more common than primary epidermoid carcinoma of the orbit, which is also rare. In this article, we discuss the diagnosis and treatment of a rare case of epidermoid carcinoma simultaneously invading the parotid gland and the orbit.
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July 2008

Effects of various densities of middle ear fluids on acoustic immittance: experimental study.

J Otolaryngol Head Neck Surg 2008 Feb;37(1):130-6

Department of Otolaryngology, Baskent University School of Medicine, Ankara, Turkey.

Objective: To study the effects of various densities of middle ear fluids on acoustic immittance and elucidate the characteristics of this study that might be beneficial for clinical use in otitis media with effusion.

Study Design: Experimental, in vivo model.

Materials And Methods: The study was performed on 12 ears of six white Vienna rabbits. Rabbits were placed in six positions: normal resting position (group 1); after drilling a hole into the tympanic bulla (group 2); filling the bulla with distilled water (group 3; density = 1000 g/cm(3)); filling the bulla with 8.4% bicarbonate solution (group 4; density = 1005 g/cm(3)); filling the bulla with Tonimer gel (group 5; density = 1035 g/cm(3)); and filling the bulla with glycerine (group 6; density > 1050 g/cm(3)). Acoustic immittance measurements were then made in vivo. During each measurement, volume, compliance, pressure, and gradient values were recorded. Analysis of variance, Student t-test, and Pearson correlation coefficient and multiple regression analyses were used for statistical evaluations of the data.

Results: Volume, compliance, and pressure values were obtained in all of the six measurements. A significant difference in volume was found between groups 1 and 2 (p < .001) and between the other four groups in this study (p < .001). With regard to compliance, group 2 was significantly different from groups 3, 4, 5, and 6 (p < .001). With regard to pressure, there was no intergroup (1 and 2) difference (p = .639); however, a significant difference (p < .001) was found between groups 1 and 2 and the other four groups. A significant difference was found between groups 3 and 6 (p = .006). A gradient value was obtained in all of the six measurements only for groups 1 and 2. In group 2, a significant rise in gradient was observed (p = .001).

Conclusion: Generally, volume, compliance, and pressure values declined significantly in rabbits in which the bulla had been filled with fluid when compared with rabbits with empty bullae. Drilling a hole into the bulla increased volumetric values under normal conditions but had no effect on compliance and pressure values. The significant difference between groups 3 and 6 regarding pressure demonstrates that the density of fluid in the middle ear plays a role in pressure values when measured with tympanometry. We conclude that the correlation between density and pressure values of middle ear fluids may be useful in the clinical decision-making process when treating disorders such as otitis media.
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February 2008

[A case of herpetic facial paralysis in which cochleovestibular symptoms outweigh facial nerve symptoms].

Kulak Burun Bogaz Ihtis Derg 2008 ;18(1):40-3

Department of Otolaryngology, Başkent University Alanya Hospital, Antalya, Turkey.

A 42-year-old man presented with sensorineural hearing loss of acute onset, tinnitus, and vertigo. Physical examination revealed slight asymmetry in facial nerve functions and spontaneous nystagmus. Magnetic resonance imaging of the internal acoustic canal showed contrast enhancement consistent with edema-inflammation, being notable and diffuse in the seventh and eighth cranial nerve complex, and minimal in the cochlea. Non-hydropic cochleovestibular syndrome was considered and the patient was treated with antiviral and corticosteroid medications. A week later, facial paralysis improved and the acute hearing loss reversed. On the twelfth day of presentation, he had no complaints other than mild imbalance on abrupt changes in movement. In this type of herpetic facial paralysis in which cochleovestibular symptoms outweigh facial nerve symptoms, it might be argued that varicella zoster virus reactivation occurs in the spiral and/or vestibular ganglion.
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February 2009

Reliability of the vestibular evoked myogenic potential test in assessing intratympanic gentamicin therapy in Meniere's disease.

Acta Otolaryngol 2008 Apr;128(4):422-6

Department of Otolaryngology, Baskent University, Ankara, Turkey.

Conclusions: The results of this preliminary study demonstrate that with regard to determining the efficacy of intratympanic (IT) gentamicin treatment in patients with Meniere's disease, the reliability of testing for vestibular evoked myogenic potentials (VEMPs) is comparable to that of caloric tests. Compared with caloric tests, VEMP measurements are more comfortable and take less time. The results of VEMP and caloric testing do not correlate with the results of hearing tests.

Objective: To test the reliability of VEMP testing to monitor the results of IT gentamicin therapy in patients with Meniere's disease.

Subjects And Methods: Twelve patients with unilateral Meniere's disease were evaluated with pure tone audiometry (PTA), bithermal caloric tests, and VEMP tests. Patients with measurable caloric and VEMP results before IT gentamicin treatment were included in the study. IT gentamicin (0.5 ml) at a concentration of 40 mg/ml was administered to the patients. Reinjection was performed 10 days later depending on patients' complaints. Patients were re-evaluated with short- and long-term VEMP, hearing, and caloric test results.

Results: Caloric responses and VEMPs changed following gentamicin therapy in 9 patients and 12 patients, respectively. Long-term results of caloric and VEMP tests in patients receiving IT gentamicin treatment changed in 7 patients and 10 patients, respectively.
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http://dx.doi.org/10.1080/00016480701808988DOI Listing
April 2008

Epley maneuver and the head autorotation test in benign paroxysmal positional vertigo.

Eur Arch Otorhinolaryngol 2008 Nov 26;265(11):1309-13. Epub 2008 Mar 26.

Department of Otolaryngology, Baskent University, Ankara, Turkey.

The head autorotation tests can be affected with the dynamic changes within the semicircular canals caused by benign paroxysmal positional vertigo (BPPV). The vestibular autorotation test is a method of examining the VOR (especially the VOR that develops at higher frequencies like those that occur in the everyday environment). Twenty patients who had been diagnosed as having posterior semicircular canal BPPV were evaluated with head autorotation tests before and after the treatment maneuver. The head autorotation tests were performed just before the use of the Epley maneuver and after the resolution of symptoms and the typical nystagmus pattern. The mean gain values for horizontal rotation tests during the pre-treatment period were 0.823, 0.844, and 0.840 for the frequencies 1, 2, and 3 Hz, respectively. The mean gain values increased by 0.095 (95% confidence interval) with Epley's maneuver. But this difference difference between the pre-treatment and post-treatment values was not statistically significant. All patients were also evaluated with vertical active tests. The differences between the pre-treatment and post-treatment values were not statistically significant in the vertical autorotation group. The phase values were within normal range in the horizontal and vertical rotation tests and remained so after the Epley maneuver. The stimulation of the VOR caused by BPPV did not affect gain and phase values to a statistically significant degree, and the values noted after the resolution of the patient's symptoms improved slightly but without statistical significance.
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http://dx.doi.org/10.1007/s00405-008-0643-7DOI Listing
November 2008

[Comparison of patients undergoing functional endoscopic sinus surgery combined with septoplasty or septorhinoplasty].

Kulak Burun Bogaz Ihtis Derg 2007 ;17(5):253-9

Department of Otolaryngology, Medicine Faculty of Başkent University, Ankara, Turkey.

Objectives: We compared patients who underwent functional endoscopic sinus surgery combined with septoplasty or septorhinoplasty and evaluated the concurrent applicability of septorhinoplasty and endoscopic sinus surgery.

Patients And Methods: We retrospectively analyzed 145 patients (96 males, 49 females; age range 16 to 78 years) who underwent endoscopic sinus surgery in conjunction with septoplasty or septorhinoplasty. The two patient groups were compared with respect to demographic characteristics, systemic diseases, allergy histories, the presence of nasal polyposis, preoperative paranasal sinus tomographies, Lund-Mackay scores, surgical procedures, operation times, and complication rates.

Results: Patients who underwent septorhinoplasty were younger than those undergoing septoplasty. There were no significant differences between the two groups in terms of paranasal sinus tomography scores, allergy histories, systemic diseases, and complication rates (p>0.05). The number of patients with nasal polyposis was significantly greater in the septoplasty group (p<0.05). Septorhinoplasty in conjunction with endoscopic sinus surgery required a significantly longer operation time (p<0.05).

Conclusion: Complications and the severity of sinus pathologies were similar in the two groups. Concurrent applications of septorhinoplasty and endoscopic sinus surgery significantly increase operation time.
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March 2008

Endoscopic endonasal-transantral surgery for an isolated orbital floor blow-out fracture in a pediatric patient.

Kulak Burun Bogaz Ihtis Derg 2007 ;17(3):179-82

Department of Otolaryngology, Medicine Faculty of Başkent University, Ankara, Turkey.

Orbital floor blow-out fractures occur due to blunt trauma causing displacement of orbital contents to the maxillary sinus while the orbital rim is intact. Surgical repair of these fractures includes transantral, transorbital, or endoscopic endonasal approaches with or without implant use. We report a 12-year-old boy who presented with diplopia after blunt trauma to the head while playing football. Computed tomography revealed a left isolated orbital blow-out fracture. The patient was treated by a combined endoscopic endonasal-transantral approach and stability was restored with a urethral balloon catheter following endoscopic reduction of the fracture. Healing of the orbital floor was confirmed by an early computed tomography scan. This technique restores eye volume and function without the use of external incisions or implants.
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October 2007

Abnormal electronystagmography in rheumatoid arthritis.

Auris Nasus Larynx 2007 Sep 8;34(3):307-11. Epub 2006 Dec 8.

Division of Rheumatology, Department of Medicine, Konya Teaching and Research Center, Baskent University, Turkey.

Objective: Although sensorineural hearing loss has been widely investigated in those with rheumatoid arthritis, studies assessing the vestibular system in patients with rheumatoid arthritis are limited. The aim of this study was to assess the vestibular system in patients with rheumatoid arthritis.

Methods: The study consisted of 43 patients with rheumatoid arthritis and 30 healthy controls. Otorhinolaryngologic and neurotologic examinations, pure-tone audiometry, impedancemetry, electronystagmography including smooth pursuit, saccade, positional, and caloric tests were performed in all patients with rheumatoid arthritis and in controls. The erythrocyte sedimentation rate, C-reactive protein level, and rheumatoid factor level were evaluated in all patients with rheumatoid arthritis.

Results: Audiograms revealed sensorineural hearing loss in 12 patients (27.9%) with rheumatoid arthritis and in two controls (6.6%); the difference was statistically significant (P=.033). In those with rheumatoid arthritis, the results of electronystagmography revealed central abnormalities in nine patients (20.9%), peripheral abnormalities in three (6.9%), and mixed abnormalities in three (6.9%). Smooth pursuit and saccade tracing impairments were significantly higher in patients with rheumatoid arthritis (P>.05). Canal paresis in patients with rheumatoid arthritis were significantly higher than those in the control group (P=.039). No association was found between electronystagmographic abnormalities in patients with rheumatoid arthritis and age, sex, duration of disease, the results of laboratory testing, sensorineural hearing loss, or medication use.

Conclusion: Our results suggest an association of rheumatoid arthritis with vestibular system dysfunction as well as auditory impairment.
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http://dx.doi.org/10.1016/j.anl.2006.11.003DOI Listing
September 2007

[Intratympanic treatment in Meniere's disease: the effect of gentamicin and dexamethasone on vertigo control and hearing].

Kulak Burun Bogaz Ihtis Derg 2006 ;16(5):193-9

Department of Otolaryngology, Medicine Faculty of Başkent University, Ankara, Turkey.

Objectives: We investigated the effect of intratympanic gentamicin and dexamethasone treatments on the control of vertigo and hearing loss in patients with Meniere's disease.

Patients And Methods: Forty-five patients with a diagnosis of Meniere's disease according to the 1995 criteria of American Academy of Otorhinolaryngology Head and Neck Surgery were assigned to receive intratympanic gentamicin (40 mg/ml, 0.7 ml; n=24; 11 males, 13 females; mean age 46 years) or dexamethasone (4 mg/ml, 0.7 ml; n=21; 8 males, 13 females; mean age 50.4 years). The results were evaluated with respect to changes in vertigo and hearing symptoms.

Results: In the gentamicin group, vertigo symptoms were controlled in 22 patients (92%), deterioration in hearing was seen in only two patients (8%). In the dexamethasone group, nine patients had complete follow-up. Of these, vertigo control was achieved in six patients (67%), none had worsened hearing, and one patient (5%) had improved hearing. When improvement in hearing was defined as at least a 5 dB change, then five patients (24%) benefited from treatment.

Conclusion: Intratympanic treatment modalities in Meniere's disease are easy to perform, cheap, and effective. They are expected to have a more extensive use with higher success rates in the future.
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January 2007

Six cases of Forestier syndrome, a rare cause of dysphagia.

Acta Otolaryngol 2006 Jul;126(7):775-8

Department of Otorhinolaryngology, Baskent University Faculty of Medicine, Bahcelievler-Ankara, Turkey.

Dysphagia is a common presenting complaint in otolaryngology practice, and there are many causes. Forestier syndrome is a rare cause of dysphagia. It is also known as diffuse idiopathic skeletal hyperostosis (DISH) syndrome or vertebral ankylosing hyperostosis. Forestier syndrome consists of anterolateral perivertebral ligament calcification. It was first described by Forestier and Rotes-Querol in 1950; diagnosis is primarily radiological and the etiology is unknown. In addition to dysphagia Forestier syndrome has been reported to cause laryngeal stridor, dyspnea, snoring and hoarseness. Other important symptoms associated with Forestier syndrome are stiffness and pain in the back, pain related to tendinitis, myelopathy related to core compression associated with the ossification of the posterior longitudinal ligament, and pain related to vertebral complications such as fracture or subluxation. We report six cases of Forestier syndrome as an etiologic factor in dysphagia and present clinical and radiological findings.
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http://dx.doi.org/10.1080/00016480500504192DOI Listing
July 2006

Vertigo in childhood: a clinical experience.

Int J Pediatr Otorhinolaryngol 2006 Sep 24;70(9):1547-54. Epub 2006 May 24.

Department of Otorhinolaryngology, Konya Research and Application Center, Baskent University, Saray Caddesi No. 1 Selcuklu, Konya, Turkey.

Objective: Vertigo in childhood is a complaint consisting of a wide spectrum of diagnoses. The aim of this study was to evaluate pediatric patients with vertigo with normal eardrum and middle ear findings and discuss the differential diagnoses.

Methods: Patient records of 50 children under 18 years of age with vertigo as the chief complaint, examined at the Baskent University, Research and Application Centers at Konya and Adana otorhinolaryngology clinics between May 2003 and October 2005 were retrospectively reviewed. The questionnaires, laboratory tests including blood samples, audiological and vestibular tests, and final diagnoses were analyzed. Patients with perforated eardrums, otitis media with effusion, and acute upper respiratory tract infections were not included in the study.

Results: The study group consisted of 50 patients (33 females, 66%; 17 males, 34%), between 4 and 17 years of age (mean age, 11.5+/-3.9 years). Severe sensorineural hearing loss was present in one patient unilaterally (2%) and one patient bilaterally (2%). Bilateral low-frequency sensorineural hearing loss was present in one patient (2%). Electronystagmography revealed central vestibular abnormalities in three patients (6%). Canal paresis was established in six patients (12%). The Dix-Hallpike test was positive in six patients (12%). The most frequent cause of vertigo was migraine, occurring in 34% of patients (n=17). Other less-frequent etiologies of vertigo were benign paroxysmal vertigo (n=6; 12%), benign paroxysmal positional vertigo (n=6; 12%), psychogenic vertigo (n=5; 10%), epilepsy (n=3; 6%), metabolic disorders (n=3; 6%), vestibular neuritis (n=2; 4%), Meniere's disease (n=1; 2%), perilymphatic fistula (n=1; 2%), amblyopia (n=1; 2%), and unclassifiable (n=5; 10%).

Conclusions: Migraine was found to be the most frequent presenting diagnosis in childhood vertigo, although several peripheral vestibular disorders also were diagnosed. Evaluation of vertigo in childhood should begin with a thorough neuro-otologic evaluation and include other relevant multidisciplinary team members as needed to avoid unnecessary effort and cost.
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http://dx.doi.org/10.1016/j.ijporl.2006.04.001DOI Listing
September 2006

Isolated fibrous dysplasia of the sphenoid sinus.

Rhinology 2005 Dec;43(4):309-12

Baskent University Faculty of Medicine, Department of Otorhinolaryngology, 06490, Ankara, Turkey.

Fibrous dysplasia is an uncommon benign bone disorder of unknown etiology in which normal medullary bone is replaced by fibrotic and osseous tissue. Solitary involvement of the sphenoid sinus is unusual. Here, we present the case of a 28-year-old man complaining of occipital and vertical headache. Imaging modalities demonstrated an expansile lesion filling the entire sphenoid sinus. Biopsy specimen was obtained by endoscopic sphenoidotomy. Diagnosis of fibrous dysplasia was made by imaging results and pathologic examination.
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December 2005

[Dermatofibroma accompanied by perforating dermatosis in the auricle: a case report].

Kulak Burun Bogaz Ihtis Derg 2005 ;15(3-4):83-6

Department of Otolaryngology, Medicine Faculty of Başkent University Ankara Hospital, Ankara, Turkey.

Although dermatofibroma is one of the most common soft tissue tumors, it is rarely seen in the face. Perforating dermatosis is characterized by papulonodules measuring 1-10 cm, with a central cup-shaped epidermal depression filled with a keratotic plug. An 82-year-old woman presented with a hyperkeratotic erythematous papular lesion, 0.8 cm in diameter, on the posterior side of the left auricle, showing no infiltration to the peripheral tissues. Total excisional biopsy was performed, which showed dermatofibroma accompanied by perforating dermatosis. No recurrence was detected during her follow-up. Our literature search did not yield any reported case of dermatofibroma accompanied by perforating dermatosis.
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June 2008

Epithelial cyst of the soft palate.

Int J Pediatr Otorhinolaryngol 2005 Apr 29;69(4):545-7. Epub 2004 Dec 29.

Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Adana Teaching and Medical Research Center, Baskent University, Dadaloglu mah. 39 Sk. No. 6, Yuregir, Adana 01250, Turkey.

Epithelial cysts are benign epithelium-lined lesions that contain fluid or semisolid material. This type of cyst is rare in the oral cavity. Most epithelial cysts in this location are situated in the anterior floor of the mouth; the soft palate is seldom affected. Oral examination in a 6-year-old boy revealed a cyst in the soft palate. The lesion was excised under general anesthesia, and histopathological examination identified it as an epithelial cyst. The report discusses this rare location for an epithelial cyst and reviews the pertinent literature.
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http://dx.doi.org/10.1016/j.ijporl.2004.11.014DOI Listing
April 2005

Complete fistula of the second branchial cleft: case report of catheter-aided total excision.

Int J Pediatr Otorhinolaryngol 2004 Aug;68(8):1109-13

Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, Baskent University, Adana Teaching and Medical Research Center, Adana, Turkey.

The authors report an extremely rare case of complete fistula of the second branchial cleft, with an external opening in the skin and an internal opening in the oropharyngeal mucosa. A 13-year-old girl presented with the complaint of intermittent drainage from the right side of her neck, a problem that had existed since birth. Fistulography revealed a complete fistula of the second branchial cleft. Before surgical excision, a 4-F catheter and a 0.018-in guide-wire were inserted into the external opening of the fistula and passed through to the tonsillar region under fluoroscopic guidance. The infrahyoid segment and parapharyngeal segment of the fistula were then excised through first- and second-step neck incisions, respectively. In this case, tonsillectomy was not necessary. Pathological examination of the wall of the fistula revealed lymphoid tissue containing lymphoid follicles. This report describes a technique in which complete excision of a fistula of the second branchial arch is facilitated by placing a catheter in the tract.
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http://dx.doi.org/10.1016/j.ijporl.2004.04.016DOI Listing
August 2004

Choanal polyp originating from the nasal septum: a case report.

Am J Otolaryngol 2003 Jul-Aug;24(4):261-4

Department of Otolaryngology, Baskent Universit, Bahçelievler, Ankara, Turkey.

Almost all nasal polyps originate from the mucosa of the lateral walls of the nasal cavity or from the paranasal sinuses. A choanal polyp is the intranasal portion of a cyst that has arisen from the wall of the maxillary sinus near the ostium. Medially based polyps, such as those that arise from the nasal septum, are rare. The literature cites a wide range of incidence rates for polyps originating from this structure, but choanal extension of this type of polyp is extremely unusual. This report describes a polyp that arose from the superior aspect of the posterior nasal septum and extended through the choana into the nasopharynx. The histology of this choanal lesion was typical of nasal polyps, but the site of origin is rare. The ethiopathogenesis of nasal polyps with its common location remains controversial so it is difficult to speculate what mechanism triggered the development of this lesion on the nasal septum. Some form of local inflammation may have induced choanal polyp formation at this atypical site.
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http://dx.doi.org/10.1016/s0196-0709(03)00048-6DOI Listing
December 2003

Factors that affect the outcome of open-technique procedures performed in the treatment of cholesteatoma.

Kulak Burun Bogaz Ihtis Derg 2003 Feb;10(2):47-50

Department of Otolaryngology, Medicine Faculty of Başkent University, Ankara, Turkey.

Objectives: We evaluated the factors that have considerable significance on the outcome of open cavity procedures in the treatment of cholesteatoma.

Patients And Methods: The study included 66 patients (43 males, 23 females; mean age 47 years; range 21 to 69 years) who underwent surgery for cholesteatoma. Of these, 56 patients completed at least a five-year follow-up.

Results: Mucosal infections and granulation tissue formation occurred in seven patients (10%) in the early postoperative period. Retraction pockets developed in three patients (4%); of these, only one patient required excision because of deep localization. Drum perforations that occurred in two patients (3%) were repaired by myringoplasty. Revision surgery was performed in four patients (7.1%) due to residual cholesteatoma within a five-year follow-up.

Conclusion: The height of the facial ridge was found as the most important factor related to a successful outcome of open-technique procedures. Other factors included the creation of a smooth mastoid cavity with round edges, removal of all diseased mastoid cells, and an extensive conchameatoplasty.
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February 2003

Auditory brain stem responses in the detection of brain death.

Kulak Burun Bogaz Ihtis Derg 2003 Jan;10(1):1-7

Department of Otolaryngology, Medicine Faculty of Başkent University, Bahçelievler, Ankara, Turkey.

Objectives: We evaluated comatose patients by auditory brain stem responses (ABR) to determine the role of ABR in the diagnosis of impending brain death.

Patients And Methods: Sixty comatose patients in the intensive care unit were evaluated by brain stem evoked response audiometry. Correlations were sought between the absence or presence of ABRs and the presenting pathology, the Glasgow Coma Scale (GCS) scores, and ultimate diagnoses.

Results: The brain stem responses were totally absent in 41 patients. Presence of wave I could be obtained in only 10 patients. All the waveforms were found in nine patients; however, in eight patients the potentials disappeared as the GCS scores decreased to 3. Detection of wave I alone strongly suggested dysfunction of the brain stem. However, loss of wave I particularly in trauma patients aroused doubt as to whether the absence was associated with auditory end organ injury or brain stem dysfunction.

Conclusion: The results suggest that evaluation of ABR may support brain death in a comatose patient (i) when wave I is present alone, (ii) the absence of wave I is accompanied by a documented auditory end organ injury, or (iii) when previously recorded potentials are no longer detectable.
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January 2003

Effects of paranasal sinus ostia and volume on acoustic rhinometry measurements: a model study.

J Appl Physiol (1985) 2003 Apr 13;94(4):1527-35. Epub 2002 Dec 13.

Department of Otorhinolaryngology, Faculty of Medicine, Baskent University, 06490, Ankara, Turkey.

We used pipe models to investigate the effects of paranasal sinus ostium size and paranasal sinus volume on the area-distance curves derived by acoustic rhinometry (AR). Each model had a Helmholtz resonator or a short neck as a side branch that simulated the paranasal sinus and sinus ostium. The AR-derived cross-sectional areas posterior to the ostium were significantly overestimated. Sinus volume affected the AR measurements only when the sinus was connected via a relatively large ostium. The experimental area-distance curve posterior to the side branch showed pronounced oscillations in association with low-frequency acoustic resonances in this distal part of the pipe. The experimental results are discussed in terms of theoretically calculated "sound-power reflection coefficients" for the pipe models used. The results indicate that the effects of paranasal sinuses and low-frequency acoustic resonances in the posterior part of the nasal cavity are not accounted for in the current AR algorithms. AR does not provide reliable information about sinus ostium size, sinus volume, or cross-sectional area in the distal parts of nasal cavity.
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http://dx.doi.org/10.1152/japplphysiol.01032.2002DOI Listing
April 2003